Stowell Thomas, Schenk Ronald, Hellman Madeleine, Ladeira Carlos
School of PA Studies, MCPHS University, Manchester, NH, USA.
Physical Therapy Department, Daemen College, Amherst, NY, USA.
J Man Manip Ther. 2018 Feb;26(1):43-51. doi: 10.1080/10669817.2017.1370521. Epub 2017 Sep 4.
To investigate the relationship between clinical outcome and the types of end range procedures used to achieve centralization in a sample of patients with low back pain (LBP) and/or peripheral symptoms.
Small sample retrospective analysis of an observational cohort. Patients with LBP who centralized during initial visit at two physical therapy clinics were recruited to participate. The types of end range procedures used to achieve centralization were documented during each office visit and a chart review was performed after 4 weeks. Outcomes were determined by improvement in the Oswestry Disability Index (ODI) score after 4 weeks. Statistical analysis determined the association between the types of end range procedures and outcomes.
Thirty-one patients gave consent to participate. Nineteen patients met inclusion criteria and were included in data analysis. After 4 weeks, the improvement in mean ODI scores was 15.89 ± 16.28. Differing end range procedures were used to achieve centralization within this cohort. The types of end range procedures used to achieve centralization were not significantly associated with outcomes.
The results observed in this study promote exhausting many different types of end range procedures to determine if centralization can be achieved. Limiting the end range procedures used to assess centralization may fail to identify patients who can achieve centralization and subsequently have positive clinical outcomes. Larger cohort studies investigating relationships between outcomes and the types of end range procedures used to achieve centralization would contribute to management of people with LBP.
在一组伴有下腰痛（LBP）和/或外周症状的患者样本中，研究临床结局与用于实现症状集中化的终末范围治疗程序类型之间的关系。
对一个观察性队列进行小样本回顾性分析。招募在两家物理治疗诊所初诊时症状出现集中化的LBP患者参与研究。每次门诊就诊时记录用于实现症状集中化的终末范围治疗程序类型，并在4周后进行病历审查。结局通过4周后Oswestry功能障碍指数（ODI）评分的改善情况来确定。统计分析确定终末范围治疗程序类型与结局之间的关联。
31名患者同意参与研究。19名患者符合纳入标准并被纳入数据分析。4周后，平均ODI评分的改善为15.89±16.28。该队列中使用了不同的终末范围治疗程序来实现症状集中化。用于实现症状集中化的终末范围治疗程序类型与结局无显著关联。
本研究观察到的结果促使我们尝试多种不同类型的终末范围治疗程序，以确定是否能够实现症状集中化。限制用于评估症状集中化的终末范围治疗程序可能无法识别出能够实现症状集中化并随后获得良好临床结局的患者。开展更大规模的队列研究，调查结局与用于实现症状集中化的终末范围治疗程序类型之间的关系，将有助于LBP患者的管理。
4级。
