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干针疗法与手法治疗对机械性颈痛患者的疗效比较:一项随机对照试验。

Dry Needling Versus Manual Therapy for Patients With Mechanical Neck Pain: A Randomized Controlled Trial.

出版信息

J Orthop Sports Phys Ther. 2024 Apr;54(4):267-278. doi: 10.2519/jospt.2024.12091.

DOI:10.2519/jospt.2024.12091
PMID:38284367
Abstract

To compare the short- and intermediate-term effects of dry needling to manual therapy on pain, disability, function, and patient-perceived improvement in patients with mechanical neck pain. A single (therapist) blinded randomized controlled trial. Seventy-eight patients (mean ± SD age, 50.74 ± 13.81) were randomly assigned to one of the 2 groups: (1) dry needling and therapeutic exercises (DN + Exercises) and (2) manual therapy and therapeutic exercises (MT + Exercises). Both groups received 7 treatment sessions over a maximum of 6 weeks. Outcome measures, collected at baseline, 2 weeks, discharge (7th treatment session), and 3 months after discharge, were as follows: Neck Disability Index (NDI), numeric pain-rating scale (NPRS), Patient-Specific Functional Scale (PSFS), global rating of change (GROC), Fear-Avoidance Belief Questionnaire (FABQ), and Deep Neck Flexor Endurance Test (DNFET). Data were analyzed with mixed-model analysis of covariance (ANCOVA), using pretest scores as covariates, and a Mann-Whitney U test for GROC scores. The ANCOVA revealed significant group-by-time interaction for all variables. Significant between-group differences, favoring MT + Exercises, were observed at all 3 time points on the NDI (2 weeks: F = 172.68, ≤.001, [Formula: see text] = .27; discharge: F = 254.15, ≤.001, [Formula: see text] = .36; and 3 months: F = 339.40, ≤.001, [Formula: see text] = .43). Results for the MT + Exercises group exceeded recommended minimal clinically important difference for all variables, at all follow-up points. MT + Exercises was more effective, both in the short term and intermediate term, than DN + Exercises in reducing pain, disability, and improving function in patients with mechanical neck pain. .

摘要

比较机械性颈痛患者干针与手法治疗在疼痛、残疾、功能和患者感知改善方面的短期和中期效果。一项单(治疗师)盲随机对照试验。78 名患者(平均±标准差年龄,50.74±13.81)随机分为 2 组:(1)干针和治疗性运动(DN+运动)组,(2)手法治疗和治疗性运动(MT+运动)组。两组均在 6 周内接受 7 次治疗。在基线、2 周、出院(第 7 次治疗)和出院后 3 个月收集以下结局指标:颈部残疾指数(NDI)、数字疼痛评分量表(NPRS)、患者特定功能量表(PSFS)、总体变化评分(GROC)、恐惧-回避信念问卷(FABQ)和深层颈屈肌耐力测试(DNFET)。采用协方差混合模型分析(ANCOVA),以预测试分数为协变量,对 GROC 评分采用曼-惠特尼 U 检验进行分析。ANCOVA 显示所有变量的组间-时间交互作用均有统计学意义。DN+运动组在 NDI 的所有 3 个时间点(2 周:F=172.68,P≤.001,[Formula: see text]=.27;出院:F=254.15,P≤.001,[Formula: see text]=.36;和 3 个月:F=339.40,P≤.001,[Formula: see text]=.43)均显示出与 MT+运动组之间存在显著的组间差异,并且均有利于 MT+运动组。MT+运动组在所有随访点的所有变量均超过了推荐的最小临床重要差异。MT+运动在机械性颈痛患者中比 DN+运动更有效,无论是短期还是中期,都能减轻疼痛、残疾和改善功能。

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