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正确的坐骨神经管理以应用超声引导下经皮神经调节治疗慢性腰痛患者:一项初步研究。

Correct Sciatic Nerve Management to Apply Ultrasound-Guided Percutaneous Neuromodulation in Patients With Chronic Low Back Pain: A Pilot Study.

机构信息

Department of Physiotherapy, University Gimbernat-Cantabria, Cantabria, Spain.

MVClinic Institute, Madrid, Spain.

出版信息

Neuromodulation. 2021 Aug;24(6):1067-1074. doi: 10.1111/ner.13396. Epub 2021 Apr 20.

Abstract

BACKGROUND

The objectives of this study were to evaluate the effects of an ultrasound (US)-guided percutaneous neuromodulation (PNM) intervention on the sciatic nerve, regarding pain, hip range of motion (ROM), balance, and functionality in patients with chronic low back pain (LBP); and to determine the optimal anatomical location of sciatic nerve stimulation to obtain therapeutic benefits in such patients.

MATERIALS AND METHODS

Thirty patients with chronic LBP were recruited and divided randomly into three groups. All patients received a single percutaneous electrical stimulation intervention on the sciatic nerve, with a different anatomical application location for each group (proximal, middle, and distal). Level of pain, hip passive ROM, dynamic balance, and Oswestry disability index were analyzed. All variables were calculated before the intervention, immediately postintervention, 48 hours and one week after the intervention, except the LBP questionnaire (before, and 48 hours and one week after the intervention).

RESULTS

All interventions decreased the level of pain and increased the ROM, balance, and functionality. Besides, these therapeutic effects were maintained during one week, regardless of the anatomical location of application.

CONCLUSIONS

The choice of an anatomical location of application of the US-guided PNM on the sciatic nerve by the physiotherapist does not influence the improvement of pain, ROM, balance, and function in patients with chronic LBP.

摘要

背景

本研究的目的在于评估超声引导下经皮神经调节(PNM)干预坐骨神经对慢性下腰痛(LBP)患者疼痛、髋关节活动度(ROM)、平衡和功能的影响,并确定刺激坐骨神经的最佳解剖位置,以在这些患者中获得治疗效果。

材料与方法

共招募 30 例慢性 LBP 患者,并随机分为三组。所有患者均接受单次经皮电刺激坐骨神经干预,每组的应用解剖位置不同(近端、中段和远端)。分析疼痛程度、髋关节被动 ROM、动态平衡和 Oswestry 残疾指数。所有变量均在干预前、干预即刻、干预后 48 小时和 1 周进行计算,除腰痛问卷(干预前和干预后 48 小时和 1 周)外。

结果

所有干预均降低了疼痛程度,增加了 ROM、平衡和功能。此外,无论应用的解剖位置如何,这些治疗效果在 1 周内均得以维持。

结论

物理治疗师选择超声引导下 PNM 干预坐骨神经的解剖位置不会影响慢性 LBP 患者疼痛、ROM、平衡和功能的改善。

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