诊断和治疗上背部疼痛:来自新西兰手法治疗物理治疗师和整骨疗法师的见解。
Diagnosing and treating upper back pain: insights from New Zealand's manipulative physiotherapists and osteopaths.
作者信息
Kovanur Sampath Kesava, Smith Tevin, Belcher Suzie, Farrell Gerard, Fryer Gary, Vaughan Brett, Moran Rob
机构信息
Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand.
Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia.
出版信息
J Man Manip Ther. 2025 Apr;33(2):149-157. doi: 10.1080/10669817.2024.2438196. Epub 2024 Dec 9.
BACKGROUND
Manual therapy is routinely used in the management of upper back pain (UBP), a disabling condition. However, the approach to diagnosis and treatment techniques used by manipulative physiotherapists and osteopaths is largely unknown.
OBJECTIVES
To explore knowledge about UBP, including diagnosis and treatment, by New Zealand (NZ) osteopaths and manipulative physiotherapists and to investigate differences (if any) in the self-reported approaches to diagnosis and management of UBP between the professions.
DESIGN
A cross-sectional survey administered through an online platform (Qualtrics) between September 2023 and January 2024.
PARTICIPANTS
One hundred and ten NZ osteopaths and manipulative physiotherapists completed the survey.
RESULTS
Forty-eight percent ( = 53) of respondents identified their profession as physiotherapists and 52% ( = 57) as osteopaths. Over three-quarters of respondents (77%) 'strongly agreed' that a multimodal approach is essential for effective UBP management. Osteopaths were significantly more likely to proffer 'wear and tear/degeneration' ( < 0.01) and 'visceral referred pain' ( = 0.02) as the cause of a patient's UBP. In terms of management, osteopaths were significantly more likely to use soft tissue techniques ( < 0.01), spinal manipulations ( < 0.01), rib manipulations ( < 0.01), rib mobilizations ( < 0.01), and visceral techniques ( < 0.01), compared to physiotherapists.
CONCLUSIONS
The survey highlights a strong consensus among respondents that a multimodal approach is essential for effective UBP management. The survey also identified profession-specific approaches to the diagnosis and management of UBP. Future research using qualitative methods is required to further explore these profession-specific differences and explore outcomes of care.
背景
手法治疗常用于上背部疼痛(UBP)的管理,这是一种致残性疾病。然而,整骨疗法师和手法治疗物理治疗师所采用的诊断方法和治疗技术在很大程度上尚不为人所知。
目的
探讨新西兰整骨疗法师和手法治疗物理治疗师对UBP的认识,包括诊断和治疗,并调查这两个专业在自我报告的UBP诊断和管理方法上的差异(如有)。
设计
2023年9月至2024年1月通过在线平台(Qualtrics)进行的横断面调查。
参与者
110名新西兰整骨疗法师和手法治疗物理治疗师完成了调查。
结果
48%(n = 53)的受访者将自己的职业确定为物理治疗师,52%(n = 57)为整骨疗法师。超过四分之三的受访者(77%)“强烈同意”多模式方法对于有效的UBP管理至关重要。整骨疗法师更有可能提出“磨损/退化”(P < 0.01)和“内脏牵涉痛”(P = 0.02)作为患者UBP的病因。在管理方面,与物理治疗师相比,整骨疗法师更有可能使用软组织技术(P < 0.01)、脊柱手法(P < 0.01)、肋骨手法(P < 0.01)、肋骨松动术(P < 0.01)和内脏技术(P < 0.01)。
结论
该调查突出了受访者之间的强烈共识,即多模式方法对于有效的UBP管理至关重要。该调查还确定了UBP诊断和管理的专业特定方法。需要使用定性方法进行未来研究,以进一步探索这些专业特定差异并探索护理结果。
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本文引用的文献
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J Man Manip Ther. 2022-10
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