Palmer College of Chiropractic, 741 Brady St., Davenport, IA, United States.
J Electromyogr Kinesiol. 2012 Oct;22(5):670-91. doi: 10.1016/j.jelekin.2012.03.006. Epub 2012 Apr 24.
Low back pain (LBP) is a well-recognized public health problem with no clear gold standard medical approach to treatment. Thus, those with LBP frequently turn to treatments such as spinal manipulation (SM). Many clinical trials have been conducted to evaluate the efficacy or effectiveness of SM for LBP. The primary objective of this paper was to describe the current literature on patient-centered outcomes following a specific type of commonly used SM, high-velocity low-amplitude (HVLA), in patients with LBP. A systematic search strategy was used to capture all LBP clinical trials of HVLA using our predefined patient-centered outcomes: visual analogue scale, numerical pain rating scale, Roland-Morris Disability Questionnaire, and the Oswestry Low Back Pain Disability Index. Of the 1294 articles identified by our search, 38 met our eligibility criteria. Like previous SM for LBP systematic reviews, this review shows a small but consistent treatment effect at least as large as that seen in other conservative methods of care. The heterogeneity and inconsistency in reporting within the studies reviewed makes it difficult to draw definitive conclusions. Future SM studies for LBP would benefit if some of these issues were addressed by the scientific community before further research in this area is conducted.
下腰痛（LBP）是一个公认的公共卫生问题，目前尚无明确的黄金标准医学方法来治疗。因此，许多 LBP 患者经常转向治疗方法，如脊柱手法治疗（SM）。已经进行了许多临床试验来评估 SM 治疗 LBP 的疗效或有效性。本文的主要目的是描述目前关于 LBP 患者接受特定类型的常用 SM（高速度低幅度（HVLA））后以患者为中心的结局的文献。使用我们预先定义的以患者为中心的结局（视觉模拟量表、数字疼痛评分量表、Roland-Morris 残疾问卷和 Oswestry 下腰痛残疾指数），采用系统搜索策略来捕获所有 HVLA 治疗 LBP 的临床试验。在我们的搜索中，有 1294 篇文章符合我们的入选标准，其中 38 篇符合我们的入选标准。与之前的 SM 治疗 LBP 系统评价一样，本评价显示治疗效果虽小，但一致，至少与其他保守治疗方法一样大。在回顾的研究中，报告的异质性和不一致性使得很难得出明确的结论。如果在该领域进一步研究之前，科学界解决了这些问题，那么未来的 SM 治疗 LBP 的研究将受益。
