ORTHOPAEDIC MANUAL THERAPY, MCKENZIE METHOD OR ADVICE ONLY FOR LOW BACK PAIN IN WORKING ADULTS: A RANDOMIZED CONTROLLED TRIAL WITH ONE YEAR FOLLOW-UP

被引:71
作者
Paatelma, Markku [1 ]
Kilpikoski, Sinikka [1 ]
Simonen, Riitta [2 ]
Heinonen, Ari [1 ]
Alen, Markku [3 ,4 ]
Videman, Tapio [5 ]
机构
[1] Univ Jyvaskyla, Dept Hlth Sci, Jyvaskyla, Finland
[2] Finnish Inst Occupat Hlth, Helsinki, Finland
[3] Oulu Univ Hosp, Dept Rehabil Med, Oulu, Finland
[4] Univ Oulu, Inst Hlth Sci, Oulu, Finland
[5] Univ Alberta, Fac Rehabil Med, Edmonton, AB, Canada
关键词
educational booklet; McKenzie method; orthopaedic manual therapy; low back pain; back pain;
D O I
10.2340/16501977-0262
中图分类号
R49 [康复医学];
学科分类号
100215 [康复医学与理疗学];
摘要
Objective: To examine the effects of 2 manual therapy methods compared with one counselling session with a physiotherapist with "advice-only to stay active" for treating low back pain/leg pain and disability. Design: A randomized, controlled trial with a 1-year follow-up. Subjects: A total of 134 subjects with low back disorders. Methods: Participants with acute to chronic first or recurrent low back pain, excluding those with "red flag" criteria, were assigned randomly to one of the 3 intervention groups: an orthopaedic manual therapy group (n = 45), a McKenzie method group (n = 52), and an "advice only to be active" group (advice-only) (n = 37). Data on leg and low back pain intensity and disability (Roland-Morris Disability questionnaire) were collected at baseline, and at 3-, 6-, and 12-month follow-up points. Results: At the 3-month follow-up point, significant improvements had occurred in all groups in leg and low back pain and in the disability index, but with no significant differences between the groups. At the 6-month follow-up, leg pain (-15 mm; 95% confidence interval (CI) -30 to -1), back pain (effect: -15 mm; -27 to -4), and disability index (-4 points; -7 to -1) improved (p < 0.05) more in the McKenzie method group than in the advice-only group. At the 1-year follow-up, the McKenzie method group had (p = 0.028) a better disability index (-3 points, -6 to 0) than did the advice-only group. In the orthopaedic manual therapy group at the 6-month and 1-year follow-up visits, improvements in the pain and disability index were somewhat better than in the advice-only group (p = 0.067 and 0.068, respectively). No differences emerged between the orthopaedic manual therapy and McKenzie method groups in pain- and disability-score changes at any follow-up. Conclusion: The orthopaedic manual therapy and McKenzie methods seemed to be only marginally more effective than was one session of assessment and advice-only.
引用
收藏
页码:858 / 863
页数:6
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