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首页> 外文期刊>Journal of Natural Science Biology and Medicine >Comparative clinical effects of spinal manipulation, core stability exercise, and supervised exercise on pain intensity, segmental instability, and health-related quality of life among patients with chronic nonspecific low back pain: A randomized control trial
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Comparative clinical effects of spinal manipulation, core stability exercise, and supervised exercise on pain intensity, segmental instability, and health-related quality of life among patients with chronic nonspecific low back pain: A randomized control trial

机译：脊柱操纵，核心稳定性运动和慢性非特异性低腰疼痛患者疼痛强度，节段性不稳定和健康相关生活质量的比较临床影响：随机对照试验

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Background: The purpose of this study was to investigate the comparative efficacy of spinal manipulative therapy-high-velocity low-amplitude (SMT-HVLA) thrust, core stability exercise (CSE), and supervised exercise on pain intensity (PI), segmental instability, and quality of life among patients with chronic nonspecific low back pain (CNSLBP). Materials and Methods: This was a randomized controlled trial conducted on 105 patients with CNSLBP (with duration of pain 3 months) distributed in three groups with 35 participants in each group, and an average age of the participants was 25.66 (standard deviation = 6.74) years. Participants received SMT-HVLA thrust (Group 1), CSE (Group 2), and supervised exercise (control group [CG]) with a common ergonomic advice (EA) for 2 weeks. The primary outcomes were PI measured by the Numeric Pain Rating Scale and segmental instability (postural sway) through the center of foot pressure measured by Win-Track platform. The secondary outcome was the quality of life measured by the EuroQoL questionnaire. All outcomes were assessed at baseline and 2 and 4 weeks. Two-way ANOVA followed by with post hoc Tukey's multiple comparison tests was carried out to examine treatment effects, and the relationship between the groups changes across outcome measures. Results: All participants completed the 2 weeks of intervention and the 4 weeks of follow-up. Group 1 had better outcomes than CG at 2 weeks (between-group difference in PI, P = 0.001; segmental instability, P = 0.001, and quality of life, P = 0.001) as compared to Group 2 and CG (between-group difference in PI, P = 0.03; segmental instability, P = 0.04; and quality of life, P = 0.05) as well as at 4 weeks (between-group difference in PI, P = 0.05; segmental instability, P = 0.03; and quality of life, P = 0.04). Conclusions: The SMT-HVLA thrust with EA providing pain reduction in patients with CNSLBP of high severity was associated with clinically better improvement in segmental instability (postural sway) and health-related quality of life. Thus, SMT may be an attractive option in such patients before proceeding for more invasive and costly treatments.
机译：背景：本研究的目的是探讨脊柱操纵治疗高速低振幅（SMT-HVLA）推力，核心稳定运动（CSE）的对比疗效，并对疼痛强度（PI）进行监督运动，细分不稳定，慢性非特异性低腰疼痛（CNSLBP）患者的生活质量。材料和方法：这是在105例CNSLBP患者（疼痛持续时间> 3个月）进行的随机对照试验，分为每组35名参与者，参与者的平均年龄为25.66（标准差= 6.74 ） 年。与会者收到SMT-HVLA推力（第1组），CSE（第2组），并具有普通符合人体工程学建议（EA）的监督运动（对照组[CG]）2周。主要结果是通过使用Win-Track平台测量的脚压中心测量的PI通过数值疼痛评定量表和节段不稳定（姿势摇摆）。次要结果是欧元季度调查问卷测量的生活质量。所有结果都在基线和2周和4周内进行评估。双向ANOVA随后进行了HOC Tukey的多个比较测试，以检查治疗效果，并且群体之间的关系在结果措施中变化。结果：所有参与者完成了2周的干预和4周后的后续行动。第1组在2周（PI的组差异之间的CG具有更好的结果（PI，P = 0.001;与第2组和CG相比，P = 0.001;分段不稳定性，P = 0.001，P = 0.001）（之间的差异在pi，p = 0.03;节段性不稳定性，p = 0.04;和生活质量，p = 0.05）以及4周（pi之间的组差异，p = 0.05;节段形不稳定性，p = 0.03;和质量生活，p = 0.04）。结论：对高严重程度CNSLBP患者的EA提供疼痛的SMT-HVLA推力与临床上更好地改善了细分不稳定（姿势摇摆）和与健康相关的生活质量有关。因此，在进行更多侵入性和昂贵的治疗之前，SMT可能是这种患者的吸引力。

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