Amstel Robbert van, Noten Karl, Malone Shaun, Vaes Peter
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands.
Fysio Science Department, Fysio Physics Groups, 3401 IJsselstein, The Netherlands.
Life (Basel). 2023 Dec 20;14(1):7. doi: 10.3390/life14010007.
The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method.
A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period.
Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life ( < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS ( < 0.05), but not for EQ-5D-3L.
The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments.
4xT方法是一种治疗肌肉骨骼疾病的规范化实践。4xT方法由四个部分组成：测试（功能诊断测试）、触发（筋膜组织手法治疗）、贴扎（弹性贴扎）和训练（运动）。目前缺乏评估4xT方法治疗效果的临床研究。
进行了一项随机对照试验，比较4xT方法与单纯运动疗法对慢性非特异性下腰痛患者的有效性。根据预先计算的样本量，51名慢性非特异性下腰痛患者被随机分配到4xT组或运动组。两组均接受为期六周的康复计划，每周进行两次治疗。主要结局指标为躯干屈伸活动度、与躯干屈伸活动度相关的疼痛以及在6周治疗期和6周停止治疗期后的生活质量。
在所有结局指标中均观察到交互作用。4xT组在躯干屈伸活动度、与躯干屈伸活动度相关的疼痛以及生活质量方面随时间有显著改善（<0.05），治疗后无显著复发（除屈伸活动度外）。运动组在使用视觉模拟评分法（VAS）测量的生活质量方面有显著的时间内变化（<0.05），但在EQ-5D-3L量表上没有。
本研究结果表明，4xT方法是慢性非特异性下腰痛患者一种有前景且有效的治疗选择，因为与单纯运动治疗相比，它在与活动度相关的疼痛方面显著减轻，躯干活动度增加，生活质量得到改善。
