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1.
Ruth Ballestero-Pérez Gustavo Plaza-Manzano Alicia Urraca-Gesto Flor Romo-Romo María de los Ángeles Atín-Arratibel Daniel Pecos-Martín Tomás Gallego-Izquierdo Natalia Romero-Franco 《Journal of manipulative and physiological therapeutics》2017,40(1):50-59
Objective
The objective of this study was to review the literature regarding the effectiveness of neural gliding exercises for the management of carpal tunnel syndrome (CTS).Methods
A computer-based search was completed through May 2014 in PubMed, Physiotherapy Evidence Database (PEDro), Web of Knowledge, Cochrane Plus, and CINAHL. The following key words were included: nerve tissue, gliding, exercises, carpal tunnel syndrome, neural mobilization, and neurodynamic mobilization. Thirteen clinical trials met the inclusion/exclusion criteria, which were: nerve gliding exercise management of participants aged 18 years or older; clinical or electrophysiological diagnostics of CTS; no prior surgical treatment; and absence of systemic diseases, degenerative joint diseases, musculoskeletal affectations in upper limbs or spine, or pregnancy. All studies were independently appraised using the PEDro scale.Results
The majority of studies reported improvements in pain, pressure pain threshold, and function of CTS patients after nerve gliding, combined or not with additional therapies. When comparing nerve gliding with other therapies, 2 studies reported better results from standard care and 1 from use of a wrist splint, whereas 3 studies reported greater and earlier pain relief and function after nerve gliding in comparison with conservative techniques, such as ultrasound and wrist splint. However, 6 of the 13 studies had a quality of 5 of 11 or less according to the PEDro scale.Conclusion
Limited evidence is available on the effectiveness of neural gliding. Standard conservative care seems to be the most appropriate option for pain relief, although neural gliding might be a complementary option to accelerate recovery of function. More high-quality research is still necessary to determine its effectiveness and the subgroups of patients who may respond better to this treatment. 相似文献2.
Billy Sin Jennifer Wiafe Christine Ciaramella Luis Valdez Sergey M. Motov 《The American journal of emergency medicine》2018,36(2):310-318
Background
Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED.Methods
The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched. Randomized controlled trials (RCT) that evaluated the use of IN analgesia for acute pain in the ED were included. Methodological quality of the trials was assessed using the Grading of Recommendations Assessment, Development, and Evaluation criteria.Results
Eleven randomized controlled trials (RCT) met the inclusion criteria. Four trials found significant reductions in pain scores, favoring IN analgesia. However, in all of the trials, pain relief was not sustained. Three trials reported superior pain reduction with comparators and three trials reported no statistical significance. One trial described effective pain relief with IN analgesia but did not provide data on statistical analysis.Conclusion
Eleven randomized controlled trials with various methodological flaws revealed conflicting conclusions. There is limited evidence to support the use of the IN analgesia over traditional routes for acute pain in the ED. The IN route may be a good alternative in scenarios where IV access is not feasible, patients are refusing injectable medications, or a fast onset of pain relief is needed. 相似文献3.
4.
Aubrey P. Monie Roger I. Price Christopher R.P. Lind Kevin P. Singer 《Journal of manipulative and physiological therapeutics》2018,41(2):111-122
Objectives
The purpose of this study was to assess the use of computer-aided combined movement examination (CME) to measure change in low back movement after neurosurgical intervention for lumbar spondylosis and to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from lumbar disk disease, disk protrusion, and nerve root compression cases.Methods
A test-retest, cohort observational study was conducted. Computer-aided CME was used to record lumbar range of motion in 18 patients, along with pain, stiffness, disability, and health self-report questionnaires. A minimal clinically important difference of 30% was used to interpret meaningful change in self-reports. z Scores were used to compare CME. Post hoc observation included subgrouping cases into 3 discrete pathologic conditions—disk disease, disk protrusion, and nerve root compression—to report intergroup differences in CME.Results
Self-report data indicated that 11, 7, and 10 patients improved by ≥30% in pain, stiffness, and function, respectively. Three patients experienced clinically significant improvement in health survey. A CME pattern reduced in all directions suggested disk disease. Unilaterally restricted movement in side-flexed or extended directions suggested posterolateral disk protrusion with or without ipsilateral nerve root compression. Bilateral restrictions in extension suggested posterior disk protrusion with or without nerve root compression. In 11 of the 18 cases, CME converged toward the NRR after surgery.Conclusion
We described the use of CME to identify atypical lumbar movement relative to an NRR. Data from this short-term postoperative study provide preliminary evidence for CME movement patterns suggestive of disk disease, disk protrusion, and nerve root compression. 相似文献5.
Purpose of Review
Peripheral nerve pain is common among patients with typical management including the use of pain medications, neuropathic agents, steroid injections, and nerve blocks. Additionally, the use of pulsed radiofrequency (PRF) and radiofrequency ablation (RFA) can be used in the management of chronic peripheral nerve pain. Previous studies investigating the effectiveness of RFA and PRF, typically case reports, have demonstrated that peripheral nerve RFA and PRF have the potential to provide relief of chronic pain for long duration. Our study aimed at testing efficacy of RFA/PRF for treating peripheral neuralgia. This was a retrospective review. We identified 16 patients who received 17 RFAs/PRFs. Outcomes of interest collected included pain scores before and after procedures, percent improvement in pain after each procedure, and duration of improvement until the time of data collection. In addition, demographic data including age, sex, and nerves involved were collected.Recent Findings
Eleven patients (12 RFAs/PRFs) (80%) reported improvement after their procedure. Pain scores improved significantly from 6.3?±?2.3 before each procedure to 3.6?±?2.7 after each procedure (p?=?0.003). Eleven patients (12 RFAs/PRFs) reported an average improvement of 60.8%?±?35% after their procedure with an average duration of improvement of 128.8?±?106.8 days.Summary
RFA and PRF can be used to treat chronic peripheral pain after conservative methods fail to do so. Large clinical trials are needed to confirm our finding.6.
Mohammad Manouchehrifar Masoumeh Lakestani Parvin Kashani Saeed Safari 《The American journal of emergency medicine》2018,36(11):2064-2067
Introduction
Differentiating between ischemic and hemorrhagic types is of special importance in the treatment process of patients with stroke. The present study was designed with the aim of evaluating the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) in differentiation of ischemic from hemorrhagic stroke.Methods
The present research is a diagnostic accuracy study on patients with stroke presenting to emergency department during 1?year. Ultrasonographic diameter of optic nerve sheath of both eyes was measured for all the patients and its sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios in differentiating ischemic stroke from hemorrhagic type were calculated considering CT scan findings as the gold standard.Results
80 patients with stroke (40 hemorrhagic and 40 ischemic) were studied. Mean age of the patients was 65.0?±?13.1?years (57.5% male). Mean ONSD was 5.5?±?0.4?mm in the ischemic group and 6.1?±?0.7?mm in the hemorrhagic group (p?<?0.0001). Area under the curve of ONSD in differentiation of hemorrhagic and ischemic stroke was 0.75 (95% CI: 0.64–0.86). In 5.5?mm cut-off point, sensitivity and specificity of ONSD in identifying the type of stroke were 75.0% (95% CI: 58.5–86.8) and 52.5% (95% CI: 36.3–68.2), respectively. These values were 57.5% (95% CI: 41.0–68.2) and 90.0% (95% CI: 75.4–96.7), respectively, in the 6?mm cut-off point.Conclusion
Findings of the present study showed that ultrasonographic diameter of optic nerve sheath has moderate accuracy in differentiation of hemorrhagic and ischemic stroke. 相似文献7.
Ryo Tanaka Takuya Umehara Yuuki Kawabata Tomohiko Sakuda 《Journal of manipulative and physiological therapeutics》2018,41(4):315-322
Objective
The purpose of this study was to assess the effect of continuous compression stimulation on pressure-pain threshold and muscle spasms in older adults with knee osteoarthritis.Methods
Thirty-two older adults with knee osteoarthritis on outpatient visits were randomly divided into 2 groups. Those in the treatment group (n = 16) received 5-minute massage therapy (continuous compression stimulation), and those in the control group (n = 16) received sham massage therapy (touch without compression). Immediately before and after single-intervention sessions, the pressure-pain threshold, muscle spasm, and pain were quantified.Results
The change in pain on walking in the treatment group exceeded 1.9 cm, corresponding to the minimum clinically important difference. In the treatment group, the pressure-pain threshold improved significantly for pain both at rest and while walking, but the improvement in muscle spasm was not significant.Conclusions
Massage therapy resulted in minimal clinically important changes for pain relief. There was an increase in the pressure-pain threshold in the older adults with knee osteoarthritis. We propose that the improvements in pain may be related to the medial thigh muscle rather than knee osteoarthritis. 相似文献8.
Lindsay M. Fox Mikiko Murakami Houman Danesh Alex F. Manini 《The American journal of emergency medicine》2018,36(6):1045-1048
Introduction
Battlefield acupuncture (BFA) is an ear acupuncture protocol used by the military for immediate pain relief. This is a pilot feasibility study of BFA as a treatment for acute low back pain (LBP) in the emergency department (ED).Methods
Thirty acute LBP patients that presented to ED were randomized to standard care plus BFA or standard care alone. In the BFA group, outcomes were assessed at the time of randomization, 5?min after intervention, and again within 1?h after intervention. In the standard care group outcomes were assessed at the time of randomization and again an hour later. Primary outcomes included post-intervention LBP on a 10-point numeric pain rating scale (NRS) and the timed get-up-and-go test (GUGT). t-Test and chi squared tests were used to compare differences between groups demographics to evaluate randomization, and Analysis of Covariance (ANCOVA) was used to assess differences in primary/secondary outcomes.Results
We randomized 15 patients to BFA plus standard care, and 15 patients to standard care alone. Demographics were similar between groups. Post-intervention LBP NRS was significantly lower in the BFA group compared with the standard care group (5.2 vs. 6.9, ANCOVA p?=?0.04). GUGT was similar between groups (21.3?s vs. 19.0?s, ANCOVA p?=?0.327). No adverse events from acupuncture were reported.Discussion
This pilot study demonstrates that BFA is feasible as a therapy for LBP in the ED. Furthermore, our data suggest that BFA may be efficacious to improve LBP symptoms, and thus further efficacy studies are warranted. (Clinicaltrials.gov registration number NCT02399969). 相似文献9.
Kristin Schoolman-Anderson Roni D. Lane Jeff E. Schunk Nancy Mecham Richard Thomas Kathleen Adelgais 《The American journal of emergency medicine》2018,36(9):1603-1607
Background
Pain management guidelines in the emergency department (ED) may reduce time to analgesia administration (TTA). Intranasal fentanyl (INF) is a safe and effective alternative to intravenous opiates. The effect of an ED pain management guideline providing standing orders for nurse-initiated administration of intranasal fentanyl (INF) is not known. The objective of this study was to determine the impact of a pediatric ED triage-based pain protocol utilizing intranasal fentanyl (INF) on time to analgesia administration (TTA) and patient and parent satisfaction.Methods
This was a prospective study of patients 3–17?years with an isolated orthopedic injury presenting to a pediatric ED before and after instituting a triage-based pain guideline allowing for administration of INF by triage nurses. Our primary outcome was median TTA and secondary outcomes included the proportion of patients who received INF for pain, had unnecessary IV placement, and patient and parent satisfaction.Results
We enrolled 132 patients; 72 pre-guideline, 60 post-guideline. Demographics were similar between groups. Median TTA was not different between groups (34.5?min vs. 33?min, p?=?.7). Utilization of INF increased from 41% pre-guideline to 60% post-guideline (p?=?.01) and unnecessary IV placement decreased from 24% to 0% (p?=?.002). Patients and parents preferred the IN route for analgesia administration.Conclusion
A triage-based pain protocol utilizing INF did not reduce TTA, but did result in increased INF use, decreased unnecessary IV placement, and was preferred by patients and parents to IV medication. INF is a viable analgesia alternative for children with isolated extremity injuries. 相似文献10.
Seval Yılmaz Serkan Taş Öznur Tunca Yılmaz 《Journal of manipulative and physiological therapeutics》2018,41(3):227-233
Objective
The purpose of this study was to investigate the presence of median nerve mechanosensitivity by comparing median nerve neurodynamic test results of patients with nonspecific neck pain (NNP) and asymptomatic individuals.Methods
A total of 40 patients (30 women, 10 men) with NNP between the ages of 21 and 62 years (39.53 ± 10.18 years) and 38 asymptomatic individuals (23 women, 15 men) between the ages of 18 and 60 years (37.13 ± 9.64 years) participated in the study. Pressure pain threshold was assessed with digital pressure algometer, cervical joint range of motion was assessed with a universal goniometer, and median nerve mechanosensitivity was assessed with Upper Limb Neurodynamic Test 1 (ULNT1). The test step where the first sensory response was given, the location and character of the sensory response, and the final elbow extension angle were recorded during ULNT1.Results
Patients with NNP had significantly decreased pressure pain threshold (P < .001), decreased range of motion of cervical flexion (P < .001), and decreased cervical lateral flexion (P = .001) compared with asymptomatic individuals, whereas no change was identified in range of motion of rotation (P = .100). In ULNT1, 45% of patients with NNP reported pain and 40% of them reported stretch. A total of 65% of asymptomatic individuals reported stretch, and 13% of them reported pain. It was identified in ULNT1 that final elbow extension angle was lower in the NNP group compared with asymptomatic individuals (P = .008).Conclusion
Median nerve mechanosensitivity increased, pressure pain threshold decreased, and active neck motion was limited in individuals with NNP compared with asymptomatic individuals. 相似文献11.
Yun Zhu Xue Peng Shuang Wang Wenyu Chen Congcong Liu Bingmei Guo Lin Zhao Yuanpeng Gao Kefang Wang Fenglan Lou 《The American journal of emergency medicine》2018,36(11):2085-2092
Background
Intravenous cannulation is a routine procedure in hospitalized patients, and pain can occur during the cannulation process. Vapocoolant spray is an advantageous analgesic alternative for intravenous cannula insertion.Objectives
The objective of our meta-analysis is to compare the effectiveness of vapocoolant spray and placebo spray/no treatment for pain reduction during intravenous cannulation.Design
A meta-analysis to identify evidence from randomized controlled trials.Methods
We searched Web of Science, PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang Data for publications before January 2018. The outcomes measured included pain during intravenous cannulation, patients' anxiety due to the spray, first attempt success rate, technical ease of the attempt, adverse events, and participant satisfaction.Results
We included 11 studies with 1410 patients. The meta-analysis results showed that vapocoolant spray significantly decreased pain during intravenous cannulation compared with placebo spray or no treatment in both adults and children. In addition, vapocoolant spray significantly increased the technical ease of the attempt and participants' satisfaction. However, patients' anxiety due to spray, first attempt success rate, and adverse events were not associated with vapocoolant spray.Conclusions
This meta-analysis suggests that vapocoolant spray significantly decreased pain during intravenous cannulation when compared with placebo spray or no treatment in both adults and children. We recommend the use of vapocoolant spray during intravenous cannulation to decrease pain. Future research may help to unify pain measurement standards. Patients' anxiety due to spray and technical ease of the attempt should be explored in future research. 相似文献12.
Joseph S. Colla Pavitra Kotini-Shah Savannah Soppet Yi-Fan Chen Robert Molokie Puja Prajapati Heather M. Prendergast 《The American journal of emergency medicine》2018,36(10):1855-1861
Background
Acute chest syndrome (ACS) is the leading cause of death for patients with sickle cell disease (SCD). Early recognition of ACS improves prognosis.Objective
Investigate the use of bedside lung ultrasound (BLU) in identification of early pulmonary findings associated with ACS in SCD patients.Methods
Prospective, observational study of a convenience sample of SCD patients presenting to the Emergency Department (ED) for a pain crisis. BLU interpretations were made by an emergency physician blinded to the diagnosis of ACS, and were validated by a second reviewer. The electronic medical record was reviewed at discharge and at 30?days.Results
Twenty SCD patients were enrolled. Median age was 31?years, median hemoglobin was 7.7?g/dL. Six patients developed ACS. Five patients in the ACS group had lung consolidations on BLU (83%) compared to 3 patients in the non-ACS group (21%), p?=?0.0181, (OR?=?12.05, 95% CI 1.24 to 116.73). The ACS group was also more likely to have a pleural effusion and B-lines on BLU than the non-ACS group, p?=?0.0175; 0.1657, respectively. In the ACS group, peripheral and frank consolidations on BLU was 83% and 50% sensitive, 79% and 100% specific for ACS, respectively; whereas an infiltrate on initial chest X-ray (CXR) was only 17% sensitive. BLU identified lung abnormalities sooner than CXR (median 3.6 vs. 31.8?h).Conclusions
Pulmonary abnormalities on BLU of an adult SCD patient presenting to the ED for a painful crisis appear before CXR, and highly suggest ACS. BLU is a promising predictive tool for ACS. 相似文献13.
Background
The emergency department evaluation of patients with abdominal pain is most appropriately directed at identifying acute inflammation, infection, obstruction, or surgical disease. Doing so commonly involves “routine” (and often extensive) diagnostic imaging and laboratory testing. Benign mimics of serious visceral abdominal pain that can be diagnosed by physical exam and confirmed with local anesthetic injections have been identified over the last century. These syndromes derive from painful irritation of the intercostal nerves by a mobile rib below, or from impingement of the cutaneous branches of those same intercostal nerves as they penetrate the abdominal wall. These peripheral neuropathic mimics of visceral abdominal pain continue to go unrecognized and underdiagnosed.Methods
Our purpose is to review the affirmative diagnosis of non-visceral abdominal pain by physical examination.Results
The consequences of failure to identify these conditions are considerable. In the search for a diagnosis that is literally at the provider's fingertips, patients frequently undergo months to years of fruitless and often invasive diagnostic tests, not uncommonly including unsuccessful surgeries.Conclusions
With proper consideration of and appropriate testing for visceral etiologies, a carefully directed physical examination may yield an affirmative diagnosis in a percentage of these common emergency department patients. 相似文献14.
Narjess Nabavi Mohammad A. Mohseni Bandpei Zahra Mosallanezhad Mahdi Rahgozar Shapour Jaberzadeh 《Journal of manipulative and physiological therapeutics》2018,41(2):102-110
Objectives
The purpose of this study was to compare the effect of 2 exercise programs combined with electrotherapy on pain intensity and lumbar stabilizer muscles dimensions in patients with nonspecific chronic low back pain.Methods
A randomized controlled clinical trial was performed with 41 patients with chronic LBP. Participants were randomly allocated into 2 groups: an experimental group (n = 20) received stabilization exercises plus electrotherapy, and a control group (n = 21) received routine exercises plus electrotherapy. Pain intensity, using a visual analog scale, and muscle dimensions of both right and left transverse abdominis and lumbar multifidus muscles, using rehabilitative ultrasonography, were assessed before and immediately after 4 weeks of intervention.Results
Significant improvement was identified after interventions on pain intensity and muscle size measurements in both groups (P < .01 in all instances). The only exception was the right-side lumbar multifidus cross-sectional area of the control group, which was not statistically significant (P = .081). No significant differences were found between the 2 exercise groups on pain intensity and muscle dimensions (P > .05 in all instances).Conclusions
The results of this study suggest that a combination of electrotherapy with either routine or stabilization exercise programs may improve pain intensity and muscle dimensions in patients with nonspecific chronic low back pain. 相似文献15.
Corrie E. Chumpitazi Elizabeth A. Camp Divya R. Bhamidipati Almea M. Montillo A. Chantal Caviness Lesby Mayorquin Faria A. Pereira 《The American journal of emergency medicine》2018,36(9):1577-1580
Background
There is no evidence of an association between fasting time and the incidence of adverse events during procedural sedation and analgesia. Pediatric and adult emergency medicine guidelines support avoiding delaying procedures based on fasting time. General pediatric guidelines outside emergent care settings continue to be vague and do not support a set fasting period for urgent and emergent procedures.Objective
To describe shortened preprocedural fasting and vomiting event rates during the implementation of a shortened fasting protocol.Methods
This was a prospective study of patients undergoing procedural sedation and analgesia (PSA) in an urban, tertiary care children's hospital emergency center from March 2010–February 2012. All consecutive patients had documentation of preprocedural fasting time and adverse events recorded on a standardized data collection form.Results
PSA occurred in 2426 patients with fasting data available for 2188 (90.2%); 1472 were fasted ≥6?h for solids and 716 patients were in the shortened fasting group (<6?h). There is no evidence of an association between emesis at any time and shortened fasting time unadjusted (OR?=?1.18 (95% CI 0.75–1.84) or adjusted for known risk factors including age >12?years, initial ketamine dose >2.5?mg/kg or total dose >5.0?mg/kg (OR?=?1.14 (95% CI 0.74–1.75).Conclusion
Analysis of a large prospective cohort study failed to find evidence of an association between emesis and shortened fasting time upon implementation of a shortened fasting protocol for procedural sedation and analgesia. 相似文献16.
Jui-Fen Cheng Xuan-Yi Huang Mei-Chu Lin Ya-Hui Wang Tzu-Pei Yeh 《Archives of Psychiatric Nursing》2018,32(4):610-616
Aims
To investigate a partnership intervention of the community-based and hospital-based home visit to improve patients' satisfaction.Methods
A time series quasi-experimental quantitative design was used. The experimental group had “partnership intervention”, while the control group maintained routine home visits. Patient satisfaction was measured pre-intervention, six months and 12?months after the partnership intervention.Results
Six and 12?months after partnership intervention, in the experimental group, items related to stabilizing disease conditions, improving daily living abilities, enhancing communication ability and providing relevant resources were significantly higher than pre-intervention. However, 12?months after the intervention, the influence of the intervention became weaken.Conclusions
The partnership intervention can significantly improve patients' satisfaction with home visit service. 相似文献17.
Hong Jun Zeng Gui Ying Zhou Hui Hong Yan Xiu Hong Yang Hui Min Jin 《Archives of Psychiatric Nursing》2018,32(6):896-900
Objective
This study summarized the cases of Chinese nurses' suicide during 2007–2016.Methods
We reviewed public reports on local media, and medical websites.Result
A total of 46 cases of nurse suicide reported or published from 2007 to 2016. In these 46 cases, the proportion of female suicide is 98%. Most cases of suicide occurred in nurses aged 18–50?years. The most common way of suicide was jump from building. Nurse suicide occurred more often in full-service tertiary hospitals.Conclusion
The Chinese Government and medical organization should be aware of severity of suicide, and take action to be avoided of more suicide in Chinese nurses. 相似文献18.
John S. Garrett Colyn Berry Hao Wong Huanying Qin Jeffery A. Kline 《The American journal of emergency medicine》2018,36(9):1581-1584
Background
To address emergency department overcrowding operational research seeks to identify efficient processes to optimize flow of patients through the emergency department. Vertical flow refers to the concept of utilizing and assigning patients virtual beds rather than to an actual physical space within the emergency department to care of low acuity patients. The aim of this study is to evaluate the impact of vertical flow upon emergency department efficiency and patient satisfaction.Methods
Prospective pre/post-interventional cohort study of all intend-to-treat patients presenting to the emergency department during a two-year period before and after the implementation of a vertical flow model.Results
In total 222,713 patient visits were included in the analysis with 107,217 patients presenting within the pre-intervention and 115,496 in the post-intervention groups. The results of the regression analysis demonstrate an improvement in throughput across the entire ED patient population, decreasing door to departure time by 17?min (95% CI 15–18) despite an increase in patient volume. No statistically significant difference in patient satisfaction scores were found between the pre- and post-intervention.Conclusions
Initiation of a vertical split flow model was associated with improved ED efficiency. 相似文献19.
Background
A total of 2.7 million patients present to US emergency departments annually for management of low back pain (LBP). Despite optimal medical therapy, more than 50% remain functionally impaired 3 months later. We performed a systematic review to address the following question: Among patients with nonchronic LBP, does spinal manipulation, massage, exercise, or yoga, when combined with standard medical therapy, improve pain and functional outcomes more than standard medical therapy alone?Methods
We used published searches to identify relevant studies, supplemented with our own updated search. Studies were culled from the Cochrane Register of Controlled Trials, Medline, EMBASE, CINAHL, and the Index to Chiropractic Literature. Our goal was to identify randomized studies that included patients with nonradicular LBP of <12 weeks’ duration that compared the complementary therapy to usual care, sham therapy, or interventions known not to be efficacious, while providing all patients with standard analgesics. The outcomes of interest were improvement in pain scores or measures of functionality.Results
We identified 2 randomized controlled trials in which chiropractic manipulation + medical therapy failed to show benefit vs medical therapy alone. We identified 4 randomized controlled trials in which exercise therapy + medical therapy failed to show benefit vs medical therapy alone. We did not identify any eligible studies of yoga or massage therapy.Conclusions
In conclusion, for patients with nonchronic, nonradicular LBP, available evidence does not support the use of spinal manipulation or exercise therapy in addition to standard medical therapy. There is insufficient evidence to determine if yoga or massage is beneficial. 相似文献20.
Serkan Taş Feza Korkusuz Zafer Erden 《Journal of manipulative and physiological therapeutics》2018,41(7):580-588