Spinal manipulation, epidural injections, and self-care for sciatica: A pilot study for a randomized clinical trial

被引:30
|
作者
Bronfort, G
Evans, RL
Maiers, M
Anderson, AV
机构
[1] NW Hlth Sci Univ, Wolfe Harris Ctr Clin Studies, Bloomington, MN 55431 USA
[2] Pain Assessment & Rehabil Ctr, Edina, MN USA
关键词
chiropractic manipulation; drug therapy; spine; sciatica;
D O I
10.1016/j.jmpt.2004.08.002
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: To assess the feasibility of recruiting sciatica patients and to evaluate their compliance in preparation forfull-scale randomized clinical trial. We also aimed to determine the responsiveness of key outcome measures. Methods: Thirty-two subjects were randomly assigned to spinal manipulation (n = 11), epidural steroid injections (n = 11), or self-care education (n = 10). No between-group comparisons were planned because of the small sample size. Results: At week 12 (the end of the treatment phase), the outcome measures indicating the most improvement/change were the Oswestry disability score (mean, 22.9; SD, 19.9; effect size [ES], 1.8), leg pain severity (mean, 2.9; SD, 1.7; ES, 1.7), and if the symptoms were bothersome (mean, 25.2; SD, 16.0; ES, 1.6). Twenty-four patients were either,"very satisfied' or "completely satisfied," and 22 of 32 patients reported 75% or 100% improvement. After 52 weeks, the outcome measure showing the most improvement/change was leg pain severity (mean, 2.3; SD, 2.6; ES, 1.35), followed by the Oswestry disability score (mean, 15.6; SD, 20; ES, 1.2) and if symptoms were bothersome (mean, 18.1; SD, 22.6; ES, 1.1). Eighteen patients were either "very satisfied" or "completely satisfied," and 15 of 32 patients reported 75% or 100% improvement. Conclusions: The results of this pilot study suggest that it is feasible to recruit subacute and chronic sciatica patients and to obtain their compliance for a full-scale randomized clinical.
引用
收藏
页码:503 / 508
页数:6
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