J Orthop Sports Phys Ther. 2016 May;46(5):391-8. doi: 10.2519/jospt.2016.6366. Epub 2016 Apr 6.
Study Design Case series. Background Low back pain (LBP) is an increasing problem in health care. The evidence for the use of spinal manipulative therapy to treat pediatric patients with LBP is minimal. The treatment of pediatrics with manual therapy, particularly spinal manipulation, is controversial within the medical community, primarily with respect to adverse events. The purpose of this case series was to illustrate the feasibility and safety of lumbar manipulation plus exercise in the adolescent population with mechanical LBP. Case Description Three patients-a 13-year-old adolescent girl, 15-year-old adolescent girl, and 13-year-old adolescent boy-were treated in an outpatient physical therapy setting for mechanical LBP. All 3 patients were assessed using a lumbar manipulation clinical prediction rule and treated with sidelying lumbar manipulation and exercise. Outcomes Patients were treated for a total of 10 to 14 visits over a course of 8 to 9 weeks. Pain (measured by a numeric pain-rating scale) and disability (measured by the modified Oswestry Disability Index) improved to 0/10 and 0%, respectively, in each patient. No adverse reactions to manipulation were reported. Discussion The results of this case series describe the use of lumbar thrust manipulation and exercise for the treatment of mechanical LBP in adolescents. The positive results indicate that lumbar manipulation may be a safe adjunct therapy. Further studies, including randomized controlled trials, are needed to determine effectiveness. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(5):391-398. Epub 6 Apr 2016. doi:10.2519/jospt.2016.6366.
病例系列。背景：下腰痛（LBP）是医疗保健中日益严重的问题。使用脊柱手法治疗治疗患有 LBP 的儿科患者的证据很少。在医学界，对儿科患者进行手法治疗，特别是脊柱手法治疗，存在争议，主要涉及不良事件。本病例系列的目的是说明在患有机械性 LBP 的青少年人群中进行腰椎推拿加运动治疗的可行性和安全性。病例描述：3 名患者，一名 13 岁的少女、一名 15 岁的少女和一名 13 岁的少年，在门诊物理治疗环境中接受机械性 LBP 的治疗。所有 3 名患者均使用腰椎推拿临床预测规则进行评估，并接受侧卧位腰椎推拿和运动治疗。结果：患者总共接受了 10 至 14 次治疗，疗程为 8 至 9 周。每位患者的疼痛（用数字疼痛评分量表测量）和残疾（用改良 Oswestry 残疾指数测量）均改善至 0/10 和 0%。没有报告手法治疗的不良反应。讨论：本病例系列的结果描述了使用腰椎推挤手法和运动治疗青少年的机械性 LBP。阳性结果表明，腰椎推拿可能是一种安全的辅助治疗方法。需要进一步的研究，包括随机对照试验，以确定其有效性。证据级别：治疗，4 级。《矫形与运动物理治疗杂志》2016 年；46（5）：391-398。在线 2016 年 4 月 6 日。doi：10.2519/jospt.2016.6366.
