Effects of manual therapy and exercise targeting the hips in patients with low-back pain-A randomized controlled trial
Effects of manual therapy and exercise targeting the hips in patients with low-back pain-A randomized controlled trial
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DOI：
10.1111/jep.12705
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发表时间：
2017-08-01
影响因子：
2.4
通讯作者：
Cook, Chad
中科院分区：
文献类型：
--
作者：
Bade, Michael;Cobo-Estevez, Manuel;Cook, Chad
基本原理为患有机械性腰痛（LBP）的患者提供针对髋关节的手动治疗和锻炼的益处尚未得到很好的确立。目的本研究的目的是确定髋关节的正式处方治疗方案是否能改善机械性腰痛患者的预后。（50名男性，46.1 ± 16.2岁）被随机分配到2组之一：仅腰椎实用治疗（LBP）（n = 39）或腰椎实用治疗和双侧髋关节处方治疗（LBP + HIP）（n = 45）。腰椎的实用治疗是基于已发表的临床指南。髋关节的处方治疗涉及使用3种针对臀部肌肉组织的髋关节练习和3种针对髋关节的活动技术。受试者进行了评估，在基线，2周，并在出院时与以下措施：改良的奥斯韦斯特里残疾指数，数字疼痛评定量表，变化的全球评级（GRoC）评分，患者可接受的症状状态（PASS），和患者satisfactions.Results在2周，组间差异显着差异，发现在GRoC和患者满意度（P <0.05）有利于LBP + HIP组。出院时，改良奥斯韦斯特里功能障碍指数、数字疼痛评分量表、GRoC和患者满意度方面存在显著差异，LBP + HIP组更优（P <0.05）。影响大小是小到medium.Conclusion我们的研究结果表明，处方治疗的髋关节可能是临床价值的个人提出的主要投诉机械LBP。
Rationale The benefits of providing manual therapy and exercise targeting the hips in individuals with mechanical low-back pain (LBP) are not well established.Objectives The objective in this study is to determine whether a formal prescriptive treatment protocol for the hips improves outcomes in patients with a primary complaint of mechanical LBP.Methods Eighty-four (84) subjects (50 males, 46.1 +/- 16.2 years) were randomized to 1 of 2 groups: pragmatic treatment of the lumbar spine only (LBP) (n = 39) or pragmatic treatment of the lumbar spine and prescriptive treatment of bilateral hips (LBP + HIP) (n = 45). Pragmatic treatment of the lumbar spine was based upon published clinical guidelines. Prescriptive treatment of the hips involved the use of 3 hip exercises targeting the gluteal musculature and 3 mobilization techniques targeting the hips. Subjects were assessed at baseline, 2 weeks, and at discharge with the following measures: Modified Oswestry Disability Index, Numeric Pain Rating Scale, a global rating of change (GRoC) score, the patient acceptable symptom state (PASS), and patient satisfaction.Results At 2 weeks, significant differences between groups differences were found in GRoC and patient satisfaction (P < .05) favoring the LBP + HIP group. At discharge, there were significant differences on the Modified Oswestry Disability Index, numeric pain rating scale, GRoC, and patient satisfaction favoring the LBP + HIP group (P < .05). Effect sizes were small to medium.Conclusion Our findings suggest that a prescriptive treatment of the hips may be of clinical value to individuals presenting with the primary complaint of mechanical LBP.