Goldby Lucy Jane, Moore Ann P, Doust Jo, Trew Marion E
Balance Performance Physiotherapy, London, United Kingdom.
Spine (Phila Pa 1976). 2006 May 1;31(10):1083-93. doi: 10.1097/01.brs.0000216464.37504.64.
Randomized, single blind, controlled trial.
To determine the efficacy of 2 components of musculoskeletal physiotherapy on chronic low back disorder.
Musculoskeletal physiotherapy encompasses many treatment methods, however, manual therapy and exercises to rehabilitate spinal stabilization are the most frequently used. Despite their popularity, scant evidence supports their use on subjects with chronic low back disorder.
A total of 346 subjects were randomized to manual therapy, a 10-week spinal stabilization rehabilitation program, or a minimal intervention control group. Data were collected at baseline, and 3, 6, 12, and 24 months after intervention. Outcome measures recorded intensity of low back pain, disability, handicap, medication, and quality of life. There were 4 main variables combined in a primary component analysis to form a single outcome measure (i.e., a measure of dysfunction).
The results indicated statistically significant improvements in favor of the spinal stabilization group at the 6-month stage in pain (65.9% reduction in symptoms) and dysfunction (combined mean reduction of 134, standard error 23.84), and at the 1-year stage in medication (34.3% reduction in medication), dysfunction (combined mean reduction of 134, standard error 18.2), and disability (mean difference in change 15.71 Oswestry Disability Index, 95% confidence interval 19.3-10.01).
As a component of musculoskeletal physiotherapy, the spinal stabilization program is more effective than manually applied therapy or an education booklet in treating chronic low back disorder over time. Both manual therapy and the spinal stabilization program are significantly effective in pain reduction in comparison to an active control. To our knowledge and up until now, this result has not been shown in patients with chronic low back disorder.
随机、单盲、对照试验。
确定肌肉骨骼物理治疗的两个组成部分对慢性下背痛疾病的疗效。
肌肉骨骼物理治疗包含多种治疗方法，然而，手法治疗和恢复脊柱稳定性的运动是最常用的。尽管它们很受欢迎，但几乎没有证据支持将其用于慢性下背痛疾病患者。
总共346名受试者被随机分配到手法治疗组、为期10周的脊柱稳定性康复计划组或最小干预对照组。在基线以及干预后3、6、12和24个月收集数据。记录的结果指标包括下背痛强度、功能障碍、残疾、药物使用情况和生活质量。在主成分分析中合并4个主要变量以形成单一结果指标（即功能障碍指标）。
结果表明，在6个月时，脊柱稳定性组在疼痛（症状减轻65.9%）和功能障碍（合并平均降低134，标准误23.84）方面有统计学上显著的改善；在1年时，在药物使用（药物使用减少34.3%）、功能障碍（合并平均降低134，标准误18.2）和残疾（变化的平均差异为15.71 Oswestry残疾指数，95%置信区间19.3 - 10.01）方面有统计学上显著的改善。
作为肌肉骨骼物理治疗的一个组成部分，随着时间推移，脊柱稳定性康复计划在治疗慢性下背痛疾病方面比手法治疗或一本教育手册更有效。与积极对照相比，手法治疗和脊柱稳定性康复计划在减轻疼痛方面均显著有效。据我们所知且截至目前，这一结果在慢性下背痛疾病患者中尚未得到证实。
