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整脊手法治疗联合经颅直流电刺激治疗慢性下腰痛的效果:一项双盲、随机、安慰剂对照试验。

Effects of osteopathic manipulative treatment associated with transcranial direct current stimulation in individuals with chronic low back pain: A double-blind, randomised placebo-controlled trial.

机构信息

Santa Casa School of Medical Sciences of São Paulo, São Paulo, Brazil.

Department of Physiotherapy, Faculty Anhanguera of Sorocaba, Sorocaba, São Paulo, Brazil.

出版信息

Clin Rehabil. 2024 Dec;38(12):1609-1621. doi: 10.1177/02692155241274718. Epub 2024 Oct 3.

Abstract

OBJECTIVE

To evaluate the effectiveness of osteopathic manipulative treatment (OMT) associated with transcranial direct current stimulation (tDCS) in reducing pain, disability, and improving quality of life in participants with non-specific chronic low back pain.

DESIGN

A randomised double-blind clinical trial.

SETTING

Clinical outpatient unit.

SUBJECTS

72 participants with non-specific chronic low back pain were randomised into three groups: active tDCS + OMT ( = 24), sham tDCS + sham OMT ( = 24), and sham tDCS + OMT ( = 24).

INTERVENTIONS

Evaluations were performed before, after the intervention, and one month post-intervention. tDCS consisted of ten 20-minute sessions over two weeks (five sessions per week). OMT was administered once per week, with two sessions conducted before the first and sixth tDCS sessions.

MAIN MEASURES

Pain, disability, and quality of life were assessed at baseline, after two weeks, and at one month of follow-up.

RESULTS

The visual analogue scale showed a significant decrease in all groups ( < 0.001). However, tDCS + OMT and sham tDCS + OMT demonstrated a clinically significant reduction compared to the sham combination (effect size ² = 0.315). Roland-Morris scores decreased across all groups without specific group effects. EuroQoL 5-Dimension 3-Level improvement was observed only in the tDCS + OMT and sham tDCS + OMT groups (significant difference between T2 and T0, = 0.002).

CONCLUSION

The combination of OMT and tDCS did not provide clinically significant improvement over OMT alone in participants with non-specific chronic low back pain.

摘要

目的

评估整脊手法治疗(OMT)联合经颅直流电刺激(tDCS)治疗非特异性慢性下腰痛的疗效,评估其对疼痛、残疾和生活质量的影响。

设计

随机双盲临床试验。

地点

临床门诊单位。

受试者

72 例非特异性慢性下腰痛患者被随机分为三组:真 tDCS+OMT 组(n=24)、假 tDCS+假 OMT 组(n=24)和假 tDCS+OMT 组(n=24)。

干预措施

分别在干预前、干预后和干预后 1 个月进行评估。tDCS 共进行 10 次 20 分钟的治疗,为期两周(每周 5 次)。OMT 每周进行 1 次,在第一次和第六次 tDCS 治疗前各进行 1 次。

主要观察指标

在基线、治疗 2 周和 1 个月随访时评估疼痛、残疾和生活质量。

结果

所有组的视觉模拟评分均显著下降(<0.001)。然而,tDCS+OMT 和假 tDCS+OMT 组与假联合组相比,疼痛程度有临床意义的降低(效应大小²=0.315)。Roland-Morris 评分在所有组中均降低,但无特定组间差异。仅在 tDCS+OMT 和假 tDCS+OMT 组中观察到 EuroQoL 5 维 3 级改善(T2 与 T0 之间存在显著差异,=0.002)。

结论

与单独 OMT 相比,OMT 联合 tDCS 治疗非特异性慢性下腰痛并未提供临床意义上的改善。

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