用于腰痛诊断的筋膜手法与标准物理治疗实践：一项实用研究。

Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study.

作者信息

Harper Brent, Steinbeck Larry, Aron Adrian

机构信息

Radford University, Doctor of Physical Therapy Program, College of Health and Human Services, USA.

出版信息

J Bodyw Mov Ther. 2019 Jan;23(1):115-121. doi: 10.1016/j.jbmt.2018.10.007. Epub 2018 Nov 3.

DOI:10.1016/j.jbmt.2018.10.007

PMID:30691738

Abstract

BACKGROUND

Connective tissue mobility alters motor unit recruitment, but the restoration of fascial mobility allows for optimal motor function. The Fascial Manipulation (FM) method is a multiplanar approach that assesses and treats the mobility of deep fascia in specific anatomical locations where motor units converge.

OBJECTIVES

To assess the effects of FM vs. standard physical therapy treatment (SPT) in patients with low back pain (LBP).

DESIGN

Six-months controlled clinical trial.

METHOD

102 participants with LBP received SPT or FM. Numeric Pain Rating Scale (NPRS), 15- point Global Rating of Change (GROC), and Oswestry Disability Index (ODI) were used to monitor progress.

RESULTS

The FM group had a significantly lower ODI (p < 0.009) and NPS scores (p < 0.0001) and significantly higher GROC scores (p < 0.003) once their means were adjusted for initial scores. When comparing the SPT to FM, the final ODI decreased by at least 1 category in 48.9% of the SPT cases, while in 36.2% of the cases was no change. ODI minimal clinical importance difference (MCID) change of 10% decrease in scores occurred in 70.2% of the SPT group compared to 96% of the FM group (p = 0.003). ODI MCID change of 50% decrease in scores occurred in 40% of the SPT group compared to 64.6% of the FM group (p = 0.02) 44.7% of the participants in the SPT group had final GROC values above +5 at discharge, compared to 92% of the participants from the FM group (p = 0.0001). The FM subjects had almost three times the change in NPRS compared to SPT counterparts (-4.3 ± 2.2 to -1.5  ± 2.4, p=0.0001).

CONCLUSIONS

FM appears to improve NPRS, GROC, and ODI more than SPT. FM may provide an effective treatment technique for LBP.

摘要

背景

结缔组织的流动性会改变运动单位的募集，而筋膜流动性的恢复有助于实现最佳运动功能。筋膜手法（FM）是一种多平面方法，用于评估和治疗运动单位汇聚的特定解剖位置处深筋膜的流动性。

目的

评估FM与标准物理治疗（SPT）对腰痛（LBP）患者的疗效。

设计

为期六个月的对照临床试验。

方法

102名LBP患者接受了SPT或FM治疗。使用数字疼痛评分量表（NPRS）、15分整体变化评分（GROC）和奥斯威斯利残疾指数（ODI）来监测进展情况。

结果

在对初始分数进行调整后，FM组的ODI（p < 0.009）和NPS分数（p < 0.0001）显著更低，GROC分数显著更高（p < 0.003）。将SPT与FM进行比较时，在48.9%的SPT病例中，最终ODI至少降低了1个类别，而在36.2%的病例中没有变化。在SPT组中，70.2%的患者ODI最小临床重要差异（MCID）分数下降了10%，而FM组为96%（p = 0.003）。在SPT组中，40%的患者ODI MCID分数下降了50%，而FM组为64.6%（p = 0.02）。在出院时，SPT组44.7%的参与者最终GROC值高于+5，而FM组为92%（p = 0.0001）。与SPT组相比，FM组受试者的NPRS变化几乎是其三倍（从-4.3 ± 2.2变为-1.5 ± 2.4，p = 0.0001）。