FREMAP-Collaborative Mutual Society with the Social Security Institute No. 61, A Coruña, Spain.
Department of Medicine, University of A Coruña, Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
J Manipulative Physiol Ther. 2020 Sep;43(7):683-690. doi: 10.1016/j.jmpt.2018.11.037. Epub 2020 Sep 12.
The aim of this study was to do a cost-benefit analysis of myofascial release therapy (MRT) compared to manual therapy (MT) for treating occupational mechanical neck pain.
Variables regarding the outcomes of the intervention were intensity of neck pain, cervical disability, quality of life, craniovertebral angle, and ranges of cervical motion. Costs were assessed based on a social perspective using diary costs. Between-groups differences in average cost, cost-effectiveness, and cost-utility ratios were assessed using bootstrap parametric techniques. The economic cost-benefit evaluation was with regard to an experimental parallel group study design. There were 59 participants.
Myofascial released therapy showed significant improvement over MT for cervical mobility (side bending, rotation, and craniovertebral angle). The total cost of MRT was approximately 20% less (-$519.81; 95% confidence interval, -$1193.67 to $100.31) than that of MT, although this was not statistically significant. Cost-effectiveness and cost-utility ratios showed that MRT could be associated with lower economic costs.
With probabilities of 93.9% and 95.8%, MRT seems to be cost-effective for treating mechanical neck pain without the need to add any additional cost to obtain a better clinical benefit. Consequently, we believe it could be included in the clinical practice guidelines of different Spanish health care institutions.
本研究旨在对肌筋膜松解疗法（MRT）与手法治疗（MT）治疗职业性机械性颈痛进行成本效益分析。
干预结果的变量包括颈痛强度、颈椎功能障碍、生活质量、颅椎角和颈椎活动范围。基于社会视角，使用日记成本评估成本。使用 bootstrap 参数技术评估组间平均成本、成本效益和成本效用比的差异。经济成本效益评估采用实验性平行组研究设计。共有 59 名参与者。
与 MT 相比，MRT 对颈椎活动度（侧屈、旋转和颅椎角）有显著改善。MRT 的总费用比 MT 低约 20%（-519.81 美元；95%置信区间，-1193.67 美元至 100.31 美元），但这没有统计学意义。成本效益和成本效用比表明，MRT 可能与较低的经济成本相关。
MRT 治疗机械性颈痛具有成本效益，概率分别为 93.9%和 95.8%，无需增加额外成本即可获得更好的临床获益。因此，我们认为它可以被纳入不同西班牙医疗机构的临床实践指南。
