Wilkey Adam, Gregory Michael, Byfield David, McCarthy Peter W
Private Practice, Oldham, United Kingdom.
J Altern Complement Med. 2008 Jun;14(5):465-73. doi: 10.1089/acm.2007.0796.
To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor.
The study was a pragmatic, randomized, controlled trial.
The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.
Patients with CLBP (i.e., symptom duration of >12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting.
The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated.
Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023).
This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.
比较一组慢性下腰痛（CLBP）患者在医院接受区域疼痛诊所或脊椎按摩师治疗时在疼痛感知和残疾方面的结果。
该研究是一项实用的随机对照试验。
试验在英国一家国民健康服务（NHS）医院门诊诊所（疼痛诊所）进行。
被转诊至区域疼痛诊所（医院门诊诊所）的CLBP患者（即症状持续时间>12周）接受评估，并随机分为脊椎按摩治疗组或疼痛诊所治疗组，为期8周。该研究注重实用性，允许使用常规治疗方案。治疗在NHS医院环境中进行。
使用罗兰 - 莫里斯残疾问卷（RMDQ）和数字评分量表来评估感知残疾和疼痛的变化。计算第0、2、4、6和8周的平均值。使用学生t检验比较两个治疗组在第0周和第8周之间的平均差异。计算组间差异的95%置信区间（CI）。
随机分组后，12名患者进入疼痛诊所组，18名患者进入脊椎按摩治疗组，其中分别有11名和16名患者完成试验。在8周时，脊椎按摩治疗组的RMDQ平均改善比疼痛诊所组高5.5分（残疾减少5.9）（95%CI为2.0分至9.0分；p = 0.004）。脊椎按摩治疗组在第8周时的平均疼痛强度降低比疼痛诊所组高1.8分（p = 0.023）。
本研究表明，在NHS环境中进行的脊椎按摩治疗可能对减少CLBP患者亚群在治疗期间的残疾水平和感知疼痛有效。
