采用特定生理和生物行为学结果指标评估麦肯锡疗法治疗慢性下腰痛的效果。
Evaluation of the McKenzie intervention for chronic low back pain by using selected physical and bio-behavioral outcome measures.
机构信息
Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait, University, Kuwait, PO Box 31470, Sulaibikhat 90805 Kuwait.
出版信息
PM R. 2011 Jul;3(7):637-46; quiz 646. doi: 10.1016/j.pmrj.2011.04.025.
OBJECTIVES
To assess the bio-behavioral and physical performance characteristics of individuals with chronic low back pain who demonstrated the pain centralization phenomenon and received the McKenzie intervention using selected bio-behavioral and physical performance measures at intake and at 5 weeks and 10 weeks after treatment.
DESIGN
A prospective cohort study with assessment at baseline and 2 follow-ups after completion of the McKenzie intervention.
SETTING
Outpatient orthopedic physical therapy clinics.
PARTICIPANTS
Sixty-two volunteers with chronic low back pain (28 men, 34 women; average ages 41.9 and 37.1 years, respectively).
METHODS
The subjects completed pain and related fear and disability questionnaires, underwent McKenzie mechanical assessment, and executed selected physical performances. They then received the McKenzie intervention.
MAIN OUTCOME MEASUREMENTS
Outcomes measurements were repeated at the end of the 5th and 10th weeks after treatment completion. Pain-related disability and fear beliefs were assessed by using the Disability Belief Questionnaire and Fear Avoidance Belief Questionnaires, respectively. The time for repeated sit to stand, trunk forward bending, and customary and fast walking were measured by stopwatch. Pain (anticipated versus actual reported) was measured before and immediately after a given physical performance. Descriptive statistics, paired t-tests, and repeated measures analysis of variance were used.
RESULTS
Significant improvements peaked at the end of the 5th week for all outcome measures (P < .001), with slight increase in bio-behavioral variables at the end of the 10th week.
CONCLUSIONS
McKenzie intervention reduced pain and related fear and disability beliefs and improved physical performances in individuals with chronic low back pain. Improvements in physical performances remained stable 10 weeks after treatment, regardless of the elevation in bio-behavioral factors.
目的
评估表现出疼痛集中现象的慢性下腰痛患者的生物行为学和身体表现特征，并使用选定的生物行为学和身体表现测量指标，在接受麦肯齐干预治疗的入组时、治疗后 5 周和 10 周时，对其进行评估。
设计
一项前瞻性队列研究，在完成麦肯齐干预治疗后进行基线和 2 次随访评估。
设置
门诊骨科物理治疗诊所。
参与者
62 名慢性下腰痛志愿者（28 名男性，34 名女性；平均年龄分别为 41.9 岁和 37.1 岁）。
方法
受试者完成疼痛和相关恐惧与残疾问卷，接受麦肯齐机械评估，并进行选定的身体表现测试。然后，他们接受了麦肯齐干预治疗。
主要观察指标
在治疗结束后的第 5 周和第 10 周结束时重复进行结果测量。使用残疾信念问卷和恐惧回避信念问卷评估与疼痛相关的残疾和恐惧信念。通过秒表测量重复坐立、躯干前屈、常规和快速行走的时间。在进行给定的身体表现之前和之后测量疼痛（预期与实际报告的疼痛）。采用描述性统计、配对 t 检验和重复测量方差分析。
结果
所有结果测量在第 5 周结束时均达到显著改善（P<0.001），生物行为学变量在第 10 周结束时略有增加。
结论
麦肯齐干预治疗可减轻慢性下腰痛患者的疼痛和相关恐惧与残疾信念，并改善其身体表现。身体表现的改善在治疗后 10 周仍然稳定，无论生物行为因素是否升高。
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