整脊治疗对有腰痛的现役美国军人的力量、平衡和耐力的影响:一项随机对照试验。

Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial.

机构信息

Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA.

College of Chiropractic Medicine, Keiser University, West Palm Beach, FL, USA.

出版信息

J Altern Complement Med. 2020 Jul;26(7):592-601. doi: 10.1089/acm.2020.0107. Epub 2020 Jun 12.

Abstract

To investigate whether chiropractic care influences strength, balance, and/or endurance in active-duty United States military personnel with low back pain (LBP). This study employed a prospective randomized controlled trial using a pragmatic treatment approach. Participants were randomly allocated to 4 weeks of chiropractic care or to a wait-list control. Chiropractic care consisted of spinal manipulation, education, advice, and reassurance. Naval Air Technical Training Center branch clinic at the Naval Hospital Pensacola Florida. One hundred ten active-duty military personnel 18-40 years of age with self-reported LBP. Isometric pulling strength from a semisquat position was the primary outcome. Secondary outcomes were single-leg balance with eyes open and eyes closed, and trunk muscle endurance using the Biering-Sorensen test. Patient-reported outcomes such as pain severity and disability were also measured. Outcomes were measured at baseline and 4 weeks. Linear mixed-effects regression models over baseline and 4 weeks were used for analysis. Participants had mean age of 30 years (18-40), 17% were female, 33% were non-white, and 86% reported chronic LBP. Mean maximum pulling strength in the chiropractic group increased by 5.08 kgs and decreased by 7.43 kgs in the wait-list group, with a statistically significant difference in mean change between groups ( = 0.003). Statistically significant differences in mean change between groups were also observed in trunk muscle endurance (13.9 sec,  = 0.002) and balance with eyes closed (0.47 sec,  = 0.01), but not in balance with eyes open (1.19 sec,  = 0.43). Differences in mean change between groups were statistically significant in favor of chiropractic for LBP-related disability, pain intensity and interference, and fear-avoidance behavior. Active-duty military personnel receiving chiropractic care exhibited improved strength and endurance, as well as reduced LBP intensity and disability, compared with a wait-list control.

摘要

研究目的

探讨整脊治疗是否会影响患有下腰痛(LBP)的现役美国军人的力量、平衡和/或耐力。本研究采用前瞻性随机对照试验,采用实用治疗方法。参与者被随机分配到 4 周的整脊治疗或等待名单对照。整脊治疗包括脊柱手法治疗、教育、建议和安慰。地点在佛罗里达州彭萨科拉海军医院海军航空技术培训中心分部诊所。110 名年龄在 18-40 岁、自我报告有 LBP 的现役军人。主要结局是半蹲位等长拉力。次要结局是睁眼和闭眼单腿平衡,以及使用 Biering-Sorensen 测试的躯干肌肉耐力。还测量了患者报告的结局,如疼痛严重程度和残疾。结局在基线和 4 周时进行测量。使用线性混合效应回归模型进行基线和 4 周的分析。参与者的平均年龄为 30 岁(18-40 岁),17%为女性,33%为非白人,86%报告慢性 LBP。整脊组的最大拉力平均增加 5.08 公斤,等待名单组减少 7.43 公斤,两组间平均变化有统计学差异( = 0.003)。组间平均变化的差异在躯干肌肉耐力(13.9 秒, = 0.002)和闭眼平衡(0.47 秒, = 0.01)也有统计学意义,但睁眼平衡无统计学意义(1.19 秒, = 0.43)。组间平均变化的差异在 LBP 相关残疾、疼痛强度和干扰、以及恐惧回避行为方面具有统计学意义,有利于整脊治疗。与等待名单对照组相比,接受整脊治疗的现役军人的力量和耐力得到改善,LBP 强度和残疾程度降低。

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