Aspegren Donald, Enebo Brian A, Miller Matt, White Linda, Akuthota Venu, Hyde Thomas E, Cox James M
Department of Rehabilitation, University of Colorado School of Medicine, Lakewood, CO 80215, USA.
J Manipulative Physiol Ther. 2009 Nov-Dec;32(9):765-71. doi: 10.1016/j.jmpt.2009.10.002.
The purpose of this study is to report on integrative care for the treatment of injured workers with neck or back pain referred to a doctor of chiropractic from a medical or osteopathic provider.
This retrospective case series study evaluated data on 100 patients referred for chiropractic care of work-related spinal injuries involving workers' compensation claims. Deidentified data included age, sex, visual analog scale scores for pain, pre- and posttreatment Functional Rating Index (FRI) scores, and subjective response to chiropractic care. Based on date of injury to first chiropractic treatment, patients were subdivided as acute, subacute, or chronic injured workers. Cases were analyzed for differences in pretreatment FRI scores, posttreatment FRI scores, FRI change scores (posttreatment FRI minus pretreatment FRI score), and subjective percentage improvement using a 1-way analysis of variance. Treatment included manual therapy techniques and exercise.
Injured workers with either an acute or subacute injury had significantly lower posttreatment FRI scores compared with individuals with a chronic injury. The FRI change scores were significantly greater in the acute group compared with either the subacute or chronic injured workers. Workers in all categories showed improved posttreatment tolerance for work-related activities and significantly lower posttreatment subjective pain scores.
The study identified positive effects of chiropractic management included in integrative care when treating work-related neck or back pain. Improvement in both functional scores and subjective response was noted in all 3 time-based phases of patient status (acute, subacute, and chronic).
本研究旨在报告综合治疗的情况，这些综合治疗用于治疗从医学或整骨疗法提供者处转介给脊椎按摩治疗师的颈部或背部疼痛的受伤工人。
这项回顾性病例系列研究评估了100例因与工作相关的脊柱损伤而转介接受脊椎按摩治疗的患者的数据，这些损伤涉及工伤赔偿申请。去识别化的数据包括年龄、性别、疼痛视觉模拟量表评分、治疗前和治疗后的功能评定指数（FRI）评分以及对脊椎按摩治疗的主观反应。根据受伤日期至首次接受脊椎按摩治疗的时间，将患者分为急性、亚急性或慢性受伤工人。使用单向方差分析对病例的治疗前FRI评分、治疗后FRI评分、FRI变化评分（治疗后FRI减去治疗前FRI评分）和主观改善百分比的差异进行分析。治疗包括手法治疗技术和运动。
与慢性损伤患者相比，急性或亚急性损伤的受伤工人治疗后的FRI评分显著更低。与亚急性或慢性受伤工人相比，急性组的FRI变化评分显著更高。所有类别的工人在治疗后对与工作相关活动的耐受性均有所改善，且治疗后的主观疼痛评分显著更低。
该研究确定了综合治疗中包含的脊椎按摩治疗在治疗与工作相关的颈部或背部疼痛时的积极效果。在患者状态的所有三个基于时间的阶段（急性、亚急性和慢性）中，均观察到功能评分和主观反应的改善。
