Randomised controlled trial of physiotherapy compared with advice for low back pain
Randomised controlled trial of physiotherapy compared with advice for low back pain
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DOI：
10.1136/bmj.38216.868808.7c
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发表时间：
2004-09-25
影响因子：
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通讯作者：
Stewart-Brown, S
中科院分区：
文献类型：
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作者：
Frost, H;Lamb, SE;Stewart-Brown, S
目的评价常规理疗与常规理疗和理疗师建议治疗腰背痛的疗效。设计实用、多中心、随机对照试验。设置7个NHS理疗科。参与者286例，腰痛持续时间超过6周。干预常规理疗或理疗师建议保持活跃。主要结果：12个月时OSwestry残疾指数评分。结果286例患者中有200例(70%)在12个月时获得了随访信息。治疗组的患者报告说受益的感觉增强了，但没有证据表明物理治疗在特定疾病或一般结果衡量标准中都有长期效果(12个月时奥斯维斯特里残疾指数评分变化的平均差异-1.0%，95%可信区间-3.7%至1.6%)。最常见的治疗方法是低速脊柱关节松动术(72.0%，104/144例)和腰椎活动度及腹部加强训练(94.00%，136例)。结论常规理疗的效果似乎并不比理疗师的一次评估和建议好。
Objective To measure the effectiveness of routine physiotherapy compared with an assessment session and advice from a physiotherapist for patients with low back pain.Design Pragmatic, multicentre, randomised controlled trial.Setting Seven NHS physiotherapy departments.Participants 286 patients with low back pain of more than six weeks' duration.Intervention Routine physiotherapy or advice on remaining active from a physiotherapist.Main outcome measures Primary outcome was scores on the Oswestry disability index at 12 months. Secondary outcomes were scores on the Oswestry disability index (2 and 6 months), scores on the Roland and Morris disability questionnaire and SF-36 (2, 6 and 12 months), and patient perceived benefit from treatment (2, 6, and 12 months).Results 200 of 286 patients (70%) provided follow up information at 12 months. Patients in the therapy group reported enhanced perceptions of benefit, but there was no evidence of a long term effect of physiotherapy in either disease specific or generic outcome measures (mean difference in change in Oswestry disability index scores at 12 months -1.0%, 95% confidence interval -3.7% to 1.6%). The most common treatments were low velocity spinal joint mobilisation techniques (72%, 104 of 144 patients) and lumbar spine mobility and abdominal strengthening exercises (94%, 136 patients).Conclusion Routine physiotherapy seemed to be no more effective than one session of assessment and advice from a physiotherapist.