RETRODISPLACEMENT & SPONDYLOLISTHESIS--BRACE TREATMENT

本计画旨在研究支撑对同质下背部的影响 疼痛患者分类的存在或不存在的过度 屈曲-伸展X线片上的前或后平移。 背痛持续四周至一年的患者分为 分为四组：后移位-伸展时更差， 后移-屈曲、脊椎前移（任何类型）时更差， 正常翻译 每个分类组被随机分配到屈曲， 延伸或非特定教育治疗。 屈曲和伸展 治疗包括特殊的教育和锻炼以及支具 治疗 为了实现这些具体目标，以下假设 将测试：（1）放射学后移（反向）患者 脊椎滑脱）和腰痛持续时间超过4周 在伸展位X光片上显示最大位移的患者将 对屈曲矫形器的反应比其他三名患者更好 组：（a）具有相同X线表现的患者，接受了延长治疗 矫形器，（B）具有相同X线表现的患者， 下背部教育，和（c）患者与正常的放射线平移 用同样的无视矫形器治疗 (2)放射学检查患者 持续时间超过四周的后移位和腰痛 在屈曲X光片上表现出最大位移的人， 比其他三个病人对伸展矫形器的反应更好 组：（a）具有相同放射学检查结果的患者， 屈曲矫形器，（B）具有相同影像学表现的患者接受治疗 非特异性下背部教育，和（c）患者正常 用相同的延伸矫形器治疗X线平移。 （三）、 影像学前移位（任何类型的脊椎前移）的患者 类型）和持续四周的腰痛会有更好的反应 三种不同的患者组：（a） 使用延伸矫形器治疗的相同X光检查结果，（B）使用 用非特异性下背部教育治疗的相同x线检查结果，和（c） 采用相同屈曲治疗的影像学平移正常的患者 矫形器 (4)对屈曲或伸展矫形器的反应可以 通过以下指标预测：（a）放射学测量，和（B）临床症状 和体征，或者社会心理变量。

This project proposes to study the effect of bracing on homogenous low back pain patients classified by the presence or absence of either excessive anterior or posterior translation on flexion-extension radiographs. Patients with back pain of four weeks' to one year duration are classified into four groups: retrodisplacement - worse in extension, retrodisplacement - worse in flexion, spondylolisthesis (of any type), and normal translation. Each classified group is randomly assigned to flexion, extension, or non-specific education treatment. Flexion and extension treatments include specific education and exercises as well as brace treatment. To accomplish these specific aims, the following hypotheses will be tested: (1) Patients with radiographic retrodisplacement (reverse spondylolisthesis) and low back pain of greater than four weeks' duration who demonstrate greatest displacement on an extension radiograph will respond more favorably to a flexion orthosis than three other patient groups: (a) those with the same x-ray findings treated with an extension orthosis, (b) those with the same x-ray findings treated with nonspecific low back education, and (c) patients with normal radiographic translation treated with the same disregard orthosis. (2) Patients with radiographic retrodisplacement and low back pain of greater than four weeks' duration who demonstrate greatest displacement on the flexion radiograph will respond more favorably to an extension orthosis than three other patient groups: (a) those with the same radiographic findings treated with a flexion orthosis, (b) those with the same radiographic findings treated with nonspecific low back education, and (c) patients with normal radiographic translation treated with the same extension orthosis. (3) Patients with radiographic anterodisplacement (spondylolisthesis of any type) and low back pain of four weeks' duration will respond more favorably to a flexion orthosis than three other patient groups: (a) those with the same x-ray findings treated with an extension orthosis, (b) those with the same x-ray findings treated with nonspecific low back education, and (c) patients with normal radiographic translation treated with the same flexion orthosis. (4) The response to either a flexion or extension orthosis can be predicted by: (a) radiographic measurements, and (b) clinical symptoms and signs, or psychosocial variables.