Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial
Por:
Martí-Salvador M, Hidalgo-Moreno L, Doménech-Fernández J, Lisón JF and Arguisuelas MD
Publicada:
1 sep 2018
Resumen:
Objective: To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP).
Design: Parallel group randomized controlled trial.
Setting: Private and institutional health centers.
Participants: Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months.
Interventions: Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention (n = 33), conducted in 5 sessions provided during 4 weeks.
Main Outcome Measures: The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire [SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland-Morris Questionnaire [RMQ] and the Oswestry Disability Index [ODI]). Secondary outcomes were fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization. All outcome measures were evaluated at baseline, at week 4, and at week 12.
Results: A statistically significant reduction was observed in the experimental group compared to the sham group in all variables assessed at week 4 and at week 12 (SF-MPQ [mean difference -6.2; 95% confidence interval, -8.6 to -3.8]; VAS [mean difference -2.7; 95% confidence interval, -3.6 to -1.8]; RMQ [mean difference -3.8; 95% confidence interval, -5.4 to -2.2]; ODI [mean difference -10.6; 95% confidence interval, -14.9 to 6.3]). Moreover, improvements in pain and disability were clinically relevant.
Conclusions: An OMT protocol that includes diaphragm techniques produces significant and clinically relevant improvements in pain and disability in patients with NS-CLBP compared to the same OMT protocol using sham diaphragm techniques. (C) 2018 by the American Congress of Rehabilitation Medicine
Filiaciones:
Martí-Salvador M:
Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
Hidalgo-Moreno L:
Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
:
Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain
Lisón JF:
Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
Arguisuelas MD:
Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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