Galleher Mindy, Crowe Briana, Selhorst Mitchell
Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, Columbus, OH, USA.
J Man Manip Ther. 2017 Dec;25(5):288-293. doi: 10.1080/10669817.2017.1314583. Epub 2017 Apr 9.
The purposes of this study were to: (1) assess the benefit of adding manual therapy (MT) to physical therapy care in pediatric patients with anterior hip pain; (2) assess the relative risk of adverse reactions when MT is used; and (3) report the types of MT used.
This study was a retrospective chart review of patients treated in a hospital-based sports medicine clinic. The charts of 201 patients (mean age = 14.23 ± 2.15 years) met the inclusion criteria and were reviewed. Patients were grouped into those who received MT during their episode of care, and those who did not. Pain efficiency (change in pain/number of visits), number and type of adverse reactions, as well as frequency and type of manual therapy interventions used, were the outcomes of interest.
The mean pain efficiency was significantly less if manual therapy was performed (MT = 0.60 [95% CI 0.47-0.72], no MT = 0.80 [95% CI 0.71-0.90] = 0.01). There was no significant difference between groups in risk of adverse reactions (MT = 5, no MT = 5). The number of visits was significantly different between groups (MT = 9.43 ± 3.9 sessions, and no MT = 7.6 ± 5.2 sessions).
MT did not increase the risk of an adverse reaction in pediatric patients with anterior hip pain. While it appears to be a safe intervention, it did not improve pain efficiency or patient adherence. Future research should be performed to assess the effectiveness of MT, when performed by skilled therapists, in pediatric patients with hip pain in a controlled manner. 3b.
本研究的目的是：（1）评估在患有髋关节前侧疼痛的儿科患者的物理治疗中增加手法治疗（MT）的益处；（2）评估使用MT时出现不良反应的相对风险；（3）报告所使用的MT类型。
本研究是对一家医院运动医学诊所治疗的患者进行的回顾性病历审查。201例患者（平均年龄 = 14.23±2.15岁）的病历符合纳入标准并进行了审查。患者被分为在护理期间接受MT的患者和未接受MT的患者。疼痛效率（疼痛变化/就诊次数）、不良反应的数量和类型，以及所使用的手法治疗干预的频率和类型，是感兴趣的结果。
如果进行手法治疗，平均疼痛效率显著更低（MT = 0.60 [95% CI 0.47 - 0.72]，无MT = 0.80 [95% CI 0.71 - 0.90] = 0.01）。两组在不良反应风险方面无显著差异（MT组 = 5例，无MT组 = 5例）。两组之间的就诊次数有显著差异（MT组 = 9.43±3.9次，无MT组 = 7.6±5.2次）。
MT并未增加患有髋关节前侧疼痛的儿科患者出现不良反应的风险。虽然它似乎是一种安全的干预措施，但它并未提高疼痛效率或患者依从性。未来应进行研究，以评估由熟练治疗师进行的MT在患有髋关节疼痛的儿科患者中的有效性，采用对照方式进行。3b。
