Aja University of Medical Sciences, Western Fatemi, Tehran.
Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Am J Med. 2021 Jan;134(1):135-141. doi: 10.1016/j.amjmed.2020.08.005. Epub 2020 Sep 13.
We evaluated the efficacy of spinal manipulation for the management of nonacute lumbar radiculopathy.
In a university hospital we performed a randomized controlled trial with 2 parallel arms. Patients (n = 44) with unilateral radicular low back pain lasting more than 4 weeks were randomly allocated to manipulation and control groups. The primary outcome was the intensity of the low back pain on a visual analog scale. The secondary outcome was the Oswestry Disability Questionnaire score. We also measured spinal ranges of motion. The assessments were carried out at the baseline, immediately after intervention, and at 3 months' follow-up. All patients underwent physiotherapy. The manipulation group received three sessions of manipulation therapy 1 week apart. For manipulation, we used Robert Maigne's technique.
Both groups experienced a decrease in back and leg pain significantly (all P ≤ 0.003). However, only the manipulation group showed significantly favorable results in the Oswestry scores (P < 0.001), and the straight leg raise test (P = 0.001). All ranges of motion increased significantly with manipulation (all P < 0.001), but the control group showed favorable results only in right and left rotations and in extension (all P < 0.001). Between-group analyses showed significantly better outcomes for manipulation in all measurements (all P ≤ 0.009) with large effect sizes.
Spinal manipulation improves the results of physiotherapy over a period of 3 months for patients with subacute or chronic lumbar radiculopathy.
我们评估了脊柱推拿治疗非急性腰椎神经根病的疗效。
在一所大学医院，我们进行了一项随机对照试验，设有 2 个平行组。患有单侧神经根性腰痛超过 4 周的患者（n=44）被随机分配到推拿组和对照组。主要结局指标是视觉模拟评分法（VAS）下腰痛的强度。次要结局指标是 Oswestry 残疾问卷（ODI）评分。我们还测量了脊柱活动范围。评估在基线、干预后即刻和 3 个月随访时进行。所有患者均接受物理治疗。推拿组在 1 周内接受 3 次推拿治疗。推拿采用 Robert Maigne 技术。
两组患者的腰痛和腿痛均显著减轻（均 P≤0.003）。然而，只有推拿组的 Oswestry 评分（P<0.001）和直腿抬高试验（P=0.001）显示出明显的有利结果。所有运动范围均显著增加（均 P<0.001），但对照组仅在右侧和左侧旋转以及伸展时显示出有利结果（均 P<0.001）。组间分析显示，推拿在所有测量指标上的结果均明显更好（均 P≤0.009），且具有较大的效应量。
在 3 个月的时间内，脊柱推拿可改善亚急性或慢性腰椎神经根病患者的物理治疗效果。
