Efectividad de los programas de fortalecimiento lumbar específico en adultos con hernia discal sintomática: impacto en el dolor y la discapacidad funcional. Una revisión sistemática
Palabras clave:
hernia discal lumbar; estabilización lumbar; ejercicio terapéutico; dolor lumbar; discapacidad funcionalResumen
DOI: https://doi.org/10.46296/gt.v9i18edespsep.0443
Resumen
El presente tiene como objetivo evaluar la efectividad de los programas de fortalecimiento/estabilización lumbar (específicos o generales) en adultos con hernia discal lumbar sintomática o dolor lumbar crónico con radiculopatía, en comparación con ejercicio general, terapias pasivas u otra modalidad conservadora, sobre la intensidad del dolor y la discapacidad funcional. Se realizó una revisión sistemática con búsqueda en PubMed, Scopus, Cochrane CENTRAL y una base bibliográfica adicional (registros exportados en septiembre de 2026), complementada con una búsqueda dirigida en la literatura ante la escasez inicial de resultados, siguiendo la metodología PRISMA 2020; se identificaron 35 registros, de los cuales 28 se cribaron tras eliminar duplicados; 5 ensayos clínicos aleatorizados (ECA) cumplieron los criterios de elegibilidad ampliados. Los cinco ECA reportaron mejoras significativas en dolor y/o discapacidad funcional con el entrenamiento de estabilización/fortalecimiento lumbar frente al comparador; la evidencia comparando distintas modalidades específicas de estabilización entre sí fue limitada e inconsistente. Los programas de fortalecimiento y estabilización lumbar mejoran el dolor y la discapacidad funcional en personas con hernia discal sintomática o radiculopatía asociada, pero la evidencia directa que compare modalidades específicas (isométrico, isotónico excéntrico, control motor puro) entre sí, y frente a un verdadero grupo control sin ejercicio, sigue siendo escasa; se requieren ECA de mayor tamaño muestral diseñados específicamente para esta subpoblación diagnóstica.
Palabras claves: hernia discal lumbar; estabilización lumbar; ejercicio terapéutico; dolor lumbar; discapacidad funcional.
Abstract
The present has the objective to evaluate the effectiveness of lumbar strengthening/stabilization programs (specific or general) in adults with symptomatic lumbar disc herniation or chronic low back pain with radiculopathy, compared with general exercise, passive therapies, or another conservative modality, on pain intensity and functional disability. We have done a systematic review with searches in PubMed, Scopus, Cochrane CENTRAL, and an additional bibliographic database (records exported in September 2026), complemented with a targeted literature search given the initial scarcity of results, following the PRISMA 2020 methodology; 35 records were identified, of which 28 were screened after removing duplicates; 5 randomized controlled trials (RCTs) met the broadened eligibility criteria. All five RCTs reported significant improvements in pain and/or functional disability with lumbar stabilization/strengthening training versus the comparator; evidence comparing different specific stabilization modalities against each other was limited and inconsistent. Lumbar strengthening and stabilization programs improve pain and functional disability in people with symptomatic disc herniation or associated radiculopathy, but direct evidence comparing specific modalities (isometric, eccentric isotonic, pure motor control) against each other, and against a true no-exercise control group, remains scarce; larger RCTs specifically designed for this diagnostic subpopulation are needed.
Keywords: lumbar disc herniation; lumbar stabilization; therapeutic exercise; low back pain; functional disability.
Información del manuscrito:
Fecha de recepción: 23 de junio de 2026.
Fecha de aceptación: 15 de agosto de 2026.
Fecha de publicación: 21 de septiembre de 2026.
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Derechos de autor 2026 Revista Científica Arbitrada en Investigaciones de la Salud GESTAR. ISSN: 2737-6273.
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