1825
中国矫形外科杂志
Orthopedic Journal of China
Vol.33,No.20
Oct.2025
第 33卷 第 20期
2 0 2 5年 10月
·专家共识·
腰椎间盘突出症运动康复的专家共识△
中国康复医学会康复治疗专业委员会
许建文*，桂裕昌*
（广西医科大学第一附属医院康复医学科，广西南宁 530021）
摘要：腰椎间盘突出症的运动康复需根据疾病阶段制定个性化方案。本文基于专家共识，系统总结了腰椎间盘突出症运动
康复的推荐意见。急性期建议在疼痛不再加重时介入运动康复，以轻至中等强度、不加重症状的运动为主，可佩戴腰部护具短
距离活动；卧床时应选择中等硬度床垫，并采用可降低腰椎负荷的体位。恢复期重点强化腰大肌、多裂肌等深层核心肌群，训
练从静态、低强度逐步过渡至动态抗阻训练，同时可联合柔韧性训练；但应避免剧烈运动、弯腰旋转及垂直振动类活动，居家
时可选择核心进阶训练、水中运动或太极拳等。围手术期分阶段康复，术前预康复结合术后系统评估制定运动计划，术后 6周
内逐步提高运动强度，同时强调早期下床活动及核心稳定性训练。康复过程中需注意疼痛管理、心理干预及护具合理使用，并
强调多学科协作与个性化方案的重要性。本共识为腰椎间盘突出症运动康复提供了循证依据与临床实践指导，旨在提高疗效并
降低复发风险。
关键词：腰椎间盘突出症，运动疗法，专家共识，康复
中图分类号：R681.53 文献标志码：A 文章编号：1005-8478（2025） 20-1825-09
Expert consensus on exercise rehabilitation for lumbar intervertebral disc protrusion // Professional Committee of Rehabilita⁃
tion Therapy of Chinese Association of Rehabilitation Medicine, Corresponding Author: XU Jian-wen, GUI Yu-chang. Department of Rehabili⁃
tation Medicine, The First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi, China
Abstract: The exercise rehabilitation for lumbar intervertebral disc protrusion needs to formulate individualized plans according to the
disease stage. Based on expert consensus, this article systematically summarizes the recommended opinions for exercise rehabilitation of
lumbar intervertebral disc protrusion. During the acute stage, it is recommended to intervene in exercise rehabilitation when the pain no lon⁃
ger aggravated. The main focus should be on light to moderate-intensity exercises that do not aggravate the symptoms, such as short-dis⁃
tance activities with lumbar braces worn. When lying in bed, one should choose a medium-hardness mattress and adopt a position that can
reduce the load on the lumbar vertebrae. During the recovery period, the focus should be on strengthening deep core muscle groups, such as
the psoas major and multifidus. The training should gradually transition from static and low-intensity to dynamic resistance training, and
flexibility training can be combined at the same time. However, vigorous exercise, bending, spinning and vertical vibration activities should
be avoided. At home, advanced core training, water exercises or Tai Chi can be chosen. Rehabilitation was carried out in stages during the
perioperative period. Preoperative pre-rehabilitation was combined with postoperative systematic assessment to formulate an exercise plan.
The exercise intensity was gradually increased within 6 weeks after the operation, while emphasizing early out-of-bed activities and core
stability training. During the rehabilitation process, attention should be paid to pain management, psychological intervention and the ratio⁃
nal use of protective gear, additionally, the importance of multidisciplinary collaboration and personalized plans should be emphasized.
This consensus provides evidence-based basis and clinical practice guidance for exercise rehabilitation of lumbar intervertebral disc protru⁃
sion, aiming to improve the therapeutic effect and reduce the risk of recurrence.
Key words: lumbar intervertebral disc protrusion, exercise therapy, expert consensus, rehabilitation
腰椎间盘突出症是由椎间盘退行性改变或外力作
用致纤维环破裂、髓核突出，从而刺激、压迫神经根
引起一系列症状的疾病。根据神经压迫节段、程度、
病程的不同，腰椎间盘突出症可引起腰背痛、腰部活
动受限、下肢放射痛、运动功能障碍、感觉异常等症
状，严重者可出现大小便失禁、下肢瘫痪等。全球约
DOI:10.20184/j.cnki.Issn1005-8478.120225
△基金项目：国家自然科学基金项目（编号：81260544）；广西科学研究与技术开发计划课题项目（编号：桂科攻 1598012-48）
*通信作者：许建文，（电子信箱）1049662254@qq.com；桂裕昌，（电子信箱）149173283@qq.com
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