The effects of side-posture positioning and spinal adjusting on the lumbar Z joints - A randomized controlled trial with sixty-four subjects
The effects of side-posture positioning and spinal adjusting on the lumbar Z joints - A randomized controlled trial with sixty-four subjects
复制标题
DOI：
10.1097/00007632-200211150-00008
复制
发表时间：
2002-11-15
期刊：
影响因子：
3
通讯作者：
Cantu, JA
中科院分区：
文献类型：
--
作者：
Cramer, GD;Gregerson, DM;Cantu, JA
研究设计：进行了一项盲法、随机对照试验。目的：检验腰椎脊椎侧位操作（调整）使关节突 (Z) 关节分离（间隙）的假设。背景数据摘要：脊柱调整被认为会使 Z 关节间隙，但没有研究最终证实这一假设，并且一些研究者报告腰椎 Z 关节在旋转过程中不会间隙。方法：在本研究中，64 名健康人年龄 22 至 30 岁、无明显腰痛病史的学生志愿者（32 名男性和 32 名女性）被随机分为四组，每组 8 名男性和 8 名女性。干预措施包括腰椎侧位脊柱调整（手法）和侧位定位。对侧位脊柱调整前后以及侧位脊柱定位前后进行的 MRI 扫描进行的 Z 关节前后测量进行比较。结果：执行测量的观察者对于第一次和第二次扫描组是盲法的。建立了测量的可靠性。各组之间存在差异（F = 24.15；P < 0.000，方差分析）。侧姿势定位显示出比控制条件更大的间隙（平均差；1.18；P < 0.000），侧姿势调整显示比控制条件更大的间隙（平均差，1.89；P < 0.000），侧姿势调整显示比侧姿势定位更大的间隙（平均差，0.71；P = 0.047）。结论：脊柱调整产生了更大的间隙（间隙）。 Z 关节。侧位定位也会产生间隙，但比腰椎侧位调节时所见的间隙要小。这项研究有助于增进对脊柱操纵作用机制的了解。
Study Design: A blinded, randomized controlled trial was conducted.Objective: To test the hypothesis that chiropractic side-posture manipulation (adjusting) of the lumbar spine separates (gaps) the zygapophysial (Z) joints.Summary of Background Data: Spinal adjusting is thought to gap the Z joints, yet no studies have conclusively validated this hypothesis, and some investigators have reported that the lumbar Z joints do not gap during rotation.Methods: For this study, 64 healthy student volunteers (32 men and 32 women) ages 22 to 30 years with no history of significant low back pain were randomized into four groups of 8 men and 8 women each. Interventions included lumbar side-posture spinal adjusting (manipulation) and side-posture positioning. Anterior to posterior measurements of the Z joints from MRI scans taken before and after side-posture spinal adjusting and before and after side-posture spinal positioning were compared.Results: Observers performing the measurements were blinded as to group first and second scans. Reliability of the measurements was established. Differences were found between the groups (F = 24.15; P < 0.000, analysis of variance). Side-posture positioning showed greater gapping than the control condition (mean difference; 1.18; P < 0.000), side-posture adjusting showed greater gapping than the control condition (mean difference, 1.89; P < 0.000), and side-posture adjusting showed greater gapping than side-posture positioning (mean difference, 0.71; P = 0.047).Conclusions: Spinal adjusting produced increased separation (gapping) of the Z joints. Side-posture positioning also produced gapping, but less than that seen with lumbar side-posture adjusting. This study helps to increase understanding about the mechanism of action for spinal manipulation.