Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain A Randomized Trial
Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain A Randomized Trial
复制标题
DOI：
10.7326/0003-4819-156-1-201201030-00002
复制
发表时间：
2012-01-03
影响因子：
39.2
通讯作者：
Grimm, Richard H.
中科院分区：
文献类型：
--
作者：
Bronfort, Gert;Evans, Roni;Grimm, Richard H.
背景：机械性颈部疼痛是一种常见的疾病，大约70%的人在其生命的某个阶段受到影响。很少有研究指导急性和亚急性颈部疼痛的治疗选择。目的：探讨脊柱推拿疗法（SMT）、药物治疗和家庭运动指导（HEA）治疗急性和亚急性颈部疼痛的短期和长期相对疗效。设计：随机对照试验。（ClinicalTrials.gov注册号：NCT00029770）研究地点：明尼苏达州1所大学研究中心和1所疼痛管理诊所。参与者：272名年龄在18岁至65岁之间，患有2至12周的非特异性颈部疼痛的人。干预：12周的SMT、药物或HEA治疗。测量：主要结果是参与者评价的疼痛，在随机分组后2、4、8、12、26和52周测量。次要测量是自我报告的残疾、整体改善、药物使用、满意度、一般健康状况（简表36健康调查身心健康量表）和不良事件。在第4周和第12周进行颈部运动的盲法评估。结果：对于疼痛，SMT在8、12、26和52周后比药物治疗有统计学上的显著优势(P
Background: Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain.Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.Design: Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00029770)Setting: 1 university research center and 1 pain management clinic in Minnesota.Participants: 272 persons aged 18 to 65 years who had nonspecific neck pain for 2 to 12 weeks.Intervention: 12 weeks of SMT, medication, or HEA.Measurements: The primary outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52 weeks after randomization. Secondary measures were self-reported disability, global improvement, medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental health scales), and adverse events. Blinded evaluation of neck motion was performed at 4 and 12 weeks.Results: For pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks (P