Ducret Gilles, Guillaume Marc, Fardini Yann, Vejux Sandrine, Chaabi Hassène
Association of Biokinergie® Practitioners, Saint-Lunaire, France.
Soladis Clinical Studies, Roubaix, France.
Medicine (Baltimore). 2024 Dec 20;103(51):e40891. doi: 10.1097/MD.0000000000040891.
The first-line treatment for nonspecific low back pain (LBP) relief is physical exercise; however, there is no uniformity in recommendations regarding the type of exercise, and physicians predominantly prescribe pharmacological treatments. This creates a treatment gap in non-pharmacological management of LBP. Preliminary data suggest that manual therapy and acupressure could be relevant therapeutic options. The primary objective of this study was to describe the evolution of pain in patients with nonspecific LBP persisting for at least 4 weeks who received 2 treatment sessions combining manual therapy with acupressure (Biokinergie® method) as part of their routine management. In this prospective, observational, and non-interventional study, participants were monitored on the days of manual therapy session delivery (initial visit on Day 0 and follow-up visit on Day 21). Follow-up assessments occurred 3 days and 3 weeks post-therapy sessions. A total of 114 participants suffering from LBP for a median duration of 11.9 weeks were enrolled from May 2021 to May 2023. The intensity of average pain experienced over a 24-hour period was significantly reduced on Day 24 (-36.0 ± 27.2 mm on a visual analog scale of 100 mm, P < .001), with 82 (75.2%) participants reporting a decrease of at least 20 mm. Participants reported significant reductions in pain (-25.9 ± 23.9 mm on Day 3, -29.7 ± 26.7 mm on Day 21, and -40.9 ± 28.3 mm on Day 42, P < .001) and functional disability (Roland-Morris Disability Questionnaire score: -5.4 ± 0.4 points on Day 21 and -7.4 ± 0.4 points on Day 42, P < .001). This was associated with an improved Dallas Pain Questionnaire score, indicating a reduced impact of LBP on daily activities (-27.2 ± 2.0% on Day 21 and -35.8 ± 2.0% on Day 42, P < .001). Posttreatment, most participants (86.3%) reported reduced analgesic intake compared to baseline, and 83.3% were very satisfied with the therapy. A significant and clinically relevant reduction in lumbar pain was observed after 2 sessions of manual therapy combined with acupressure, paving the way for future clinical research.
缓解非特异性下腰痛(LBP)的一线治疗方法是体育锻炼;然而,关于锻炼类型的建议并不统一,医生主要开的是药物治疗。这在LBP的非药物管理方面造成了治疗缺口。初步数据表明,手法治疗和指压可能是相关的治疗选择。本研究的主要目的是描述持续至少4周的非特异性LBP患者在接受2次将手法治疗与指压(生物能量法®)相结合的治疗作为常规管理一部分后的疼痛演变情况。在这项前瞻性、观察性和非干预性研究中,在进行手法治疗的当天(第0天的初次就诊和第21天的随访就诊)对参与者进行监测。在治疗后3天和3周进行随访评估。2021年5月至2023年5月共招募了114名LBP患者,中位病程为11.9周。在第24天,24小时内平均经历的疼痛强度显著降低(在100毫米视觉模拟量表上为-36.0±27.2毫米,P<.001),82名(75.2%)参与者报告疼痛至少减轻了20毫米。参与者报告疼痛(第3天为-25.9±23.9毫米,第21天为-29.7±26.7毫米,第42天为-40.9±28.3毫米,P<.001)和功能障碍(罗兰-莫里斯残疾问卷评分:第21天为-5.4±0.4分,第42天为-7.4±0.4分,P<.001)显著减轻。这与达拉斯疼痛问卷评分的改善相关,表明LBP对日常活动的影响降低(第21天为-27.2±2.0%,第42天为-35.8±2.0%,P<.001)。治疗后,大多数参与者(86.3%)报告与基线相比镇痛药物摄入量减少,83.3%的人对治疗非常满意。在2次手法治疗与指压相结合后,观察到腰椎疼痛有显著且具有临床意义的减轻,为未来的临床研究铺平了道路。