关节松动术与麦肯基技术对非特异性下腰痛的对比研究

nullPowers CM, Beneck GJ, Kulig K, et al. Effects of a Single Session of Posterior-to-Anterior Spinal Mobilization and Press-up Exercise on Pain Response and Lumbar Spine Extension in People With Nonspecific Low Back Pain. Phys Ther. 2008 Apr;88(4):485-93. Powers CM, Beneck GJ, Kulig K, et al. Effects of a Single Session of Posterior-to-Anterior Spinal Mobilization and Press-up Exercise on Pain Response and Lumbar Spine Extension in People With Nonspecific Low Back Pain. Phys Ther. 2008 Apr;88(4):485-93. qiang897 2011.4.5文献阅读背景及目的（ Background and Purpose ）背景及目的（ Background and Purpose ）Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. （后向前滑动和俯卧撑练习是治疗下腰痛常用的物理治疗方式） The purpose of this study was to examine the immediate effects of PA mobilization and a press-up exercise on pain with standing extension and lumbar extension in people with nonspecific low back pain. （这篇论文研究的目的是检测，后向前滑动和俯卧撑练习对非特异性下腰痛患者的疼痛以及站立位伸展的即刻效果）press-up exercisesPosterior-to-anterior (PA) mobilizationIntroductionIntroductionPeople who report low back pain often have reduced spinal motion. When motion is limited, spinal extension is frequently more restricted than flexion.（经历腰痛的人常常会导致脊柱活动度下降，而脊柱的伸展比屈曲更容易受限。）IntroductionIntroductionTwo commonly used methods for improving spinal extension are passive segmental mobilization and press-up exercises. （改善脊柱伸展通常的两种方法是脊柱松动术和麦肯基中的俯卧伸展练习） Maitland advocated the use of a segment-specific approach (ie, posterior-to-anterior [PA] mobilization)（ Maitland提倡使用特殊节段方法，例如：前向后的滑动 ） In contrast, McKenzie advocated a more general approach, in which a press-up exercise is used as a means of decreasing pain and increasing spinal motion. （然而，麦肯基提倡使用整体，俯卧伸展练习能减少疼痛和增加脊柱的活动度）IntroductionIntroductionThe purpose of this study was to assess the immediate effects of a single session of PA spinal mobilization and a press-up exercise on pain with standing extension and lumbar segmental extension(as quantified by dynamic imaging techniques)in people with low back pain.SubjectsSubjectsThe study participants were 30 adults (19 women and 11 men) who were 18 to 45 years of age and had a diagnosis of nonspecific low back pain. （受试对象为30名非特异性下腰痛成年人，19名女性和11名男性，年龄18岁-45岁）MethodsMethodsLumbar segmental extension during a press-up maneuver was measured by dynamic magnetic resonance imaging prior to and immediately following a single session of either PA spinal mobilization or a press-up exercise. （在PA滑动和俯卧撑练习前后进行俯卧位的腰椎伸展测试，测试用于动态MRI） Pain scores before and after intervention were recorded with a visual analog scale. （干预前后进行VAS评分） Differences between the treatment groups in pain and total lumbar extension were compared over time by use of a 2-way analysis of variance. （不同治疗组的疼痛与腰椎伸展的结果进行2次单因素方差分析）null 试验设计技术路线两组受试者基本资料两组受试者基本资料干预方式（Intervention）干预方式（Intervention）Both interventions were administered by a physical therapist with 18 years of manual therapy experience and certification as an Orthopaedic Clinical Specialist by the American Board of Physical Therapy Specialties.（两组干预手段都由一个具有18年手法治疗经验的物理治疗师完成，并且具有美国物理治疗专业委员会颁发的临床Orthopaedic专家）动态MRI监测的方式动态MRI监测的方式Intersegmental lumbar motion was measured in the resting position (left) Intersegmental lumbar motion was measured on the end-range image (right)结果——疼痛评分结果——疼痛评分The ANOVA results for average pain scores revealed a significant main effect for time(F=23.274;df=1,14;P=.001).结果——腰椎伸展度结果——腰椎伸展度The ANOVA results for average total lumbar extension revealed a significant main effect for time(F=11.764;df= 1,14;P=0.004;). DiscussionDiscussionThere was a slightly greater amount of motion improvement in the mobilization group. However, one treatment was not more effective than the other in achieving overall pain relief or increasing motion. （脊柱松动术比麦肯基有较轻微的改善，但是两种方法没有显著差异）文章不足之处一文章不足之处一 First, the small change in lumbar motion may have been linked to the patient‘s age or activity level. All the patients in this study were young and active.（本研究主要以青年人及运动水平较积极为主，不同年龄和运动水平不一样的受试者是否也是这样的效果？）文章不足之处二文章不足之处二the results of this study are short-term (after one session). Long-term results still need to be investigated. （远期效果有待于观察）ConclusionConclusionThe findings of this study support the use of PA mobilization and a press-up exercise for improving lumbar extension in people with nonspecific low back pain.（本研究发现P-A滑动和俯卧撑练习能提高非特异性下腰痛患者的腰椎伸展度） There were no significant differences in pain and lumbar extension between the 2 interventions studied. 想要更多信息，请战友看原文！想要更多信息，请战友看原文！