Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study.

Pub Date : 2020-12-01 Epub Date: 2020-03-20 DOI:10.1142/S1013702520500109
Wahyuddin Wahyuddin, Mantana Vongsirinavarat, Keerin Mekhora, Sunee Bovonsunthonchai, Rachaneewan Adisaipoapun
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Abstract

Background: Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported.

Objective: This study aimed to compare the immediate effects of MET and LSE in patients with chronic LBP with suspected facet joint origin.

Methods: Twenty-one patients with low back pain were recruited and randomly assigned to receive treatment either MET or LSE. The outcomes were kinematic changes, pain intensity, and disability level. Lumbar active range of motion (ROM) of flexion, extension, left and right lateral flexion, and left and right rotation were evaluated using the three-dimension motion analysis system at baseline and immediately after treatment. Pain intensity was evaluated using visual analogue scale (VAS) at baseline, immediately after, and two days after treatment. Thai version of the modified Oswestry disability questionnaire (ODQ) was utilized at baseline and two days after treatment. The mixed model analysis of variance was used to analyze all outcomes.

Results: The results showed that all outcomes were not different between groups after treatments. Although there were statistically significant improvements after the treatments when collapsing the groups, the minimal clinically important change was found only for pain but not for lumbar movements and disabilities scores.

Conclusion: The effect of MET and LSE alone in single session might not be intensive enough to improve movements and decrease disability in patients with chronic LBP with suspected facet joint origin.

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肌肉能量技术和稳定运动对疑似面关节源性慢性腰痛患者的立竿见影效果:试点研究。
背景:面关节是导致慢性腰背痛(LBP)的潜在结构,会影响腰部活动、疼痛和残疾。除了腰椎稳定运动(LSE)这一推荐治疗方法外,物理治疗诊所还常用包括肌肉能量技术(MET)在内的几种徒手治疗方法。然而,有关肌能技术效果的报道却很少:本研究旨在比较 MET 和 LSE 对疑似面关节源性慢性腰背痛患者的直接效果:方法:招募 21 名腰痛患者,随机分配其接受 MET 或 LSE 治疗。研究结果为运动学变化、疼痛强度和残疾程度。在基线和治疗后立即使用三维运动分析系统对腰椎屈曲、伸展、左右侧屈、左右旋转的主动运动范围(ROM)进行评估。使用视觉模拟量表(VAS)对基线、治疗后和治疗后两天的疼痛强度进行评估。泰语版改良奥斯韦特里残疾问卷(ODQ)在基线和治疗后两天使用。所有结果均采用混合方差分析模型进行分析:结果显示,治疗后各组间的所有结果均无差异。尽管将各组进行合并后,治疗后的结果在统计学上有显著改善,但只有在疼痛方面发现了最小临床意义变化,而在腰部运动和残疾评分方面却没有发现:结论:对疑似面关节源性慢性腰痛患者而言,单靠单次治疗中的 MET 和 LSE 的效果可能不足以改善其运动和减少残疾。
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