Bergman Gert J, Winters Jan C, Groenier Klaas H, Meyboom-de Jong Betty, Postema Klaas, van der Heijden Geert J
Formerly Department of General Practice and Center for Rehabilitation, University Medical Center Groningen, The Netherlands.
J Manipulative Physiol Ther. 2010 Feb;33(2):96-101. doi: 10.1016/j.jmpt.2009.12.004.
The purpose of this study was to examine the effect of manipulative therapy on the shoulder girdle, in addition to usual care provided by the general practitioner, on the outcomes of physical examination tests for the treatment of shoulder complaints.
This was a randomized controlled trial in a primary care setting in the Netherlands. A total of 150 participants were recruited from December 2000 until December 2002. All patients received usual care by the general practitioner. Usual care included one or more of the following depending on the needs of the patient: information/advice, oral analgesics or nonsteroidal antiinflammatory drugs, corticosteroid injections, exercises, and massage. In addition to usual care, the intervention group received manipulative therapy, up to 6 treatment sessions in a 12-week period. Twenty-four physical examination tests were done at baseline and after 6, 12, and 26 weeks. Factor analysis was done to reduce the number of outcome measures.
The factor analysis resulted in 4 factors: "shoulder pain," "neck pain," "shoulder mobility," and "neck mobility." At 6 weeks, no significant differences between groups were found. At 12 weeks, the mean changes of all 4 factors favored the intervention group; the factors "shoulder pain" and "neck pain" reached statistical significance (95% confidence interval [CI], 0.1-2.1). At 26 weeks, differences in the factors "shoulder pain" (95% CI, 0.0-2.6), "shoulder mobility" (95% CI, 0.2-1.7), and "mobility neck" (95% CI, 0.2-1.3) statistically favored the intervention group.
In this pragmatic study, manipulative therapy, in addition to usual care by the general practitioner, diminished severity of shoulder pain and neck pain and improved shoulder and neck mobility.
本研究旨在探讨在全科医生提供的常规护理基础上，手法治疗对肩带的影响，以及对肩部疾病物理检查测试结果的影响。
这是一项在荷兰初级保健机构进行的随机对照试验。从2000年12月至2002年12月共招募了150名参与者。所有患者均接受全科医生的常规护理。常规护理根据患者需求包括以下一项或多项：信息/建议、口服镇痛药或非甾体抗炎药、皮质类固醇注射、锻炼和按摩。除常规护理外，干预组接受手法治疗，在12周内最多进行6次治疗。在基线时以及6周、12周和26周后进行了24项物理检查测试。进行因子分析以减少结果测量的数量。
因子分析得出4个因子：“肩部疼痛”、“颈部疼痛”、“肩部活动度”和“颈部活动度”。在6周时，两组之间未发现显著差异。在12周时，所有4个因子的平均变化都有利于干预组；“肩部疼痛”和“颈部疼痛”因子达到统计学显著性（95%置信区间[CI]，0.1 - 2.1）。在26周时，“肩部疼痛”（95% CI，0.0 - 2.6）、“肩部活动度”（95% CI，0.2 - 1.7）和“颈部活动度”（95% CI，0.2 - 1.3）因子的差异在统计学上有利于干预组。
在这项实用研究中，在全科医生的常规护理基础上，手法治疗减轻了肩部疼痛和颈部疼痛的严重程度，并改善了肩部和颈部的活动度。
