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workplace急性肌肉性下背痛连续低水平热疗法的随机临床试验

A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace.

作者信息

Tao Xuguang Grant, Bernacki Edward J

机构信息

Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

出版信息

J Occup Environ Med. 2005 Dec;47(12):1298-306. doi: 10.1097/01.jom.0000184877.01691.a3.

DOI:10.1097/01.jom.0000184877.01691.a3
PMID:16340712
Abstract

OBJECTIVES

We sought to compare the therapeutic benefits of ThermaCare Heat Wrap combined with an education program to an education-only program on reducing pain and disability from acute work-related low back pain.

METHODS

Forty-three eligible patients, aged 20 to 62 years who presented to an occupational injury clinic, were randomized into one of two intervention arms: 1) education regarding back therapy and pain management alone or 2) education regarding back therapy and pain management combined with three consecutive days of topical heat therapy (104 degrees F or 40 degrees C for 8 hours). The primary endpoints in this trial were measures of pain intensity and pain relief levels obtained approximately four times per day for the three consecutive working days of treatment, followed by measures of pain intensity and pain relief levels obtained in three follow-up visits at day 4 and 14 from treatment initiation. The secondary measures were overall impairment due to injury and disability caused by low back pain assessed at Intake, Visit 2 (day 4), 3 (day 7), and 4 (day 14).

RESULTS AND CONCLUSION

A total of 18 individuals enrolled in the education-only group and 25 in the treatment group completed the intervention and all follow-up visits. The general linear model adjusting for age, sex, baseline pain intensity, and pain medication indicated that the topical heat therapy had significantly reduced pain intensity, increased pain relief, and improved disability scores during and after treatment.

摘要

目的

我们试图比较ThermaCare热贴联合教育计划与单纯教育计划在减轻急性工作相关下背痛所致疼痛和残疾方面的治疗效果。

方法

43名年龄在20至62岁之间、前往职业伤害诊所就诊的符合条件的患者被随机分为两个干预组之一:1)仅接受背部治疗和疼痛管理方面的教育;2)接受背部治疗和疼痛管理方面的教育,并连续三天接受局部热疗(104华氏度或40摄氏度,持续8小时)。本试验的主要终点是在连续三个工作日的治疗期间,每天大约测量四次疼痛强度和疼痛缓解水平,随后在治疗开始后的第4天和第14天进行三次随访时测量疼痛强度和疼痛缓解水平。次要指标是在入组时、第2次就诊(第4天)、第3次就诊(第7天)和第4次就诊(第14天)评估的因损伤导致的总体功能损害和下背痛引起的残疾。

结果与结论

共有18名仅接受教育组的个体和25名治疗组的个体完成了干预及所有随访。对年龄、性别、基线疼痛强度和止痛药物进行校正的一般线性模型表明,局部热疗在治疗期间和治疗后显著降低了疼痛强度,增加了疼痛缓解,并改善了残疾评分。

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