Department of Physiotherapy, Faculty of Medicine, Espinardo Campus, University of Murcia, Murcia 30100, Spain.
BMC Musculoskelet Disord. 2013 Feb 2;14:55. doi: 10.1186/1471-2474-14-55.
Low back pain (LBP) in adolescents is associated with LBP in later years. In recent years treatments have been administered to adolescents for LBP, but it is not known which physical therapy treatment is the most efficacious. By means of a meta-analysis, the current study investigated the effectiveness of the physical therapy treatments for LBP in children and adolescents.
Studies in English, Spanish, French, Italian and Portuguese, and carried out by March 2011, were selected by electronic and manual search. Two independent researchers coded the moderator variables of the studies, and performed the effect size calculations. The mean effect size index used was the standardized mean change between the pretest and posttest, and it was applied separately for each combination of outcome measures, (pain, disability, flexibility, endurance and mental health) and measurement type (self-reports, and clinician assessments).
Eight articles that met the selection criteria enabled us to define 11 treatment groups and 5 control groups using the group as the unit of analysis. The 16 groups involved a total sample of 334 subjects at the posttest (221 in the treatment groups and 113 in the control groups). For all outcome measures, the average effect size of the treatment groups was statistically and clinically significant, whereas the control groups had negative average effect sizes that were not statistically significant.
Of all the physical therapy treatments for LBP in children and adolescents, the combination of therapeutic physical conditioning and manual therapy is the most effective. The low number of studies and control groups, and the methodological limitations in this meta-analysis prevent us from drawing definitive conclusions in relation to the efficacy of physical therapy treatments in LBP.
青少年腰痛(LBP)与日后的腰痛有关。近年来,已经对青少年的 LBP 进行了治疗,但尚不清楚哪种物理治疗最有效。通过荟萃分析,本研究调查了儿童和青少年 LBP 的物理治疗效果。
选择了 2011 年 3 月前发表的英文、西班牙文、法文、意大利文和葡萄牙文的研究。两位独立的研究人员对研究的调节变量进行了编码,并进行了效应量计算。使用的平均效应量指标是前后测试之间的标准化平均变化,分别针对每种结果测量(疼痛、残疾、柔韧性、耐力和心理健康)和测量类型(自我报告和临床医生评估)进行应用。
符合选择标准的 8 篇文章使我们能够使用组作为分析单位定义 11 个治疗组和 5 个对照组。16 个组共涉及 334 名受试者的后期测试(治疗组 221 名,对照组 113 名)。对于所有结果测量,治疗组的平均效应量在统计学和临床上均有显著意义,而对照组的平均效应量为负且无统计学意义。
在儿童和青少年腰痛的所有物理治疗中,治疗性身体调理和手法治疗的组合是最有效的。荟萃分析中的研究和对照组数量较少以及方法学限制,使我们无法对物理治疗治疗 LBP 的疗效得出明确的结论。