比较应变-反应变法与运动疗法对下背部肌筋膜疼痛综合征的治疗效果：一项随机试验
Comparing the Therapeutic Impact of Strain-Counterstrain and Exercise on Low Back Myofascial Pain Syndrome: A Randomized Trial.
作者信息
Koura Ghada Mohamed Rashad, Elshiwi Ahmed Mohamed Fathi, Selim Mohamed Naeem, Asiri Amani Abdu Mohammed, Alqahtani Reem Hadi Jowaied, Elimy Doaa Ayoub, Alshehri Mohammed Abdullah, Alnakhli Hani Hassan, Assiri Sultan Mofreh, Ahmad Fuzail, Ahmad Irshad
机构信息
Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.
Consultant & Head of Physical Therapy Department, Saudi German Hospital, Aseer, Saudi Arabia.
出版信息
J Multidiscip Healthc. 2025 Jan 6;18:1-12. doi: 10.2147/JMDH.S499927. eCollection 2025.
BACKGROUND
Background: Strain-Counterstrain (SCS) therapy is a manual therapeutic technique used to treat myofascial pain by addressing tender points through passive positioning. Despite anecdotal evidence, limited peer-reviewed research supports its efficacy in chronic low back pain (LBP). This study evaluates the effects of SCS combined with exercise on pain severity, lumbar range of motion (ROM), and functional disability in patients with chronic LBP.
METHODS
A randomized controlled trial was conducted with 30 participants aged 45-55 years, divided into Group A (SCS + Exercise) and Group B (Exercise Only). Outcome measures included pain intensity, lumbar ROM (flexion, extension, side bending), and functional disability (Oswestry Disability Index). Assessments were conducted at baseline and after four weeks of intervention. MANOVA was performed to evaluate group, time, and interaction effects, with detailed univariate follow-ups and effect sizes. Reliability of ROM measurements was ensured using intraclass correlation coefficients (ICC > 0.90).
RESULTS
MANOVA revealed statistically significant group, time, and interaction effects for all outcomes (Wilks' Lambda = 0.065, F (6, 51) = 91.34, p < 0.001). Pain severity decreased by 26.7% in Group A compared to 5.2% in Group B (F (1, 56) = 65.78, p < 0.001, partial η² = 0.77). Lumbar ROM improved significantly in Group A for flexion (10.9%), extension (20.3%), and right-side bending (17.7%) (p < 0.001, partial η² = 0.68-0.74), with no significant improvement in left-side bending. Functional disability scores reduced by 25.2% in Group A versus 2.3% in Group B (F (1, 56) = 53.45, p < 0.001, partial η² = 0.73).
CONCLUSION
SCS therapy combined with exercise significantly reduces pain, improves lumbar ROM, and enhances functional capacity in patients with chronic LBP compared to exercise alone. These findings highlight SCS as a promising adjunctive treatment for managing chronic musculoskeletal pain. Future studies should investigate long-term outcomes and further refine treatment protocols.
背景
应变-反应变（SCS）疗法是一种手动治疗技术，通过被动体位处理压痛点来治疗肌筋膜疼痛。尽管有一些传闻证据，但经同行评审的研究有限，支持其对慢性下腰痛（LBP）的疗效。本研究评估SCS联合运动对慢性LBP患者疼痛严重程度、腰椎活动范围（ROM）和功能障碍的影响。
方法
对30名年龄在45-55岁的参与者进行了一项随机对照试验，分为A组（SCS+运动）和B组（仅运动）。结果测量包括疼痛强度、腰椎ROM（前屈、后伸、侧屈）和功能障碍（Oswestry功能障碍指数）。在基线和干预四周后进行评估。进行多变量方差分析以评估组、时间和交互作用的影响，并进行详细的单变量随访和效应大小分析。使用组内相关系数确保ROM测量的可靠性（ICC>0.90）。
结果
多变量方差分析显示所有结果在组、时间和交互作用方面均有统计学显著差异（威尔克斯'λ=0.065，F（6,51）=91.34，p<0.001）。A组疼痛严重程度下降了26.7%，而B组下降了5.2%（F（1,56）=65.78，p<0.001，偏η²=0.77）。A组腰椎ROM在前屈（10.9%）、后伸（20.3%）和右侧屈（17.7%）方面有显著改善（p<0.001，偏η²=0.68-0.74），左侧屈无显著改善。A组功能障碍评分降低了25.2%，而B组降低了2.3%（F（1,56）=53.45,p<0.001，偏η²=0.73）。
结论
与单独运动相比，SCS疗法联合运动可显著减轻慢性LBP患者的疼痛，改善腰椎ROM，并增强其功能能力提升功能。这些发现突出了SCS作为一种有前景的辅助治疗方法来管理慢性肌肉骨骼疼痛。未来的研究应调查长期结果并进一步完善治疗方案。
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