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对机械运动策略有反应的颈胸段肌肉骨骼性脊柱疼痛的诊断:一项多中心观察性研究

Diagnosis of cervical and thoracic musculoskeletal spinal pain receptive to mechanical movement strategies: a multicenter observational study.

作者信息

Luetchford Sara, Declich Maria, Tavella Roberto, Zaninelli Davide, May Stephen

机构信息

Altalena McKenzie Clinic, Milan, Italy.

Metica Medical & Physiotherapy Centre, Paderno Dugnano, Italy.

出版信息

J Man Manip Ther. 2018 Dec;26(5):292-300. doi: 10.1080/10669817.2018.1505328. Epub 2018 Aug 22.

Abstract

: The McKenzie's Mechanical Diagnosis and Therapy (MDT), which uses a combination of repeated movements and sustained positions to affect signs and symptoms, is commonly used for the conservative evaluation and management of cervical and thoracic spinal conditions. : Report a consecutive cohort of neck and thoracic pain patients managed using MDT and to record their classifications and physiotherapy management strategies. : Therapists provided demographic data on themselves and the patients, clinical data on the patients, and Neck Disability Index scores at baseline and final visit. : Sixteen therapists collected data on 138 patients at baseline, of who 120 (87%) were followed up three to five visits later; these were patients with 131 cervical and seven thoracic problems. The therapists and patients are described. Regarding MDT classifications 83% were recorded as cervical and 100% as thoracic Derangement; there was a Directional Preference for extension in 80% of cervical spine patients, and 100% of thoracic spine patients. In addition, 13% of cervical spine patients were classified as OTHER, for which specific classifications were given. Classifications remained stable between initial and discharge sessions in 94% of patients. Neck Disability Index scores reduced from a mean of 24-12 at discharge (< 0.001). : Routinely collected data can describe both therapists and patients involved, demonstrate the MDT classification clinical utility in terms of prevalence and stability between visits, provide information on the clinical course of this patients' population, which could help establish treatment efficacy. Randomized controlled trials are needed to test for efficacy.

摘要

麦肯齐力学诊断与治疗法(MDT),通过重复动作和持续姿势的组合来影响体征和症状,常用于颈椎和胸椎疾病的保守评估与管理。报告一组连续的使用MDT治疗的颈部和胸部疼痛患者,并记录他们的分类以及物理治疗管理策略。治疗师提供了关于他们自己和患者的人口统计学数据、患者的临床数据,以及基线和末次就诊时的颈部残疾指数评分。16名治疗师在基线时收集了138名患者的数据,其中120名(87%)在三到五次就诊后接受了随访;这些患者有131例颈椎问题和7例胸椎问题。对治疗师和患者进行了描述。关于MDT分类,83%被记录为颈椎疾病,100%为胸椎紊乱;80%的颈椎患者和100%的胸椎患者有伸展方向偏好。此外,13%的颈椎患者被归类为其他类型,并给出了具体分类。94%的患者在初始和出院阶段的分类保持稳定。颈部残疾指数评分从出院时的平均24降至12(<0.001)。常规收集的数据可以描述参与的治疗师和患者,从患病率和就诊间的稳定性方面展示MDT分类的临床实用性,提供关于该患者群体临床病程的信息,这有助于确定治疗效果。需要进行随机对照试验来检验疗效。

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