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体外冲击波疗法联合口服药物和运动治疗慢性下腰痛:一项随机对照试验。

Extracorporeal Shock Wave Therapy Combined With Oral Medication and Exercise for Chronic Low Back Pain: A Randomized Controlled Trial.

机构信息

Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Arch Phys Med Rehabil. 2021 Jul;102(7):1294-1299. doi: 10.1016/j.apmr.2020.12.008. Epub 2021 Jan 14.

Abstract

OBJECTIVE

To compare extracorporeal shock wave therapy combined with oral medication and an exercise program vs sham treatment with medication and exercise for the treatment of chronic low back pain (CLBP).

DESIGN

Randomized controlled trial.

SETTING

Outpatient clinic at a university hospital.

PARTICIPANTS

Eligibility criteria were age older than 18 years and duration of CLBP exceeding 3 months. Exclusion criteria were concurrent treatment or history of surgery for CLBP, cancer, fractures, infections, and disk degeneration.

INTERVENTION

The intervention group received extracorporeal shock wave therapy once a week for 4 weeks along with oral medications and an exercise program. The control group received sham extracorporeal shock wave therapy along with oral medications and an exercise program.

MAIN OUTCOME MEASURES

Visual analog scale and Oswestry Disability Index (ODI) were used to assess pain and disability at baseline and after 3 months.

RESULTS

The pain score in the intervention group (N=16) was 6.6 at baseline and 3.0 after 1 month (P<.0001) and 1.8 after 3 months (P<.0001). In the control group (N=16), the pain score was 6.8 at baseline, 4.6 after 1 month (P<.0001), and 1.1 after 3 months (P<.0001). ODI scores decreased significantly in both groups compared with baseline values (first month: P<.001, third month: P<.05). The mean ODI score did not differ significantly between the groups (P=.942).

CONCLUSION

Extracorporeal shock wave therapy combined with oral medication and exercise was safe and effective in the short-term treatment of chronic low back pain.

摘要

目的

比较体外冲击波疗法联合口服药物和运动方案与药物和运动方案联合假治疗治疗慢性下腰痛(CLBP)的效果。

设计

随机对照试验。

设置

大学医院的门诊诊所。

参与者

纳入标准为年龄大于 18 岁且 CLBP 持续时间超过 3 个月。排除标准为 CLBP 同时接受治疗或有手术史、癌症、骨折、感染和椎间盘退变。

干预

干预组每周接受一次体外冲击波治疗,共 4 周,同时接受口服药物和运动方案。对照组接受假体外冲击波治疗,同时接受口服药物和运动方案。

主要观察指标

基线和 3 个月时采用视觉模拟评分法和 Oswestry 残疾指数(ODI)评估疼痛和残疾情况。

结果

干预组(N=16)的疼痛评分在基线时为 6.6,1 个月后为 3.0(P<.0001),3 个月后为 1.8(P<.0001)。对照组(N=16)的疼痛评分在基线时为 6.8,1 个月后为 4.6(P<.0001),3 个月后为 1.1(P<.0001)。与基线值相比,两组的 ODI 评分均显著降低(第 1 个月:P<.001,第 3 个月:P<.05)。两组间平均 ODI 评分无显著差异(P=.942)。

结论

体外冲击波疗法联合口服药物和运动在慢性下腰痛的短期治疗中是安全有效的。

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