Descarreaux Martin, Blouin Jean-Sébastien, Drolet Marc, Papadimitriou Stanislas, Teasdale Normand
Laval University, Kinesiology Division and Quebec University in Trois-Rivières, Chiropractic Department, Quebec, Canada.
J Manipulative Physiol Ther. 2004 Oct;27(8):509-14. doi: 10.1016/j.jmpt.2004.08.003.
To document the potential role of maintenance chiropractic spinal manipulation to reduce overall pain and disability levels associated with chronic low-back conditions after an initial phase of intensive chiropractic treatments.
Thirty patients with chronic nonspecific low-back pain were separated into 2 groups. The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period. For this group, a 4-week period preceding the initial phase of treatment was used as a control period to examine the sole effect of time on pain and disability levels. The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period. Pain and disability levels were evaluated with a visual analog scale and a modified Oswestry questionnaire, respectively.
The 1-month control period did not modify the pain and disability levels. For both groups, the pain and disability levels decreased after the intensive phase of treatments. Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores. The disability scores of the other group went back to their pretreatment levels.
Intensive spinal manipulation is effective for the treatment of chronic low back pain. This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels. Future studies, however, are needed to confirm the finding in a larger group of patients with chronic low-back pain.
记录在初始强化整脊治疗阶段后，维持性整脊脊柱手法治疗在降低与慢性下背部疾病相关的总体疼痛和残疾水平方面的潜在作用。
30例慢性非特异性下背痛患者被分为两组。第一组在1个月的强化期接受12次治疗，但在随后的9个月内不接受治疗。对于该组，将治疗初始阶段前的4周作为对照期，以研究时间对疼痛和残疾水平的单独影响。第二组在1个月的强化期接受12次治疗，并且在9个月的随访期内每3周接受一次维持性脊柱手法治疗。分别使用视觉模拟量表和改良的奥斯维斯特里问卷评估疼痛和残疾水平。
1个月的对照期未改变疼痛和残疾水平。两组在强化治疗阶段后疼痛和残疾水平均下降。在整个随访期内，两组的疼痛评分均维持在与强化治疗后相似的水平。然而，对于残疾评分，只有在随访期接受脊柱手法治疗的组维持了强化治疗后的评分。另一组的残疾评分恢复到治疗前水平。
强化脊柱手法治疗对慢性下背痛有效。本实验表明，在强化手法治疗后进行维持性脊柱手法治疗可能有助于患者维持强化治疗后的主观残疾水平。然而，需要未来的研究在更大规模的慢性下背痛患者群体中证实这一发现。
