Licciardone John C, Stoll Scott T, Fulda Kimberly G, Russo David P, Siu Jeff, Winn William, Swift Jon
Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth 76107, USA.
Spine (Phila Pa 1976). 2003 Jul 1;28(13):1355-62. doi: 10.1097/01.BRS.0000067110.61471.7D.
A randomized controlled trial was conducted.
To determine the efficacy of osteopathic manipulative treatment as a complementary treatment for chronic nonspecific low back pain.
Osteopathic manipulative treatment may be useful for acute or subacute low back pain. However, its role in chronic low back pain is unclear.
This trial was conducted in a university-based clinic from 2000 through 2001. Of the 199 subjects who responded to recruitment procedures, 91 met the eligibility criteria. They were randomized, with 82 patients completing the 1-month follow-up evaluation, 71 completing the 3-month evaluation, and 66 completing the 6-month evaluation. The subjects were randomized to osteopathic manipulative treatment, sham manipulation, or a no-intervention control group, and they were allowed to continue their usual care for low back pain. The main outcomes included the SF-36 Health Survey, a 10-cm visual analog scale for overall back pain, the Roland-Morris Disability Questionnaire, lost work or school days because of back pain, and satisfaction with back care.
As compared with the no-intervention control subjects, the patients who received osteopathic manipulative treatment reported greater improvements in back pain, greater satisfaction with back care throughout the trial, better physical functioning and mental health at 1 month, and fewer cotreatments at 6 months. The subjects who received sham manipulation also reported greater improvements in back pain and physical functioning and greater satisfaction than the no-intervention control subjects. There were no significant benefits with osteopathic manipulative treatment, as compared with sham manipulation.
Osteopathic manipulative treatment and sham manipulation both appear to provide some benefits when used in addition to usual care for the treatment of chronic nonspecific low back pain. It remains unclear whether the benefits of osteopathic manipulative treatment can be attributed to the manipulative techniques themselves or whether they are related to other aspects of osteopathic manipulative treatment, such as range of motion activities or time spent interacting with patients, which may represent placebo effects.
进行了一项随机对照试验。
确定整骨手法治疗作为慢性非特异性下腰痛辅助治疗的疗效。
整骨手法治疗可能对急性或亚急性下腰痛有用。然而，其在慢性下腰痛中的作用尚不清楚。
该试验于2000年至2001年在一家大学诊所进行。在199名响应招募程序的受试者中，91名符合入选标准。他们被随机分组，82名患者完成了1个月的随访评估，71名完成了3个月的评估，66名完成了6个月的评估。受试者被随机分为整骨手法治疗组、假手法治疗组或无干预对照组，并且允许他们继续其针对下腰痛的常规治疗。主要结局包括SF-36健康调查、用于评估总体背痛的10厘米视觉模拟量表、罗兰-莫里斯残疾问卷、因背痛而损失的工作或学习天数以及对背部护理的满意度。
与无干预对照组受试者相比，接受整骨手法治疗的患者报告称背痛改善更大，在整个试验过程中对背部护理的满意度更高，1个月时身体功能和心理健康状况更好，6个月时联合治疗更少。接受假手法治疗的受试者也报告称与无干预对照组受试者相比，背痛和身体功能改善更大，满意度更高。与假手法治疗相比，整骨手法治疗没有显著益处。
整骨手法治疗和假手法治疗在用于慢性非特异性下腰痛的常规治疗之外时似乎都能带来一些益处。尚不清楚整骨手法治疗的益处是否可归因于手法技术本身，或者它们是否与整骨手法治疗的其他方面有关，例如活动范围或与患者互动所花费的时间，这可能代表安慰剂效应。
