CHIROPRACTIC DEMONSTRATION PROJECTS GRANT

脊椎按摩疗法示范项目拨款

• 批准号: 2056457
• 负责人: Chang-Yu John Hsieh
• 金额: --
• 依托单位: SOUTHERN CALIFORNIA UNIV OF HEALTH SCIS
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1998-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2056457
• 关键词: articular cartilage; backache; biomechanics; chiropractic; clinical trials; exercise; health care cost /financing; health care service evaluation; health service demonstration project; human subject; human therapy evaluation; muscle disorder diagnosis; muscle relaxation; physical therapy; questionnaires

Low back pain is a leading cause of disability in the United States. Many patients have myofascial pain and/or articular dysfunctions and undergo a variety of therapies without knowing what works the best. Practitioners' diagnoses vary depending results of their manual palpation. Subsequently, ambiguity and controversy arise. The major goal of this study is to compare the treatment outcome and cost- effectiveness of allopathic, chiropractic, and combination of both in the treatment of mechanical low back pain due to myofascial and articular dysfunctions. The study has four specific aims: 1) to determine which therapy is the most cost-effective for treating low back pain; 2) to examine the inter-examiner reliability of manual diagnostic procedures and the effect of interprofessional training; 3) to determine the prevalence of the myofascial and articular dysfunctions; 4) to observe the clinician- patient encounter patterns and their relationships to the outcomes. The study has two stages. In stage I, inter-examiner reliability will be studied using 78 subjects separated into two groups (one with myofascial pain and the other with articular dysfunction). Four allopathic and four chiropractic physicians will participate and half of them will receive training before the study. In stage II, we will screen approximately 1000 patients and select 300 patients for a randomized controlled trial involving four treatment group: back school (as control), back school and myofascial therapy, back school and chiropractic manipulation, and combined therapies. Treatment will last three weeks. The outcome variables will be evaluated four times, i.e. Week 0,3, and again at one week and six months after completion of therapy. Pain and disability questionnaires, clinical outcomes and cost data will be collected and analyzed using appropriate statistics. Clinician-patient encounters will also be observed throughout the second stage. This study has several strengths: involvement of one major allopathic university and one major chiropractic college, addressing the cost- effectiveness issue of low back pain therapy with multiple therapies, use of multiple outcome measures, and true multi-disciplinary collaborations. The result of this project not only will improve the practitioners' skills, but also will have important implications to national practice guidelines.

腰痛是美国残疾的主要原因。 许多 患者患有肌筋膜疼痛和/或关节功能障碍并接受治疗 各种疗法都不知道哪种效果最好。练习者的 诊断因手动触诊的结果而异。随后， 就会产生歧义和争议。 本研究的主要目的是比较治疗结果和成本 对抗疗法、脊椎按摩疗法以及两者结合的有效性 治疗由肌筋膜和关节引起的机械性腰痛 功能障碍。该研究有四个具体目标：1）确定哪些 治疗是治疗腰痛最经济有效的疗法； 2）到 检查手动诊断程序的检查者间的可靠性，以及 跨专业培训的效果； 3) 确定患病率 肌筋膜和关节功能障碍； 4) 观察临床医生- 患者的遭遇模式及其与结果的关系。 该研究分为两个阶段。在第一阶段，考官间的可靠性将 研究人员将 78 名受试者分为两组（一组患有肌筋膜损伤） 疼痛和其他关节功能障碍）。四对抗疗法和四 脊椎按摩医生将参与其中，其中一半将获得 学习前的培训。在第二阶段，我们将筛选大约1000个 患者并选择 300 名患者进行随机对照试验 涉及四个治疗组：回到学校（作为对照组）、回到学校和 肌筋膜疗法、背部学校和脊椎按摩疗法，以及 联合疗法。治疗将持续三周。结果变量 将评估四次，即第 0,3 周，并在第 1 周和第 6 周再次评估 治疗完成后几个月。 疼痛和残疾调查问卷， 将使用以下方法收集和分析临床结果和成本数据 适当的统计数据。还将观察临床医生与患者的接触情况 整个第二阶段。 这项研究有几个优点： 涉及一种主要的对抗疗法 大学和一所主要的脊椎按摩疗法学院，解决成本问题 多种疗法、使用方法的腰痛治疗的有效性问题 多种结果衡量标准以及真正的多学科合作。 该项目的成果不仅将提高从业者的 技能，但也将对国家实践产生重要影响 指导方针。