Learman Kenneth E, Showalter Christopher, O'Halloran Bryan, Cook Chad E
Department of Physical Therapy, Youngstown State University, Youngstown, Ohio 44555, USA.
J Manipulative Physiol Ther. 2013 Jun;36(5):284-91. doi: 10.1016/j.jmpt.2013.05.007. Epub 2013 Jun 12.
The purpose of the study was to compare the effects of thrust manipulation (TM) and non-TM (NTM) on a sample of older subjects with low back pain.
This is a secondary data analysis of a randomized control trial. Forty-nine subjects aged 55 to 88 years participated in the trial, who received either a TM or NTM on at least 2 occasions during the course of care, and were extracted from the larger data set. The treatment program included a standardized home exercise program for the first 2 sessions, which could be modified by the therapist after those 2 sessions. Numeric pain rating scale and Oswestry Disability Index (ODI) were the outcomes for this study.
Multivariate analysis revealed no significant between-group differences for treatment group (P=.99) without group×time interaction (P=.90). Significant within-group changes were observed for both groups for ODI and numeric pain rating scale (P<.001); the average self-report of recovery was 78.0% (SD, 19.8%). Age stratification of the older subset revealed between-group differences in ODI change scores for the oldest subjects (>70 years) compared with 60 to 69 years (P=.02).
This study showed that outcomes for both TM and NTM improved in older adults with low back pain.
本研究旨在比较推力手法治疗(TM)和非推力手法治疗(NTM)对老年腰痛患者样本的影响。
这是一项对随机对照试验的二次数据分析。49名年龄在55至88岁之间的受试者参与了该试验,他们在治疗过程中至少接受了2次TM或NTM治疗,并从更大的数据集中提取。治疗方案在前2次治疗中包括标准化的家庭锻炼计划,在这2次治疗后可由治疗师进行调整。数字疼痛评分量表和Oswestry功能障碍指数(ODI)是本研究的结果指标。
多变量分析显示,治疗组之间无显著组间差异(P = 0.99),且无组×时间交互作用(P = 0.90)。两组在ODI和数字疼痛评分量表上均观察到显著的组内变化(P < 0.001);平均自我报告的恢复率为78.0%(标准差,19.8%)。对老年亚组进行年龄分层后发现,与60至69岁的受试者相比,年龄最大的受试者(>70岁)在ODI变化评分上存在组间差异(P = 0.02)。
本研究表明,TM和NTM对老年腰痛患者的治疗效果均有所改善。