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一项针对急性和亚急性颈部疼痛患者的随机临床试验的试点研究,该试验评估了整脊治疗、医疗护理和自我护理教育。

A pilot study for a randomized clinical trial assessing chiropractic care, medical care, and self-care education for acute and subacute neck pain patients.

作者信息

Evans Roni, Bronfort Gert, Bittell Sarah, Anderson Alfred V

机构信息

Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, 2501 W. 84th Street, Bloomington, MN 55431, USA.

出版信息

J Manipulative Physiol Ther. 2003 Sep;26(7):403-11. doi: 10.1016/S0161-4754(03)00093-9.

Abstract

OBJECTIVE

To conduct a pilot study in preparation for a full-scale randomized clinical trial assessing conservative treatments for acute and subacute neck pain. Study design Prospective, randomized pilot study.

SETTING

Primary contact chiropractic and medical clinics.

PATIENTS

Ages 21 to 65 with current episode of neck pain less than 12 weeks in duration. Outcome measures Patient self-report questionnaires and cervical spine motion were assessed at baseline and 3 and 12 weeks post-randomization.

INTERVENTIONS

Chiropractic spinal manipulation, prescription medications, and self-care education.

RESULTS

Recruitment took place over a 1-month period. Twenty-eight patients were randomized to treatment, and 1 patient (medical care group) refused their treatment assignment and was lost to further follow-up. Twenty-three patients were either "very satisfied" or "completely satisfied" with the care they received in the study. More than half the patients reported 75% or 100% improvement (n = 17). No between-group comparisons were planned or performed due to the small sample size.

CONCLUSION

Recruitment of patients appears feasible for a full-scale randomized clinical trial evaluating chiropractic spinal manipulation, medical care, and self-care education for acute and subacute neck pain. Patient and provider compliance with study protocols was excellent, and the pilot study allowed us to further develop and optimize our data collection processes. Although pilot studies such as these require substantial time, money, and effort, they provide valuable information for future research efforts.

摘要

目的

开展一项预试验,为全面评估急性和亚急性颈部疼痛保守治疗方法的随机临床试验做准备。研究设计:前瞻性随机预试验。

地点

初级接触性整脊诊所和医疗诊所。

患者

年龄在21至65岁之间,当前颈部疼痛发作持续时间少于12周。结局指标:在基线、随机分组后3周和12周时评估患者自我报告问卷和颈椎活动度。

干预措施

整脊手法治疗、处方药治疗和自我保健教育。

结果

招募工作历时1个月。28名患者被随机分配接受治疗,1名患者(医疗护理组)拒绝接受其治疗分配并失访。23名患者对他们在研究中接受的护理“非常满意”或“完全满意”。超过一半的患者报告有75%或100%的改善(n = 17)。由于样本量小,未计划或进行组间比较。

结论

对于一项评估整脊手法治疗、医疗护理和自我保健教育对急性和亚急性颈部疼痛疗效的全面随机临床试验而言,患者招募似乎是可行的。患者和提供者对研究方案的依从性良好,该预试验使我们能够进一步完善和优化数据收集流程。尽管此类预试验需要大量时间、资金和精力,但它们为未来的研究工作提供了有价值的信息。

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