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桡侧体外冲击波疗法对慢性下腰痛患者疼痛强度、功能效率和姿势控制参数的影响:一项随机临床试验

Effect of Radial Extracorporeal Shock Wave Therapy on Pain Intensity, Functional Efficiency, and Postural Control Parameters in Patients with Chronic Low Back Pain: A Randomized Clinical Trial.

作者信息

Walewicz Karolina, Taradaj Jakub, Dobrzyński Maciej, Sopel Mirosław, Kowal Mateusz, Ptaszkowski Kuba, Dymarek Robert

机构信息

Faculty of Physiotherapy, Opole Medical School, 45-060 Opole, Poland.

Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland.

出版信息

J Clin Med. 2020 Feb 19;9(2):568. doi: 10.3390/jcm9020568.

Abstract

Low back pain (LBP) is the leading cause of disability worldwide, placing a significant economic burden on healthcare systems. Radial extracorporeal shock wave therapy (rESWT) is useful in the rehabilitation of orthopedic diseases; however, there is still limited evidence for patients with LBP. The aim of this study was to assess the effect of rESWT on pain level, functional efficiency, and parameters of postural control in patients with LBP. Participants were randomized into group A ( = 20) treated with rESWT and group B ( = 20) treated with sham rESWT (placebo). Both groups received conventional physiotherapy, including core stability exercises. The following tests were performed: the Laitinen Pain Scale (LPS), the Roland-Morris Questionnaire (RMQ), the original Schober Test (OST), and a stabilometric platform for the assessment of postural sway, including total sway path (TSP). We found that the analgesic effect was higher after rESWT, especially in the follow-up's ( < 0.05). Similar results were found for functional efficiency and range of motion ( < 0.05). The improved posture stability in placebo group B was not statistically significant ( > 0.05). The stabilometric parameters in group A were still gradually improved and statistically significant, even in follow-ups ( < 0.05). In conclusion, the rESWT had a significant effect on the reduction of pain and the improvement of functional condition compared to a conventional physiotherapy program. Also, rESWT with core stability exercises led to significant improvements in postural sway compared with conventional physiotherapy in patients with LBP.

摘要

下腰痛(LBP)是全球致残的主要原因,给医疗系统带来了巨大的经济负担。放射状体外冲击波疗法(rESWT)在骨科疾病康复中有用;然而,对于LBP患者,证据仍然有限。本研究的目的是评估rESWT对LBP患者疼痛程度、功能效率和姿势控制参数的影响。参与者被随机分为接受rESWT治疗的A组( = 20)和接受假rESWT(安慰剂)治疗的B组( = 20)。两组均接受包括核心稳定性训练在内的传统物理治疗。进行了以下测试:莱蒂宁疼痛量表(LPS)、罗兰 - 莫里斯问卷(RMQ)、原始肖伯试验(OST)以及用于评估姿势摆动的稳定平台,包括总摆动路径(TSP)。我们发现rESWT后镇痛效果更高,尤其是在随访时( < 0.05)。在功能效率和活动范围方面也发现了类似结果( < 0.05)。安慰剂B组姿势稳定性的改善无统计学意义( > 0.05)。A组的稳定参数即使在随访时仍逐渐改善且具有统计学意义( < 0.05)。总之,与传统物理治疗方案相比,rESWT对减轻疼痛和改善功能状况有显著效果。此外,在LBP患者中,rESWT结合核心稳定性训练与传统物理治疗相比,在姿势摆动方面有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc31/7074373/971656cd45b6/jcm-09-00568-g001.jpg

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