Vanti Carla, Ferrari Silvano, Berjano Pedro, Villafañe Jorge Hugo, Monticone Marco
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Department of Biomedical Sciences, University of Padova, Padua, Italy.
Physiother Res Int. 2017 Oct;22(4). doi: 10.1002/pri.1682. Epub 2017 Jan 6.
To date no study was made on the responsiveness of Bridge tests (BTs) in subjects with low back pain and spondylolisthesis (SPL) submitted to a physical therapy program. The objective of this study is to examine the responsiveness of the BTs in subjects with symptomatic lumbar SPL.
One hundred twenty patients with symptomatic SPL received physical therapy treatments for a number of sessions depending on the individual patient's needs. Each session included supervised exercises and the teaching of home exercises aiming to improve the lumbar stability, for about 1 hr in total. At the beginning and immediately after the last session of treatment, participants completed the Oswestry Disability Index - Italian version and the Pain Numerical Rating Scale, and performed the supine bridging (SBT) and the prone bridging (PBT). The global perception of effectiveness was measured with a seven-point Likert scale Global Perceived Effect questionnaire.
The mean post-treatment change score (95% confidence interval [CI]) was 18.2 s (14.5; 21.9) for the PBT and 43.9 s (35.1; 52.8) for the SBT, all p < .001. The area under the receiver operating characteristic curve for the PBT was 0.83 (95% CI 0.74-0.91) and for the SBT was 0.703 (95% CI 0.61-0.80). The optimal cutoff points were 19.5 s for the PBT and 62.5 s for the SBT. Logistic regression revealed that PBT (odds ratio = 0.952) was associated with the type of SPL. The final regression model explained 36.4% (R = 0.36; p = .001) of the variability.
Bridge maneuvers proved to be responsive, because their results were significantly related to pain and disability changes. BTs may be suggested to detect clinical changes after physical therapy treatment in symptomatic SPL. Copyright © 2017 John Wiley & Sons, Ltd.
迄今为止，尚未有关于接受物理治疗计划的腰痛和腰椎滑脱（SPL）患者的桥式试验（BTs）反应性的研究。本研究的目的是检验BTs在有症状的腰椎SPL患者中的反应性。
120例有症状的SPL患者根据个体需求接受了若干疗程的物理治疗。每个疗程包括有监督的锻炼和家庭锻炼指导，旨在改善腰椎稳定性，总共约1小时。在治疗的第一疗程开始时和最后一疗程结束后，参与者完成了奥斯威斯利残疾指数意大利语版和疼痛数字评定量表，并进行了仰卧位桥式试验（SBT）和俯卧位桥式试验（PBT）。用七点李克特量表全球感知效果问卷测量总体疗效感知。
PBT治疗后平均变化得分（95%置信区间[CI]）为18.2秒（14.5；21.9），SBT为43.9秒（35.1；52.8），所有p<0.001。PBT的受试者工作特征曲线下面积为0.83（95%CI 0.74 - 0.91），SBT为0.703（95%CI 0.61 - 0.80）。PBT的最佳截断点为19.5秒，SBT为62.5秒。逻辑回归显示PBT（优势比 = 0.952）与SPL类型相关。最终回归模型解释了36.4%（R = 0.36；p = 0.001）的变异性。
桥式动作被证明具有反应性，因为其结果与疼痛和残疾变化显著相关。对于有症状的SPL患者，在物理治疗后，可建议采用BTs来检测临床变化。版权所有© 2017约翰·威利父子有限公司。
