医学
坐骨神经痛
物理疗法
Oswestry残疾指数
指南
生活质量(医疗保健)
随机对照试验
腰痛
人口
可视模拟标度
康复
心理干预
背痛
外科
替代医学
护理部
环境卫生
病理
作者
Sinikka Kilpikoski,Arja Häkkinen,Jussi P. Repo,Kati Kyrölä,Juhani Multanen,Markku Kankaanpää,Aki Vainionpää,Esa-Pekka Takala,Hannu Kautiainen,Jari Ylinen
标识
DOI:10.1177/02692155231196393
摘要
Objective To compare the effectiveness of a McKenzie Method intervention in patients with sciatica with guideline-based patient education. Design Multi-centre, assessor-blinded, parallel-group, randomised trial Setting Two tertiary hospitals providing operative spinal care. Subjects Sciatica patients with magnetic resonance imaging-confirmed lumbar disc herniation compressing a nerve root. Interventions The McKenzie group received specific back exercises for seven visits combined with an educational book, and the Control group received a single session of self-management guidance according to usual practices. Main measures The primary outcome was the number of surgical operations. Secondary outcomes were pain measured using the Visual Analogue Scale, disability using the Oswestry Disability Index and health-related quality of life using a RAND-36 questionnaire at baseline and 24-month follow-up. Results Altogether 66 patients, mean age of 43 years, of which 50% were females with long-lasting sciatica, mean 16 weeks, were randomised to two groups. Nineteen patients (29%) had surgery. There was no significant difference in surgery rates between the groups. Back and leg pain decreased, and disability improved in both groups. Health-related quality of life improved in six dimensions out of eight in both groups. There were no significant between-group changes in the patient-reported outcomes at the follow-up. Conclusions Multiple sessions of McKenzie-based back exercises with a McKenzie-specific patient's educational book produced effects equal to guideline-based advice at long-term follow-up. However, the power of these results is diminished due to the small patient population and confounding factors.
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