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电针干针与非侵入性多组分干预治疗慢性腰痛患者肌筋膜触发点的比较:一项随机临床试验。

Electrical dry needling versus a non-invasive multicomponent intervention in the treatment of myofascial trigger points in patients with chronic low back pain: A randomised clinical trial.

机构信息

Department of Nursing, Physical Therapy and Medicine, University of Almería, Almería, Spain.

出版信息

Clin Rehabil. 2024 Mar;38(3):347-360. doi: 10.1177/02692155231201589. Epub 2023 Sep 13.

Abstract

OBJECTIVE

To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain.

DESIGN

A randomised single-blind clinical trial.

SETTING

Outpatient Physiotherapy Clinic; home.

PARTICIPANTS

Sixty-four patients with chronic low back pain aged 30-65 years.

INTERVENTIONS

Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression).

MAIN MEASURES

Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months.

RESULTS

ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points ( < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14,  = 0.016; and Oswestry Disability Index: F = 7.36,  = 0.009), for trunk anteflexion (F = 10.03,  = 0.002) and for habitual sleep efficacy (F = 6.65,  = 0.012), use of hypnotics (F = 4.77,  = 0.033) and total score of quality of sleep (F = 8.23,  = 0.006).

CONCLUSIONS

In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients' sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228.

摘要

目的

比较电干针与非侵入性多组分干预对慢性下腰痛患者的影响。

设计

随机单盲临床试验。

设置

门诊物理治疗诊所;家庭。

参与者

64 名年龄在 30-65 岁之间的慢性下腰痛患者。

干预措施

电干针治疗肌筋膜触发点,非侵入性多组分干预(家庭运动计划、伸展和缺血性压迫)。

主要测量指标

疼痛(视觉模拟量表)、残疾(Roland-Morris 残疾问卷和 Oswestry 残疾指数)、运动恐惧(坦帕运动恐惧量表)、生活质量和睡眠(SF-36 健康调查和匹兹堡睡眠质量指数)、躯干屈肌等长耐力(McQuade 测试)、腰椎前屈活动度(指尖至地面距离)和压力疼痛阈值(压力计),在基线、6 周后和 2 个月后进行评估。

结果

ANOVA 显示,在大多数肌筋膜触发点的疼痛压力阈值方面,组间时间交互作用具有统计学意义( < 0.05),在残疾(Roland-Morris 残疾问卷:F = 6.14, = 0.016;Oswestry 残疾指数:F = 7.36, = 0.009)、躯干前屈(F = 10.03, = 0.002)和习惯性睡眠功效(F = 6.65, = 0.012)、催眠药物使用(F = 4.77, = 0.033)和睡眠质量总分(F = 8.23, = 0.006)方面也有统计学意义。

结论

与非侵入性多组分干预相比,电干针在治疗后和 2 个月时,对残疾、疼痛强度、运动恐惧以及降低患者对肌筋膜触发点压力的敏感性有更积极的影响。

临床试验注册号

NCT04804228。于 2021 年 5 月 28 日注册。可在 https://clinicaltrials.gov/ct2/show/NCT04804228 上获得。

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