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单次筋膜手法治疗骶髂关节功能障碍的初步研究:有效减轻疼痛的临床意义。

Pilot Study of Sacroiliac Joint Dysfunction Treated with a Single Session of Fascial Manipulation Method: Clinical Implications for Effective Pain Reduction.

机构信息

Fascial Manipulation Institute by Stecco, 35129 Padua, Italy.

Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy.

出版信息

Medicina (Kaunas). 2021 Jul 6;57(7):691. doi: 10.3390/medicina57070691.

Abstract

Sacroiliac joint dysfunction (SIJD) generally refers to pain in the lower back due to abnormal sacroiliac joint movement, either from hypomobility or hypermobility. It is considered to be the principal cause in up to 40% of low back pain cases. In literature, it emerges that the "fascia", by its anatomical continuity, if altered or densified in different regions of the body with respect to the sacroiliac joint and its surroundings, may have a fundamental role in the genesis of SIJD and low back pain. The purpose of the present study is to evaluate the effectiveness of incorporating a single session of Fascial ManipulationStecco method, treating the muscular fasciae at distance from the painful region. : Twenty patients with acute and chronic sacroiliac joint dysfunction (SIJD) were recruited (16 males and 4 females, mean age of 46.6 ± 12.98 years). Patients underwent a predefined assessment protocol, followed by an evaluation of myofascial pain and subsequent manipulation of the fascia at points at least 20 cm away from the posterior inferior iliac spines (PIIS). Each patient underwent three pain evaluations: pre-treatment (t0), post-treatment (t1), and at a 1-month follow-up (t2). For the evaluation in t0, t1 the numerical rating scale (NRS) for the intensity of pain and the algometer for the pain threshold at the PIIS were used; in t2 only the NRS scale. : The results obtained by comparing the algometer measurements with the NRS values between t0 and t1 were in both cases statistically significant ( < 0.0001), whereas the comparison between the NRS values at t1 and at t2 was not statistically significant ( > 0.05). : A single Fascial Manipulation treatment, even when applied at least 20 cm from the PIIS, can potentially decrease pain around the SIJ. The inclusion of this type of approach in SIJD can allow for improved patient management, better tolerance for other treatments and a more rapid application of pain-free exercise programs.

摘要

骶髂关节功能障碍(SIJD)通常是指由于骶髂关节运动异常引起的下背部疼痛,可能是由于活动不足或过度活动引起的。据文献报道,在高达 40%的下腰痛病例中,它被认为是主要原因。在文献中,“筋膜”由于其解剖连续性,如果在与骶髂关节及其周围区域相关的身体不同区域发生改变或密集化,可能在 SIJD 和下腰痛的发生中起重要作用。本研究旨在评估单次筋膜手法治疗的效果,即治疗远离疼痛区域的肌肉筋膜。

共招募了 20 名患有急性和慢性骶髂关节功能障碍(SIJD)的患者(16 名男性和 4 名女性,平均年龄 46.6±12.98 岁)。患者接受了预先确定的评估方案,然后评估肌筋膜疼痛,并随后在至少距后下髂嵴(PIIS)20cm 远的部位对筋膜进行操作。每位患者接受了三次疼痛评估:治疗前(t0)、治疗后(t1)和 1 个月随访(t2)。在 t0、t1 时使用数字评分量表(NRS)评估疼痛强度和 PIIS 的疼痛阈值,在 t2 时仅使用 NRS 量表。

比较 t0 和 t1 时的测力计测量值与 NRS 值的结果在两种情况下均具有统计学意义(<0.0001),而 t1 和 t2 时的 NRS 值之间的比较则没有统计学意义(>0.05)。

单次筋膜手法治疗,即使在距 PIIS 至少 20cm 的部位进行,也可能减轻 SIJ 周围的疼痛。在 SIJD 中加入这种治疗方法可以改善患者的管理,提高对其他治疗方法的耐受性,并更快地应用无疼痛的运动方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2be/8306333/2ba365b62ee9/medicina-57-00691-g001.jpg

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