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肾结石患者胸腰段交界处手法治疗后痛觉测量、倾角测量、姿势稳定测量及尿液pH分析的短期变化

Short-Term Changes in Algometry, Inclinometry, Stabilometry, and Urinary pH Analysis After a Thoracolumbar Junction Manipulation in Patients with Kidney Stones.

作者信息

Oliva Pascual-Vaca Ángel, Punzano-Rodríguez Ramón, Escribá-Astaburuaga Pablo, Fernández-Domínguez Juan Carlos, Ricard François, Franco-Sierra Maria Angeles, Rodríguez-Blanco Cleofás

机构信息

1 Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain .

2 Madrid Osteopathic School , Valencia, Spain .

出版信息

J Altern Complement Med. 2017 Aug;23(8):639-647. doi: 10.1089/acm.2017.0041. Epub 2017 May 24.

Abstract

OBJECTIVES

To determine the efficacy of a high-velocity low-amplitude manipulation of the thoracolumbar junction in different urologic and musculoskeletal parameters in subjects suffering from renal lithiasis.

DESIGN

Randomized, controlled blinded clinical study.

SETTINGS/LOCATION: The Nephrology departments of two hospitals and one private consultancy of physiotherapy in Valencia (Spain).

SUBJECTS

Forty-six patients suffering from renal lithiasis.

INTERVENTIONS

The experimental group (EG, n = 23) received a spinal manipulation of the thoracolumbar junction, and the control group (CG, n = 23) received a sham procedure.

OUTCOME MEASURES

Pressure pain thresholds (PPTs) of both quadratus lumborum and spinous processes from T10 to L1, lumbar flexion range of motion, stabilometry, and urinary pH were measured before and immediately after the intervention. A comparison between pre- and postintervention phases was performed and an analysis of variance for repeated measures using time (pre- and postintervention) as intrasubject variable and group (CG or EG) as intersubject variable.

RESULTS

Intragroup comparison showed a significant improvement for the EG in the lumbar flexion range of motion (p < 0.001) and in all the PPT (p < 0.001 in all cases). Between-group comparison showed significant changes in PPT in quadratus lumborum (p < 0.001), as well as in the spinous processes of all of the evaluated levels (p < 0.05). No changes in urinary pH were observed (p = 0.419).

CONCLUSION

Spinal manipulation of the thoracolumbar junction seems to be effective in short term to improve pain sensitivity, as well as to increase the lumbar spine flexion.

摘要

目的

确定在患有肾结石的受试者中,胸腰段关节的高速低振幅手法治疗在不同泌尿系统和肌肉骨骼参数方面的疗效。

设计

随机、对照、双盲临床研究。

地点

西班牙巴伦西亚两家医院的肾病科和一家私人物理治疗咨询机构。

受试者

46例肾结石患者。

干预措施

实验组(EG,n = 23)接受胸腰段关节的脊柱手法治疗,对照组(CG,n = 23)接受假手术。

观察指标

在干预前和干预后立即测量腰方肌和T10至L1棘突的压力痛阈(PPT)、腰椎前屈活动范围、姿势稳定分析和尿液pH值。对干预前和干预后阶段进行比较,并以时间(干预前和干预后)作为受试者内变量、组(CG或EG)作为受试者间变量进行重复测量方差分析。

结果

组内比较显示,实验组在腰椎前屈活动范围(p < 0.001)和所有PPT方面均有显著改善(所有病例p < 0.001)。组间比较显示,腰方肌的PPT以及所有评估节段棘突的PPT均有显著变化(p < 0.001),所有评估节段棘突的PPT也有显著变化(p < 0.05)。未观察到尿液pH值的变化(p = 0.419)。

结论

胸腰段关节的脊柱手法治疗在短期内似乎能有效改善疼痛敏感性,并增加腰椎前屈。

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