Preyde M
Faculty of Social Work, University of Toronto, Ont.
CMAJ. 2000 Jun 27;162(13):1815-20.
The effectiveness of massage therapy for low-back pain has not been documented. This randomized controlled trial compared comprehensive massage therapy (soft-tissue manipulation, remedial exercise and posture education), 2 components of massage therapy and placebo in the treatment of subacute (between 1 week and 8 months) low-back pain.
Subjects with subacute low-back pain were randomly assigned to 1 of 4 groups: comprehensive massage therapy (n = 25), soft-tissue manipulation only (n = 25), remedial exercise with posture education only (n = 22) or a placebo of sham laser therapy (n = 26). Each subject received 6 treatments within approximately 1 month. Outcome measures obtained at baseline, after treatment and at 1-month follow-up consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion).
Of the 107 subjects who passed screening, 98 (92%) completed post-treatment tests and 91 (85%) completed follow-up tests. Statistically significant differences were noted after treatment and at follow-up. The comprehensive massage therapy group had improved function (mean RDQ score 1.54 v. 2.86-6.5, p < 0.001), less intense pain (mean PPI score 0.42 v. 1.18-1.75, p < 0.001) and a decrease in the quality of pain (mean PRI score 2.29 v. 4.55-7.71, p = 0.006) compared with the other 3 groups. Clinical significance was evident for the comprehensive massage therapy group and the soft-tissue manipulation group on the measure of function. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group.
Patients with subacute low-back pain were shown to benefit from massage therapy, as regulated by the College of Massage Therapists of Ontario and delivered by experienced massage therapists.
按摩疗法对腰痛的有效性尚无文献记载。这项随机对照试验比较了综合按摩疗法（软组织手法治疗、康复锻炼和姿势教育）、按摩疗法的两个组成部分以及安慰剂在治疗亚急性（1周 至8个月）腰痛中的效果。
患有亚急性腰痛的受试者被随机分配到4组中的1组：综合按摩疗法组（n = 25）、仅软组织手法治疗组（n = 25）、仅康复锻炼与姿势教育组（n = 22）或假激光疗法安慰剂组（n = 26）。每位受试者在大约1个月内接受6次治疗。在基线、治疗后和1个月随访时获得的结果测量指标包括罗兰残疾问卷（RDQ）、麦吉尔疼痛问卷（PPI和PRI）、状态焦虑指数和改良肖伯试验（腰椎活动范围）。
在通过筛查的107名受试者中, 98名（92%）完成了治疗后测试，91名（85%）完成了随访测试。在治疗后和随访时发现了统计学上的显著差异。与其他3组相比，综合按摩疗法组的功能有所改善（平均RDQ评分1.54对2.86 - 6.5，p < 0.001），疼痛减轻（平均PPI评分0.42对1.18 - 1.75，p < 0.001），疼痛质量下降（平均PRI评分2.29对4.55 - 7.71，p = 0.006）。在功能测量方面，综合按摩疗法组和软组织手法治疗组具有明显的临床意义。在1个月随访时，综合按摩疗法组63%的受试者报告无疼痛，相比之下，软组织手法治疗组为27%，康复锻炼组为14%，假激光疗法组为0%。
研究表明，亚急性腰痛患者可从按摩疗法中获益，该按摩疗法由安大略省按摩治疗师学院监管，并由经验丰富的按摩治疗师实施。
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