Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial
Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial
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DOI：
10.1016/j.pain.2006.12.008
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发表时间：
2007-09-01
期刊：
影响因子：
7.4
通讯作者：
Refshauge, Kathryn M.
中科院分区：
文献类型：
--
作者：
Ferreira, Manuela L.;Ferreira, Paulo H.;Refshauge, Kathryn M.
实践指南推荐各种类型的运动和手法治疗慢性背痛，但很少有这些干预措施的头对头比较。我们进行了一项随机对照试验，以比较一般运动，运动控制运动和手法治疗对慢性背痛患者的功能和干预效果的影响。240名患有非特异性腰痛≥ 3个月的成年人被分配到接受8周一般锻炼、运动控制锻炼或脊柱推拿治疗的组中。一般运动包括加强、伸展和有氧运动。运动控制练习涉及使用超声波反馈重新训练特定的躯干肌肉。脊柱推拿治疗包括关节松动术和手法治疗。主要结局为8周时患者特异性功能（PSFS，3-30）和总体感知效应（GPE，-5至5）。还在6个月和12个月时测量了这些结局。8周随访率为93%，6个月和12个月随访率为88%。运动控制运动组在8周时的结果略好于一般运动组（组间差异：PSFS 2.9，95% CI：0.9-4.8; GPE 1.7，95% CI：0.9-2.4），脊柱推拿治疗组也是如此（PSFS 2.3。95%CI：0.4-4.2; GPE 1.2，95%CI：0.4-2.0）。两组在6个月和12个月时的结果相似。运动控制运动和脊柱推拿疗法在慢性非特异性背痛患者中产生的短期功能和效果感知略好于一般运动，但中期或长期效果并不好。(C)2006年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
Practice guidelines recommend various types of exercise and manipulative therapy for chronic back pain but there have been few head-to-head comparisons of these interventions. We conducted a randomized controlled trial to compare effects of general exercise, motor control exercise and manipulative therapy on function and perceived effect of intervention in patients with chronic back pain. Two hundred and forty adults with non-specific low back pain >= 3 months were allocated to groups that received 8 weeks of general exercise, motor control exercise or spinal manipulative therapy. General exercise included strengthening, stretching and aerobic exercises. Motor control exercise involved retraining specific trunk muscles using ultrasound feedback. Spinal manipulative therapy included joint mobilization and manipulation. Primary outcomes were patient- specific function (PSFS, 3-30) and global perceived effect (GPE, -5 to 5) at 8 weeks. These outcomes were also measured at 6 and 12 months. Follow-up was 93% at 8 weeks and 88%, at 6 and 12 months. The motor control exercise group had slightly better outcomes than the general exercise group at 8 weeks (between-group difference: PSFS 2.9, 95% CI: 0.9-4.8; GPE 1.7, 95% CI: 0.9-2.4), as did the spinal manipulative therapy group (PSFS 2.3. 95% CI: 0.4-4.2; GPE 1.2, 95% CI: 0.4-2.0). The groups had similar outcomes at 6 and 12 months. Motor control exercise and spinal manipulative therapy produce slightly better short-term function and perceptions of effect than general exercise, but not better medium or long-term effects, in patients with chronic non-specific back pain. (C) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.