Dudzic Jason, Szymusiak Brett, McCormick Hannah, Miller Eric R
Hamot Medical Center, Orthopaedic Institute, Erie, PA, USA.
J Man Manip Ther. 2011 Feb;19(1):42-7. doi: 10.1179/106698110X12804993427081.
A 15-year-old female presented to physical therapy 2 months after a traumatic injury with severe low back pain, referred unilateral leg pain below the knee, and a lumbar lateral shift. A classification-based approach, mechanical diagnosis and therapy, was utilized to identify the patient with respect to a particular subgroup, and interventions were applied according to symptomatic response to loading strategies, sustained and repeated movements. Outcome measures included the Modified Oswestry Disability Questionnaire (MODQ) and a visual analog scale (VAS) for pain rating. After nine visits (4 weeks), there was a 60% improvement in MODQ score, 0/10 pain on the VAS, and the patient resumed participation in recreational activities. At the 1-year follow-up, there was a 78% overall improvement in MODQ score with continued 0/10 rated pain. Improvements after nine visits and at the 1-year follow-up both exceeded the minimal clinically important difference for the MODQ.
一名15岁女性在创伤性损伤后2个月前来接受物理治疗，伴有严重的下背部疼痛、膝盖以下单侧腿部放射性疼痛以及腰椎侧移。采用基于分类的方法，即机械诊断与治疗，来确定该患者所属的特定亚组，并根据对负荷策略、持续和重复运动的症状反应进行干预。结果测量包括改良奥斯威斯利功能障碍问卷（MODQ）和用于疼痛评分的视觉模拟量表（VAS）。经过9次就诊（4周）后，MODQ评分提高了60%，VAS疼痛评分为0/10，患者恢复了参加娱乐活动。在1年随访时，MODQ评分总体提高了78%，疼痛评分持续为0/10。9次就诊后和1年随访时的改善均超过了MODQ的最小临床重要差异。
