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评估整骨手法治疗对非特异性慢性颈部疼痛患者颈部锻炼的长期影响:一项随机试验。

Assessment of Long-term Effects of Adding Osteopathic Manipulative Treatment to Neck Exercises for Individuals With Non-specific Chronic Neck Pain: A Randomized Trial.

作者信息

Groisman Sandro, da Silva Luciano de Souza, Sanches Tamara Rocha Ribeiro, Rocha Clarice Sperotto Dos Santos, Malysz Tais, Jotz Geraldo Pereira

机构信息

Doctoral Program in Health Sciences; Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre/RS, Brazil.

FEEVALE University, Novo Hamburgo/RS, Brazil.

出版信息

J Chiropr Med. 2023 Dec;22(4):265-274. doi: 10.1016/j.jcm.2023.10.003. Epub 2023 Nov 18.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the long-term effects of adding osteopathic manipulative treatment (OMT) to neck exercises compared to exercises alone for individuals with non-specific chronic neck pain (NCNP).

METHODS

A randomized controlled trial was conducted by assigning 90 individuals with NCNP into the following 2 groups: (1) exercises group (EG, n = 45) or (2) OMT plus exercises group (OMT/EG, n = 45). All participants received 4 weeks of treatment. The clinical outcomes were recorded at baseline and at 3 and 6 months after the treatment. The primary outcomes were pain and function-Numerical Pain Rating Scale (NPRS), Pressure Pain Threshold, and the Neck Disability Index (NDI). The secondary outcomes included range of motion for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire.

RESULTS

In comparison to baseline data, both groups had a reduction of NPRS ( < .05) and NDI ( < .05) after the treatment. However, no statistically significant differences in pain intensity or disability were found when OMT/EG was compared to EG alone at 3 months ( = 0.1 and  = 0.2, respectively) and at 6 months ( = 0.4 and  = 0.9, respectively for pain and disability) and no difference was found between OMT/EG and the EG in the secondary outcomes during the same follow-up period ( > .05).

CONCLUSION

Outcomes of pain and functionality for patients in both groups were improved at 6 months. Our findings show that the combination of OMT and neck exercises for 4 weeks did not improve functionality and reduction of pain in patients with NCNP.

摘要

目的

本研究旨在评估与单纯颈部锻炼相比,为非特异性慢性颈部疼痛(NCNP)患者增加整骨手法治疗(OMT)的长期效果。

方法

进行了一项随机对照试验,将90名NCNP患者分为以下两组:(1)锻炼组(EG,n = 45)或(2)OMT加锻炼组(OMT/EG,n = 45)。所有参与者均接受4周的治疗。在基线以及治疗后3个月和6个月记录临床结果。主要结果指标为疼痛和功能——数字疼痛评分量表(NPRS)、压力疼痛阈值和颈部功能障碍指数(NDI)。次要结果指标包括颈椎旋转活动范围、恐惧回避信念问卷和疼痛自我效能问卷。

结果

与基线数据相比,两组在治疗后NPRS(P <.05)和NDI(P <.05)均有所降低。然而,在3个月时(疼痛和残疾的P值分别为0.1和0.2)以及6个月时(疼痛和残疾的P值分别为0.4和0.9),将OMT/EG与单纯EG组相比,在疼痛强度或残疾方面未发现统计学上的显著差异,并且在同一随访期内,OMT/EG与EG组在次要结果指标方面也未发现差异(P >.05)。

结论

两组患者在6个月时疼痛和功能结局均有所改善。我们的研究结果表明,OMT与颈部锻炼相结合4周,并未改善NCNP患者的功能和减轻疼痛。

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Neck Pain: Revision 2017.颈部疼痛:2017 年修订版。
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Epidemiology, diagnosis, and treatment of neck pain.颈部疼痛的流行病学、诊断与治疗
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Systematic review of manual therapies for nonspecific neck pain.系统评价手法治疗非特异性颈痛。
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