基于治疗的分类系统在腰痛患者计划管理中的可行性

Anitha M.N, Nityal Kumar Alagingi
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摘要

背景:腰痛(LBP)是普通人群中极为常见的症状,也是最令人烦恼的主诉。疼痛可以从持续的钝痛到突然的刺痛。在任何时候,80%的人都会经历某种形式的腰痛。对日益普遍的背痛的治疗效果是一个巨大的挑战,无论是卫生保健提供者和个人应对这个问题3。为了在日常临床实践中选择有效、快捷的治疗方法,腰痛患者在检查和体检时应根据症状进行分类。以治疗为基础的分类系统是关注个体临床表现的主要分类系统之一。以治疗为基础的分类系统也将影响下背痛治疗的临床决策3。目的:教育所有治疗背痛患者的治疗师使用基于治疗的分类系统对每个患者进行分类。目的:建立治疗师对腰痛患者使用基于治疗的分类系统的一致性和准确性。分析治疗师对基于治疗的分类系统规划腰痛治疗的可行性意见。研究设计:观察性研究方法:本观察性研究共招募46例患者。对每个患者进行评估,并根据治疗情况进行分类。在治疗的第一天和最后一天采用视觉模拟量表和患者特异性功能量表,并由训练有素的治疗师记录会话次数。结果:通过对5位治疗师的提问对结果进行分析。所有五个人都同意分类和时间的准确性,60%的人同意使用和目标设定的一致性,只有40%的人同意有用性。总可行性水平为75%。结论:采用TBC系统对腰痛进行分类、准确性和时间上的规划治疗是可行的,但成本效益不高。
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Feasibility of using Treatment based Classification System to Plan Management of Patients with Low Back Pain
Background: Low back pain (LBP) is an extremely common symptom and most troublesome of complaints in the general population. Pain can vary from a dull constant ache to a sudden sharp feeling. At any point in time 80% of general population will experience some type of low back pain1. Treatment efficacy for the increasing prevalence of this back pain is a great challenge for both health care providers and individuals coping with this problem3. In order to select an effective and efficient treatment in daily clinical practice, low back pain patients should be classified by symptoms during testing and physical examination. One of the main classification systems which focus individual clinical presentation is treatment based classification system. Treatment based classification system will also have impact on clinical decision-making in the management of low back pain3. Objectives: To educate all therapist working with patients with back pain to categorize each patients using treatment based classification system. To establish the consistency and accuracy of therapists in using treatment based classification system for patients with LBP. To analyze therapists opinion of the feasibility of treatment based classification system to plan the management of LBP. Study design: Observational study Method: A total of 46 patients were recruited in this observational study. Each patients was assessed and allocated to treatment based classification system. Visual analogue scale and Patient-Specific Functional Scale for first and last day of the treatment was taken and number of session also documented by the trained therapist. Results: Results were analysed by the questions obtained from the five therapists. All five agreed for the accuracy in categorization and time, 60% agreed for the consistency in usage and goal setting and only 40% agreement for the usefulness. The total feasibility level was 75%. Conclusion: The study concludes that using TBC system to plan management for low back pain is feasible in terms of categorization, accuracy and time but not cost effectiveness.
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