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手法牵引对缓解腰骶部脊柱疼痛有效:一项随机对照试验的证据。

Manual traction is effective in alleviating lumbosacral spine pain: Evidence from a randomized controlled trial.

作者信息

Studnicki Rafał, Szymczyk Piotr, Adamczewski Tomasz, Studzińska Karolina, Hansdorfer-Korzon Rita, Silva Ana Filipa, Kawczyński Adam

机构信息

Sub-Faculty of Physiotherapy, Medical University of Gdańsk, Gdańsk, Poland.

Medical Rehabilitation Clinic, Chair of Rehabilitation, Faculty of Health Sciences, Medical University of Lódź, Łódź, Poland.

出版信息

Heliyon. 2024 May 10;10(10):e31013. doi: 10.1016/j.heliyon.2024.e31013. eCollection 2024 May 30.

Abstract

BACKGROUND

Manual traction, a therapeutic technique frequently employed in healthcare, involves applying controlled pulling force by hand, usually to the spine, to stretch muscles and decompress joints, thereby alleviating pain. This method can be particularly beneficial for addressing lumbosacral spine pain exacerbated by radicular symptoms, characterized by pain radiating from the lower back due to compression or irritation of spinal nerves.

PURPOSE

This study aimed to compare the effects of manual traction against control group in alleviating the lumbosacral spine pain caused by radicular symptoms.

METHODS

A randomized controlled study design was utilized with a sample of 60 patients experiencing lumbosacral spine pain, evenly distributed between an experimental group (n = 30; receiving manual traction) and a control group (n = 30). Patients underwent assessments before and after six treatment sessions, which included the Straight Leg Raise test, modified Bragard's test, Kernig's test, and the visual analogue scale for pain perception.

RESULTS

Between-group significant differences were found at post-intervention, favoring the experimental group on SLR - Left (°) (p = 0.004; medium effect size), SLR - Right (°) (p = 0.004; medium effect size), Modified Bragard test - Left (°) (p = 0.024; small effect size), Modified Bragard test - Right (°) (p = 0.003; medium effect size), Kernig's Test - Left (°) (p = 0.013; medium effect size) and Kernig's Test - Right (°) (p = 0.010; medium effect size). Additionally, between-group significant differences were found at post-intervention, favoring the experimental group on VAS scores at SLR left (p < 0.001; medium effect size), and right (p < 0.001); medium effect size, Modified Bragard test left (p < 0.001; medium effect size) and right (p < 0.001; medium effect size) and at Kernig's Test left (p < 0.001; medium effect size) and right (p < 0.001; medium effect size).

CONCLUSIONS

In conclusion, manual traction is recommended as an effective approach for alleviating lumbosacral spine pain in patients experiencing symptoms resulting from irritation or compression of a spinal nerve root.

摘要

背景

手法牵引是医疗保健中常用的一种治疗技术,通过手动施加可控的拉力,通常作用于脊柱,以拉伸肌肉和减轻关节压力,从而缓解疼痛。这种方法对于缓解因神经根症状加重的腰骶部脊柱疼痛可能特别有益,这种疼痛的特征是由于脊神经受压或受刺激而从下背部放射出来。

目的

本研究旨在比较手法牵引与对照组在缓解神经根症状引起的腰骶部脊柱疼痛方面的效果。

方法

采用随机对照研究设计,选取60例腰骶部脊柱疼痛患者作为样本,平均分为实验组(n = 30;接受手法牵引)和对照组(n = 30)。患者在六个疗程前后进行评估,评估内容包括直腿抬高试验、改良布拉加德试验、克尼格试验以及疼痛感知视觉模拟量表。

结果

干预后组间存在显著差异,在直腿抬高试验 - 左侧(°)(p = 0.004;中等效应量)、直腿抬高试验 - 右侧(°)(p = 0.004;中等效应量)、改良布拉加德试验 - 左侧(°)(p = 0.024;小效应量)、改良布拉加德试验 - 右侧(°)(p = 0.003;中等效应量)、克尼格试验 - 左侧(°)(p = 0.013;中等效应量)和克尼格试验 - 右侧(°)(p = 0.010;中等效应量)方面,实验组表现更优。此外,干预后组间存在显著差异,在直腿抬高试验左侧的视觉模拟量表评分(p < 0.001;中等效应量)、右侧(p < 0.001;中等效应量)、改良布拉加德试验左侧(p < 0.001;中等效应量)和右侧(p < 0.001;中等效应量)以及克尼格试验左侧(p < 0.001;中等效应量)和右侧(p < 0.001;中等效应量)方面,实验组表现更优。

结论

总之,对于因脊神经根受刺激或受压而出现症状的患者,手法牵引被推荐为缓解腰骶部脊柱疼痛的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dc5/11126845/43993453bd38/gr1.jpg

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