Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain.
University of Extremadura, Translation, Badajoz University Campus, Badajoz, Spain.
J Back Musculoskelet Rehabil. 2022;35(6):1219-1226. doi: 10.3233/BMR-210120.
One of the main problems faced by physiotherapists in primary care is low back pain with or without radiation to lower limbs. There are many different treatment approaches for the management of low back pain. Despite the large amount of published studies, the evidence remains contradictory.
To evaluate the influence of the osteopathic manipulation of the sacroiliac joint on low back pain with or without radiation to lower limbs.
Single-blind randomized clinical controlled trial. Participants with low back pain with or without lower limb radiation were randomized to osteopathic manipulation of the sacroiliac joint group (intervention, 6 sessions) or to an electrotherapy group (control, 15 sessions) for 3 weeks. Measures were taken at baseline (week 0) and post-intervention (week 4). The primary outcome measures were pain (Visual Analogue Scale), functional disability (Oswestry disability index and Roland Morris questionnaire). The secondary outcome measure was pain threshold at muscular tender points in the quadratus lumborum, pyramidal, mayor gluteus, and hamstrings.
In all, 37 participants completed the study. The results of the intragroup comparisons showed statistically significant improvements in both groups in the visual analogue scale (Osteopathic manipulation group, P= 0.000; Electrotherapy group, P= 0.005) and Oswestry disability index (Osteopathic manipulation group, P= 0.000; Electrotherapy group- P= 0.026) but not in the Roland Morris questionnaire (P= 0.121), which only improved in the intervention group (P= 0.01). The osteopathic manipulation was much more effective than electrotherapy improving to pain and functional disability.
Osteopathic manipulation of the sacroiliac joint improves pain and disability in patients with sacroiliac dysfunction after three weeks of treatment.
在初级保健中,物理治疗师面临的主要问题之一是下腰痛伴或不伴有下肢放射痛。对于下腰痛的管理,有许多不同的治疗方法。尽管有大量已发表的研究,但证据仍然存在矛盾。
评估骶髂关节整骨治疗对下腰痛伴或不伴有下肢放射痛的影响。
单盲随机对照临床试验。将下腰痛伴或不伴有下肢放射痛的患者随机分为骶髂关节整骨治疗组(干预组,6 次)或电疗组(对照组,15 次),治疗 3 周。在基线(第 0 周)和干预后(第 4 周)进行测量。主要结局指标为疼痛(视觉模拟量表)、功能障碍(Oswestry 残疾指数和 Roland Morris 问卷)。次要结局指标为竖脊肌、腰方肌、臀大肌和股二头肌肌痛点的疼痛阈值。
共有 37 名参与者完成了研究。组内比较结果显示,两组视觉模拟量表(整骨治疗组,P=0.000;电疗组,P=0.005)和 Oswestry 残疾指数(整骨治疗组,P=0.000;电疗组,P=0.026)均有统计学意义的改善,但 Roland Morris 问卷(P=0.121)无改善,仅干预组有改善(P=0.01)。整骨治疗对疼痛和功能障碍的改善明显优于电疗。
骶髂关节整骨治疗可改善骶髂关节功能障碍患者的疼痛和功能障碍,治疗 3 周后即可见效。