Melkersson Camilla, Nasic Salmir, Starzmann Karin, Bengtsson Boström Kristina
Närhälsan, R&D Centre, Skaraborg Primary Care, Skövde, Sweden.
J Chiropr Med. 2017 Sep;16(3):211-219. doi: 10.1016/j.jcm.2017.05.003. Epub 2017 Jul 25.
The objective of this study was to investigate if the research process to evaluate the effect of foot manipulation on pregnancy-related pelvic girdle pain (PPGP) is feasible.
A randomized, single-blind (patients and evaluators) pilot trial was performed to compare foot manipulation to a comparative group at 6-weekly treatment sessions at 5 physiotherapy outpatient clinics in Skaraborg primary care (Skövde, Sweden). Women at 12 to 31 weeks of pregnancy with well-defined PPGP (n = 97) and joint dysfunction or decreased range of movement in the feet were included. Women with a twin pregnancy, low back pain, rheumatoid arthritis, or other serious diseases and those who had previous foot manipulation were excluded. Visual analog scale scores were recorded before study start, before and after each treatment session, and 3 months after delivery.
One-hundred and two women were eligible, and 97 were included (group 1: foot manipulation, n = 47; group 2: comparative treatment, n = 50); 40 and 36 in the foot manipulation and comparative treatment groups, respectively, completed the study. The foot manipulation group had a nonsignificant pain relief score compared with that of the comparative group, which had higher pain relief scores. The difference was most pronounced at the first and second treatment sessions. A power analysis showed that at least 250 individuals would be needed in each group to confirm the effect of foot manipulation.
This study showed that it is feasible to assess the effect of foot manipulation on PPGP in a multicenter physical therapy outpatient clinic setting. A new larger study should choose a different comparative method and test this hypothesis in a full-scale trial.
本研究旨在调查评估足部推拿对妊娠相关骨盆带疼痛(PPGP)影响的研究过程是否可行。
在瑞典斯科讷省初级保健(舍夫德)的5家物理治疗门诊进行了一项随机、单盲(患者和评估者)试点试验,将足部推拿与对照组进行比较,治疗周期为每6周一次。纳入妊娠12至31周、PPGP明确(n = 97)且足部有关节功能障碍或活动范围减小的女性。排除双胎妊娠、腰痛、类风湿关节炎或其他严重疾病的女性以及既往接受过足部推拿的女性。在研究开始前、每次治疗前后以及分娩后3个月记录视觉模拟量表评分。
102名女性符合条件,97名被纳入研究(第1组:足部推拿,n = 47;第2组:对照治疗,n = 50);足部推拿组和对照治疗组分别有40名和36名完成研究。与对照组相比,足部推拿组的疼痛缓解评分无显著差异,对照组的疼痛缓解评分更高。这种差异在第一次和第二次治疗时最为明显。功效分析表明,每组至少需要250名个体才能证实足部推拿的效果。
本研究表明,在多中心物理治疗门诊环境中评估足部推拿对PPGP的影响是可行的。一项新的更大规模研究应选择不同的对照方法,并在全面试验中验证这一假设。