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非特异性慢性下腰痛患者接受颅骨整骨手法治疗后脑电图活动的即时变化:一项随机对照交叉试验的研究方案

Immediate changes in electroencephalography activity in individuals with nonspecific chronic low back pain after cranial osteopathic manipulative treatment: study protocol of a randomized, controlled crossover trial.

作者信息

Martins Wagner Rodrigues, Diniz Leonardo Rios, Blasczyk Juscelino Castro, Lagoa Karina Ferreira, Thomaz Sérgio, Rodrigues Marcia Elisabeth, de Oliveira Ricardo Jacó, Bonini-Rocha Ana Clara

机构信息

College of Physical Therapy, University of Brasilia, Brasilia, DF, Brasil.

Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil.

出版信息

BMC Complement Altern Med. 2015 Jul 13;15:223. doi: 10.1186/s12906-015-0732-2.

Abstract

BACKGROUND

Osteopathic medicine is based on a diagnostic and therapeutic system to treat tissue mobility/ motility dysfunctions in general, using different approaches (depending on the target tissue) known as osteopathic manipulative treatment. Among the available techniques those ones addressed to the cranial field are the most questioned because of the lack of scientific evidence; but the compression of the 4th ventricle technique has been largely studied in clinical trials. Studies have shown that the technique may affect both central and autonomous nervous system, modulating some reflexes (Traube-Hering baro signal), and modifying brain cortex electrical activity through central sensitization in subjects with chronic low back pain. Thus, investigators hypothesize that the compression of the 4th ventricle may modulate peak alpha frequency (eletroencephalographic assessment) and promote physical relaxation in subjects in vigil.

METHODS/DESIGN: A randomized, controlled crossover trial with blinded assessor was designed to test the hypothesis. A total of 81 participants will be assigned to three treatment conditions, with seven days of washout: (I) compression of the 4th ventricle; (II) sham compression of the fourth ventricle; (III) control (no intervention). The (I) power amplitude and the (II) frequencies of the dominant peak in the alpha band will be the primary outcome measures of the study. All participants will be recruited at the Outpatient Rehabilitation Service of the University Hospital of Brasília-University of Brasília. All the electroencephalographic exams will be conducted by a blinded assessor.

DISCUSSION

The investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation.

TRIAL REGISTRATION

NCT02111382.

摘要

背景

整骨医学基于一种诊断和治疗系统,总体上用于治疗组织活动度/运动功能障碍,采用不同方法(取决于目标组织),即整骨手法治疗。在现有技术中,针对颅部区域的技术因缺乏科学证据而受到最多质疑;但第四脑室压迫技术已在临床试验中得到大量研究。研究表明,该技术可能影响中枢和自主神经系统,调节一些反射(特劳贝-黑林压力信号),并通过慢性下腰痛患者的中枢敏化作用改变大脑皮层电活动。因此,研究人员推测,第四脑室压迫可能调节峰值阿尔法频率(脑电图评估),并促进清醒状态下受试者的身体放松。

方法/设计:设计了一项由盲法评估者进行的随机对照交叉试验来检验该假设。总共81名参与者将被分配到三种治疗条件下,洗脱期为七天:(I)第四脑室压迫;(II)第四脑室假压迫;(III)对照(无干预)。阿尔法波段中(I)功率幅值和(II)主峰频率将作为该研究的主要结局指标。所有参与者将在巴西利亚大学大学医院门诊康复服务中心招募。所有脑电图检查将由一名盲法评估者进行。

讨论

研究人员推测,接受该技术治疗的慢性下腰痛患者的峰值阿尔法频率将得到调节,从而体验到身体放松。

试验注册

NCT02111382。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60fc/4499448/3a750ad385b8/12906_2015_732_Fig1_HTML.jpg

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