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物理治疗Godelive Denys-Struyf方法治疗非特异性下腰痛的有效性:初级保健随机对照试验。

Effectiveness of the physical therapy Godelive Denys-Struyf method for nonspecific low back pain: primary care randomized control trial.

作者信息

Díaz Arribas María José, Ramos Sánchez Mabel, Pardo Hervás Pedro, López Chicharro José, Angulo Carreré Teresa, Ortega Molina Paloma, Astasio Arbiza Paloma

机构信息

Department of Physical Medicine and Rehabilitation, Complutense University of Madrid, Madrid, Spain.

出版信息

Spine (Phila Pa 1976). 2009 Jul 1;34(15):1529-38. doi: 10.1097/BRS.0b013e3181aa2771.

Abstract

STUDY DESIGN

A simple blind, random controlled clinical trial.

OBJECTIVE

To assess the effectiveness of physiotherapy treatment based on the muscular and articular chains Godelive Denys-Struyf (GDS) method for nonspecific low back pain (LBP) in primary care.

SUMMARY OF BACKGROUND DATA

Despite a systematic review by the European COST ACTION B13 "Low back pain: guidelines for its management," there are still many unresolved questions regarding the effectiveness of the different physical therapy treatments used for LBP.

SETTING

21 physicians and physiotherapists in 7 Primary Care Centers and 6 researches in the Complutense University of Madrid (Spain).

PARTICIPANTS

137 patients diagnosed with nonspecific LBP.

METHODS

The control group underwent 15 sessions of conventional physiotherapy in Primary Care Centers, and the experimental group received 15 GDS treatment sessions. Pain was evaluated by Visual Analogical Scale (VAS), functional disability by Oswestry questionnaire, and quality of life by the physical and mental components of SF-36 questionnaire. Outcome measures were assessed before treatment (A1), at the end of treatment (A2), and at 3 months (A3), and 6 months (A4) of follow-up.

RESULTS

Repeated measures analysis of variance revealed that at the end of treatment and 3 months later, subjects in both groups showed less pain, reduced functional disability, and an improved quality of life, though improvements were greater in the GDS group.Six months after treatment, patients in the GDS group continued to show reduced pain (VAS(A4-A1) = -3.54, 95% CI: -4.18 to -2.90) while VAS scores in the control group returned to initial values (VAS(A4-A1) = 0.15, 95% CI: -0.36 to 0.67).

CONCLUSION

Treatment of nonspecific LBP using the GDS method provides greater improvements in the midterm (6 months) in terms of the pain, functional ability, and quality of life perceived by patients than the conventional treatment based administered in primary care.

摘要

研究设计

一项简单的盲法随机对照临床试验。

目的

评估基于肌肉和关节链戈德利夫·德尼斯 - 斯特鲁伊夫(GDS)方法的物理治疗对初级保健中非特异性下腰痛(LBP)的有效性。

背景数据总结

尽管欧洲COST ACTION B13“下腰痛:管理指南”进行了系统评价,但关于用于LBP的不同物理治疗方法的有效性仍有许多未解决的问题。

地点

7个初级保健中心的21名医生和物理治疗师以及马德里康普顿斯大学(西班牙)的6名研究人员。

参与者

137例被诊断为非特异性LBP的患者。

方法

对照组在初级保健中心接受15次常规物理治疗,实验组接受15次GDS治疗。通过视觉模拟量表(VAS)评估疼痛,通过奥斯威斯问卷评估功能障碍,通过SF - 36问卷的身体和心理成分评估生活质量。在治疗前(A1)、治疗结束时(A2)、随访3个月(A3)和6个月(A4)时评估结果指标。

结果

重复测量方差分析显示,在治疗结束时和3个月后,两组受试者的疼痛均减轻,功能障碍减少,生活质量改善,尽管GDS组的改善更大。治疗6个月后,GDS组患者的疼痛持续减轻(VAS(A4 - A1)=-3.54,95%CI:-4.18至-2.90),而对照组的VAS评分恢复到初始值(VAS(A4 - A1)=0.15,95%CI:-0.36至0.67)。

结论

与初级保健中实施的传统治疗相比,使用GDS方法治疗非特异性LBP在中期(6个月)对患者感知的疼痛、功能能力和生活质量有更大改善。

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