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胸腰段关节进行高速度低幅度(HVLA)手法整复后,内感受准确性与活动范围之间的即时效应及关联:一项随机对照试验。

Immediate effects and associations between interoceptive accuracy and range of motion after a HVLA thrust on the thoracolumbar junction: A randomised controlled trial.

作者信息

Griffiths Ffion Sian, McSweeney Terence, Edwards Darren J

机构信息

Swansea University, Swansea, UK.

Swansea University, Swansea, UK.

出版信息

J Bodyw Mov Ther. 2019 Oct;23(4):818-824. doi: 10.1016/j.jbmt.2019.06.007. Epub 2019 Jun 8.

Abstract

BACKGROUND

There is paucity in the literature regarding the role of interoceptive accuracy (IAc) at predicting the effectiveness of osteopathic techniques which increase spinal mobility when directed specifically at the thoracolumbar junction (TLJ).

AIMS

The study aimed to explore whether a high velocity, low amplitude (HVLA) thrust of the TLJ would increase spinal mobility (measured through Range of Motion; ROM) and change IAc. Also, whether baseline IAc correlated with the post-ROM measures and change in ROM.

METHOD

21 asymptomatic participants were allocated into three conditions in a randomised order. These were; (1) a high velocity low amplitude manipulation of the TLJ; (2) sham (basic touch); and (3) a control (laying supine on a plinth). Before and following each intervention, the participants' spinal ROM was measured using an Acumar digital inclinometer. In addition to this an ECG was used to measure their pre and post condition IAc.

RESULTS

There were significant increases in ROM for all condition, however, the HVLA thrust led to a significantly greater increase in ROM (p < 0.001) when compared to the control and sham. Baseline IAc was inversely associated with post-ROM but there was no association with change in ROM. The HVLA thrust did not significantly change IAc scores from pre to post intervention.

CONCLUSIONS

HVLA thrust over the TLJ is a useful intervention for increasing spinal ROM. IAc maybe a useful predictor for intervention effectiveness of this technique and spinal area which could in the future be utilised by osteopaths as part of their diagnostics.

摘要

背景

关于本体感受准确性(IAc)在预测整骨技术有效性方面的作用,文献资料匮乏,这些整骨技术专门针对胸腰段交界处(TLJ)时可增加脊柱活动度。

目的

本研究旨在探讨TLJ的高速低幅(HVLA)推力是否会增加脊柱活动度(通过活动范围;ROM测量)并改变IAc。此外,基线IAc是否与ROM测量后的值及ROM的变化相关。

方法

21名无症状参与者被随机分配到三种情况。分别是:(1)TLJ的高速低幅手法操作;(2)假操作(基本触摸);(3)对照组(仰卧在检查台上)。在每次干预前后,使用Acumar数字倾角仪测量参与者的脊柱ROM。除此之外,还使用心电图测量他们干预前后的IAc。

结果

所有情况的ROM均有显著增加,然而,与对照组和假操作相比,HVLA推力导致ROM显著更大幅度的增加(p < 0.001)。基线IAc与ROM测量后的值呈负相关,但与ROM的变化无关。从干预前到干预后,HVLA推力并未显著改变IAc评分。

结论

TLJ上的HVLA推力是增加脊柱ROM的有效干预措施。IAc可能是该技术和脊柱区域干预效果的有用预测指标,未来整骨医生可将其作为诊断的一部分加以利用。

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