Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, P.O. Box 141, 57400 Thessaloniki, Greece.
Department of Public Health, Medical School, University of Patras, 26504 Patra, Greece.
Medicina (Kaunas). 2023 Jul 9;59(7):1275. doi: 10.3390/medicina59071275.
Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer than 12 weeks. Capacitive and resistive electric transfer (TECAR) therapy utilizes radiant energy to generate endogenous heat and is widely used for the treatment of chronic musculoskeletal pain. The aim of this study was to investigate the efficacy of manual therapy (MT) program combined with TECAR therapy in individuals with CNSLBP. Sixty adults with CNSLBP were randomly divided equally into three groups. The first group followed an MT protocol in the lumbar region (MT group), the second group followed the same MT protocol combined with TECAR therapy (MT + TECAR group) using a conventional capacitive electrode as well as a special resistive electrode bracelet, and the third group (control group) received no treatment. Both intervention programs included six treatments over two weeks. Pain in the last 24 h with the Numeric Pain Rating Scale (NPRS), functional ability with the Roland-Morris Disability Questionnaire (RMDQ), pressure pain threshold (PPT) in the lumbar region with pressure algometry, and mobility of the lumbo-pelvic region through fingertip-to-floor distance (FFD) test were evaluated before and after the intervention period with a one-month follow-up. Analysis of variance with repeated measures was applied. In the NPRS score, both intervention groups showed statistically significant differences compared to the control group both during the second week and the one-month follow-up ( < 0.001). Between-group differences were also noticed between the two intervention groups in the second week ( < 0.05). Differences in the RMDQ score were detected between the intervention groups and the control group in the second week and at the one-month follow-up ( < 0.001), while differences between the two intervention groups were only detected at the one-month follow-up ( < 0.001). Regarding the PPT values, differences were found mainly between the MT + TECAR group and the control group and between the MT + TECAR group and the MT group ( < 0.05), with the MT + TECAR group in most cases showing the greatest improvement compared to the other two groups, which remained statistically significant at the one-month follow-up ( < 0.05). Finally, both intervention groups improved the mobility of the lumbo-pelvic region at both time points compared to the control group without, however, statistically significant differences between them ( > 0.05). The application of an MT protocol with TECAR therapy appeared more effective than conventional MT as well as compared to the control group in reducing pain and disability and improving PPT in individuals with CNSLBP. No further improvement was noted in the mobility of the lumbo-pelvic region by adding TECAR to the MT intervention.
慢性非特异性下腰痛（CNSLBP）定义为持续超过 12 周的腰痛。电容和电阻电传递（TECAR）疗法利用辐射能产生内源性热量，广泛用于治疗慢性肌肉骨骼疼痛。本研究旨在探讨手动疗法（MT）方案联合 TECAR 疗法在 CNSLBP 患者中的疗效。60 名 CNSLBP 成年人被随机平均分为三组。第一组在腰部进行 MT 方案（MT 组），第二组在相同的 MT 方案中结合 TECAR 疗法（MT+TECAR 组），使用常规电容电极和特殊电阻电极手镯，第三组（对照组）未接受治疗。两个干预方案均包括两周内的六次治疗。在干预前后，使用数字疼痛评分量表（NPRS）评估 24 小时内的疼痛，使用 Roland-Morris 残疾问卷（RMDQ）评估功能能力，使用压力测痛仪评估腰椎区的压力痛阈（PPT），使用指尖到地板距离（FFD）测试评估腰椎骨盆区的活动度。采用重复测量方差分析。NPRS 评分显示，两组干预组与对照组相比，在第二周和一个月随访时均有统计学差异（<0.001）。两组干预组在第二周时，组间差异也有统计学意义（<0.05）。在第二周和一个月随访时，干预组与对照组的 RMDQ 评分均有差异（<0.001），而两组干预组之间仅在一个月随访时存在差异（<0.001）。关于 PPT 值，主要在 MT+TECAR 组与对照组之间以及 MT+TECAR 组与 MT 组之间存在差异（<0.05），MT+TECAR 组在大多数情况下显示出比其他两组更大的改善，且在一个月随访时仍具有统计学意义（<0.05）。最后，两组干预组均改善了腰椎骨盆区的活动度，与对照组相比，在第二周和一个月随访时均有统计学意义（>0.05），但两组之间无统计学差异。将 TECAR 应用于 MT 方案除了在减轻疼痛和残疾方面比传统 MT 更有效外，与对照组相比，在改善 CNSLBP 患者的 PPT 方面也更有效。在加入 TECAR 后，MT 干预对腰椎骨盆区的活动度没有进一步改善。
