物理治疗师实施脊柱推拿治疗腰痛的有效性：文献系统综述
Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain: a systematic review of the literature.
作者信息
Kuczynski John J, Schwieterman Braun, Columber Kirby, Knupp Darren, Shaub Lauren, Cook Chad E
机构信息
Walsh University, North Canton, OH, USA.
出版信息
Int J Sports Phys Ther. 2012 Dec;7(6):647-62.
BACKGROUND CONTEXT
Low back pain (LBP) is a prevalent disorder in society that has been associated with increased loss of work time and medical expenses. A common intervention for LBP is spinal manipulation, a technique that is not specific to one scope of practice or profession.
PURPOSE
The purpose of this systematic review was to examine the effectiveness of physical therapy spinal manipulations for the treatment of patients with low back pain.
METHODS
A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, Pro Quest Nursing and Allied Health Source, Scopus, and Cochrane Controlled Trials Register. Studies were included if each involved: 1) individuals with LBP; 2) spinal manipulations performed by physical therapists compared to any control group that did not receive manipulations; 3) measurable clinical outcomes or efficiency of treatment measures, and 4) randomized control trials. The quality of included articles was determined by two independent authors using the criteria developed and used by the Physiotherapy Evidence Database (PEDro).
RESULTS
Six randomized control trials met the inclusion criteria of this systematic review. The most commonly used outcomes in these studies were some variation of pain rating scales and disability indexes. Notable results included varying degrees of effect sizes favoring physical therapy spinal manipulations and minimal adverse events resulting from this intervention. Additionally, the manipulation group in one study reported statistically significantly less medication use, health care utilization, and lost work time.
CONCLUSION
Based on the findings of this systematic review there is evidence to support the use of spinal manipulation by physical therapists in clinical practice. Physical therapy spinal manipulation appears to be a safe intervention that improves clinical outcomes for patients with low back pain.
背景
下腰痛（LBP）是一种在社会中普遍存在的疾病，与工作时间损失和医疗费用增加有关。LBP的一种常见干预措施是脊柱推拿，这是一种并非特定于某一执业范围或专业的技术。
目的
本系统评价的目的是检验物理治疗脊柱推拿对下腰痛患者的治疗效果。
方法
使用PubMed、CINAHL、SPORTDiscus、Pro Quest护理与联合健康资源库、Scopus和Cochrane对照试验注册库对当前文献进行检索。纳入的研究需满足以下条件：1）患有LBP的个体；2）物理治疗师进行的脊柱推拿与未接受推拿的任何对照组相比；3）可测量的临床结果或治疗措施的有效性，以及4）随机对照试验。两名独立作者使用物理治疗证据数据库（PEDro）制定和使用的标准确定纳入文章的质量。
结果
六项随机对照试验符合本系统评价的纳入标准。这些研究中最常用的结果是疼痛评分量表和残疾指数的某种变体。显著结果包括不同程度的效应量有利于物理治疗脊柱推拿，且该干预导致的不良事件最少。此外，一项研究中的推拿组报告在药物使用、医疗保健利用和工作时间损失方面在统计学上显著更少。
结论
基于本系统评价的结果，有证据支持物理治疗师在临床实践中使用脊柱推拿。物理治疗脊柱推拿似乎是一种安全的干预措施，可改善下腰痛患者的临床结果。
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