Muehlemann Malin B, Peterson Cynthia K, Humphreys B Kim
Chiropractic Medicine, Faculty of Medicine, University of Zürich, Zürich, Switzerland.
Orthopedic Chiropractic Medicine, Faculty of Medicine, University Hospital Balgrist, Zürich, Switzerland.
J Manipulative Physiol Ther. 2017 Jul-Aug;40(6):420-426. doi: 10.1016/j.jmpt.2017.05.001. Epub 2017 Jun 21.
The purpose of this study was to compare treatment outcomes of low back pain patients depending on the sex of the treating doctor of chiropractic (DC).
For this study, 1095 adult patients with no manual therapy in the prior 3 months were recruited. Pretreatment pain levels (Numeric Rating Scale for pain [NRS]), Oswestry Disability Index (ODI), and patient demographic details were recorded. The NRS and Patient Global Impression of Change were assessed after 1 week and 1, 3, 6, and 12 months. The ODI was completed up to 3 months. The χ test compared sex of the DC with the proportion of patients "improved" at all time points and with baseline categorical variables. The unpaired t test compared changes in NRS and ODI scores between patients of male and female DCs.
Female DCs saw proportionally more acute patients (P = .012). Patients of male DCs presented more often with radiculopathy (P = .007). There were no differences in NRS and ODI baseline scores between male and female DCs' patients. At 1 week and 3 and 12 months, significantly more patients of female DCs reported improvement and they had greater decreases in NRS and ODI scores at 1 week. Removing acute patients from the data, there were no longer differences in outcome.
Significant differences in treatment outcome in favor of female DCs was no longer present on removal of the acute subgroup from the data. This suggests that patient outcome is influenced by other factors, such as chronicity, rather than sex of the treating DC.
本研究旨在比较根据脊椎按摩治疗师（DC）性别分类的下背痛患者的治疗结果。
本研究招募了1095名在过去3个月内未接受过手法治疗的成年患者。记录治疗前的疼痛水平（疼痛数字评定量表[NRS]）、奥斯维斯特残疾指数（ODI）以及患者的人口统计学详细信息。在1周、1、3、6和12个月后评估NRS和患者总体改善印象。ODI评估持续至3个月。χ检验比较DC的性别与所有时间点“改善”患者的比例以及基线分类变量。独立样本t检验比较男性和女性DC的患者之间NRS和ODI评分的变化。
女性DC接诊的急性患者比例相对更高（P = 0.012）。男性DC的患者神经根病的发病率更高（P = 0.007）。男性和女性DC的患者之间NRS和ODI基线评分没有差异。在1周、3个月和12个月时，女性DC的患者中报告病情改善的明显更多，并且在1周时他们的NRS和ODI评分下降幅度更大。从数据中剔除急性患者后，结果不再有差异。
从数据中剔除急性亚组后，治疗结果有利于女性DC的显著差异不再存在。这表明患者的治疗结果受其他因素影响，如病程长短因素，而非治疗DC的性别。
