Efficacy of cervical endplay assessment as an indicator for spinal manipulation
Efficacy of cervical endplay assessment as an indicator for spinal manipulation
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DOI：
10.1097/00007632-200306010-00002
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发表时间：
2003-06-01
期刊：
影响因子：
3
通讯作者：
Aickin, M
中科院分区：
文献类型：
--
作者：
Haas, M;Groupp, E;Aickin, M
研究设计。双盲、随机、安慰剂对照试验。目标。评估手动终末作用评估对接受脊柱手法治疗的颈部疼痛患者的颈部疼痛和僵硬结果的影响。背景数据摘要。目前还没有关于触诊作为治疗背部和颈部疼痛的操作指标的功效的研究。方法。颈部疼痛患者 (n = 104) 被随机分为两组。研究组根据检查临床医生指出的尾部限制接受针对个体颈椎的操作。对照组接受由计算机生成的假检查结果确定的操作；最终检查被忽略并作为安慰剂评估。由脊椎按摩师一次性进行治疗。结果是在操作前后以及治疗后至少 5 小时评估颈部疼痛和僵硬。结果。研究组和对照组在颈部疼痛和僵硬方面表现出临床上重要的改善。然而，研究组和对照组之间在疼痛或僵硬结果方面没有临床上重要或统计学上的显着差异。就患者、主诉和治疗特征而言，研究结果是稳健的。结论。 Endplay 评估本身并不能缓解接受脊柱手法治疗的颈部疼痛患者当天观察到的疼痛和僵硬。对较长疗程的影响仍有待研究。数据表明，疼痛调节可能不仅限于与操纵假定的运动限制相关的机制。
Study Design. Double-blind, randomized, placebo-controlled trial.Objectives. To evaluate the effect of manual endplay assessment on neck pain and stiffness outcomes in neck pain patients receiving spinal manipulation.Summary of the Background Data. There have been no studies on the efficacy of palpation used as an indicator for manipulation in the management of back and neck pain.Methods. Neck pain patients (n = 104) were randomly assigned to two groups. The study group received manipulation targeted to individual cervical vertebrae according to endplay restriction noted by the examining clinician. The control group received manipulation determined by sham, computer-generated examination findings; endplay examination was ignored and served as a placebo assessment. Treatment was rendered on a single occasion by a chiropractor. Outcomes were neck pain and stiffness assessed before and after manipulation and at least 5 hours following treatment.Results. The study and control groups showed clinically important improvement in neck pain and stiffness. However, there were no clinically important or statistically significant differences between the study and control groups in terms of pain or stiffness outcomes. Findings were robust across patient, complaint, and treatment characteristics.Conclusions. Endplay assessment in and of itself did not contribute to the same-day pain and stiffness relief observed in neck pain patients receiving spinal manipulation. The impact on a longer course of treatment remains to be investigated. The data suggest that pain modulation may not be limited to mechanisms associated with manipulation of putative motion restrictions.