Willett Elaine, Hebron Clair, Krouwel Oliver
University of Brighton, Faculty of Health, School of Health Professions, United Kingdom.
Man Ther. 2010 Apr;15(2):173-8. doi: 10.1016/j.math.2009.10.005. Epub 2009 Nov 28.
Lumbar mobilisations are commonly used in clinical practice to reduce pain and increase function. Mobilisations to the cervical spine have been shown to reduce pain using pressure pain thresholds (PPTs). Yet there is no evidence to confirm that this happens in the lumbar spine. Furthermore little is known about the effects of different treatment doses on the amount of hypoalgesia produced. It is unknown if changing the rate of application of mobilisations has an effect on hypoalgesia. The aim of this study was to investigate the immediate effects of lumbar posteroanterior mobilisations performed at different rates on PPT and the extent of the hypoalgesia. A repeated measures, single blind, randomised-trial was conducted on 30 asymptomatic subjects. PPTs were measured at 4 sites in the upper and lower quadrants, before and after the application of lumbar posteroanterior mobilisations performed at 2 Hz, 1 Hz and quasi-static. The results demonstrated an immediate and significant improvement in PPT measures (P = 0.000) irrespective of the rate or site tested. The effects were both local and widespread. There was no significant difference in PPT between the rates of mobilisations. This study provides new experimental evidence that lumbar posteroanterior mobilisations produce an immediate and significant widespread hypoalgesic effect, regardless of the rates of mobilisation in asymptomatic subjects.
腰椎松动术在临床实践中常用于减轻疼痛和提高功能。已有研究表明，对颈椎进行松动术可通过压力疼痛阈值（PPT）减轻疼痛。然而，尚无证据证实腰椎松动术也能如此。此外，对于不同治疗剂量产生的痛觉减退程度的影响知之甚少。改变松动术的应用速率是否会对痛觉减退产生影响尚不清楚。本研究的目的是调查以不同速率进行腰椎后前向松动术对PPT和痛觉减退程度的即时影响。对30名无症状受试者进行了一项重复测量、单盲、随机试验。在以2Hz、1Hz和准静态进行腰椎后前向松动术前后，在上、下象限的4个部位测量PPT。结果表明，无论测试的速率或部位如何，PPT测量值均有即时且显著的改善（P = 0.000）。这种影响是局部的也是广泛的。不同松动速率之间的PPT没有显著差异。本研究提供了新的实验证据，即无论无症状受试者的松动速率如何，腰椎后前向松动术都会产生即时且显著的广泛痛觉减退效果。
