Tikhile Priya, Patil Deepali S
Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2024 Mar 12;16(3):e56013. doi: 10.7759/cureus.56013. eCollection 2024 Mar.
Low back pain (LBP) presents a significant burden globally, affecting individuals of all ages, but it is more common in adults aged 30-60 years old and demographics including race, ethnicity, and socioeconomic status. Physiotherapy interventions are commonly employed to manage LBP due to their non-invasive nature and potential for addressing underlying biomechanical dysfunctions. This comprehensive review aims to evaluate the efficacy of various physiotherapy strategies in alleviating LBP, considering a range of interventions and their associated outcomes. Through a thorough examination of existing literature from January 2017 to October 2023, this review synthesises evidence on the effectiveness of interventions such as manual therapy, exercise therapy, electrotherapy modalities, and education-based approaches. The review also scrutinizes the comparative effectiveness of different physiotherapy modalities and their suitability for specific patient populations, considering factors such as chronicity, severity, and underlying pathology. By critically evaluating the evidence base, this review aims to provide insights into the most effective physiotherapy strategies for alleviating LBP, chronic low back pain (CLBP) and chronic nonspecific low back pain (CNLBP) and guiding clinical practice toward evidence-based interventions. The Visual Analogue Scale and Numerical Pain Rating Scale for pain, Oswestry Disability Index and Roland-Morris Disability Questionnaire for disability, Modified-Modified Schober Test for measurement of lumbar flexion and extension and static and dynamic balance for assessing postural stability and balance were among the measures used to foresee enhancements in pain, disability, balance, and LBP symptoms. Twenty-one studies that fulfilled the criteria for inclusion (aged 20 to 50 years and of both genders) were added to the review. Exercises for core stability, strengthening, orthosis (a medical device designed to support, align, stabilise, or correct musculoskeletal structures and functions), transcutaneous electrical nerve stimulation, heat massage therapy, interferential current (a form of electrical stimulation used in physical therapy), Mulligan's mobilization (a manual therapy technique), low-level laser therapy, and McGill stabilization exercises (core exercises) were among the therapeutic strategies. The McKenzie method (back exercises), ultrasound, sensory-motor training, Swiss ball exercises, and other techniques reduced pain and enhanced strength, balance, and ease of daily activities. Every therapeutic approach has an impact on recovery rates ranging from minimal to maximal. Conventional physical therapy is less effective than most recent advanced techniques like mobilisation and exercises. In summary, the integration of manual techniques, orthoses and alternative intervention strategies with conservative therapeutic approaches can effectively alleviate pain, enhance function and yield better overall outcomes. To get more information about the optimal dosage, therapeutic modalities and long-term effects of these treatments, more admirable research is required. This paper aims to expand the scientific discourse by exploring non-traditional physiotherapy interventions and assessing their efficacy in light of the rigorous standards set forth by the latest WHO guidelines.
腰痛在全球范围内造成了沉重负担,影响着各个年龄段的人群,但在30至60岁的成年人以及不同种族、民族和社会经济地位的人群中更为常见。物理治疗干预因其非侵入性以及解决潜在生物力学功能障碍的潜力,常用于管理腰痛。本综述旨在评估各种物理治疗策略在缓解腰痛方面的疗效,考虑一系列干预措施及其相关结果。通过全面审查2017年1月至2023年10月的现有文献,本综述综合了关于手法治疗、运动疗法、电疗方式和基于教育的方法等干预措施有效性的证据。该综述还审视了不同物理治疗方式的比较有效性及其对特定患者群体的适用性,考虑了慢性程度、严重程度和潜在病理等因素。通过严格评估证据基础,本综述旨在深入了解缓解腰痛、慢性腰痛(CLBP)和慢性非特异性腰痛(CNLBP)最有效的物理治疗策略,并指导临床实践采用基于证据的干预措施。用于预测疼痛、残疾、平衡和腰痛症状改善情况的测量指标包括疼痛的视觉模拟量表和数字疼痛评分量表、残疾的Oswestry残疾指数和罗兰 - 莫里斯残疾问卷、测量腰椎屈伸的改良 - 改良肖伯试验以及评估姿势稳定性和平衡的静态和动态平衡测试。有21项符合纳入标准(年龄在20至50岁之间,男女皆有)的研究被纳入本综述。治疗策略包括核心稳定性训练、强化训练、矫形器(一种用于支撑、对齐、稳定或纠正肌肉骨骼结构和功能的医疗器械)、经皮电刺激神经疗法、热按摩疗法、干扰电流(物理治疗中使用的一种电刺激形式)、米利根松动术(一种手法治疗技术)、低强度激光疗法和麦吉尔稳定训练(核心训练)。麦肯齐方法(背部训练)、超声波、感觉运动训练、瑞士球训练和其他技术减轻了疼痛,增强了力量、平衡能力,并使日常活动更加轻松。每种治疗方法对恢复率的影响从最小到最大不等。传统物理治疗的效果不如动员和训练等最新先进技术。总之,将手法技术、矫形器和替代干预策略与保守治疗方法相结合,可以有效减轻疼痛、增强功能并产生更好的总体效果。为了获取有关这些治疗的最佳剂量、治疗方式和长期效果的更多信息,还需要进行更出色的研究。本文旨在通过探索非传统物理治疗干预措施,并根据世界卫生组织最新指南设定的严格标准评估其疗效,来拓展科学讨论。