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1.
Medicine (Baltimore) ; 100(16): e25652, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879748

RESUMO

BACKGROUND: Lumbar herniated intervertebral disc (LHIVD) is a common disease that causes low back pain. Traditional Chinese medicine (TCM) with conservative conventional treatment is known to be effective at treating LHIVD, but evidence for complex TCM therapies with conventional intervention has not been sufficiently collected to facilitate quality assessment and synthesis of data. METHODS AND ANALYSIS: Studies were retrieved from the following databases: the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, 7 Korean databases (Korean Studies Information Service System, Korean Traditional Knowledge Portal, Oriental Medicine Advanced Searching Integrated System, Korean National Assembly Digital Library, Korean Association of Medical Journal Editors, National Digital Science Library, and Database Periodical Information Academic), Japan Medical Abstracts Society, and Chinese National Knowledge Infrastructure. The risk of bias of the included studies will be assessed using the Cochrane Assessment Tool for Risk of Bias. Eligible studies were quantitatively synthesized through a meta-analysis. The primary outcome will be pain scales, and the secondary outcomes will include range of motion, questionnaires for lumbar function, questionnaire for quality of life, etc. ETHICS AND DISSEMINATION: Ethical approval was waived for this study protocol because it does not provide any patient data. The results of this review will be disseminated through peer-reviewed publications. REGISTRATION NUMBER: DOI 10.17605/OSF.IO/K7NJ8 (https://osf.io/k7nj8).


Assuntos
Tratamento Conservador/métodos , Deslocamento do Disco Intervertebral/terapia , Dor Lombar/terapia , Vértebras Lombares , Medicina Tradicional Chinesa/métodos , Terapia Combinada , Humanos , Deslocamento do Disco Intervertebral/complicações , Dor Lombar/etiologia , Metanálise como Assunto , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
2.
Zhongguo Zhen Jiu ; 41(4): 391-4, 2021 Apr 12.
Artigo em Chinês | MEDLINE | ID: mdl-33909359

RESUMO

OBJECTIVE: To observe the clinical effect of single acupoint [Yaotu (extra)] electroacupuncture (EA) therapy on lumbar intervertebral disc herniation (LIDH) and its promotion and application in community medical institutions. METHODS: This research adopted a three-level promotion model, and used multi-center collaboration topics as a platform. A total of 240 patients with LIDH were divided into a group A (top three hospital, 80 cases, 3 cases dropped off), a group B (secondary hospital, 80 cases, 8 cases dropped off), and a group C (community health center, 80 cases, 7 cases dropped off). All groups were treated with EA at a single acupoint [Yaotu (extra)] under the guidance of a unified experimental protocol. The EA was given 60 min each time and performed 3 times a week for a total of 2 weeks. The changes of visual analogue scale (VAS) scores of three groups before and after each treatment were compared, and the clinical efficacy was evaluated. RESULTS: Compared with before each treatment, the VAS scores of three groups after each treatment decreased (P<0.05). Except for the second and fifth treatments, the immediate effect in the group A was higher than that in the group B and C (P<0.05). The total effective rate of group A, group B, and group C respectively was 90.9% (70/77), 93.1% (67/72), 86.3% (63/73), and there was no statistically significant difference among the three groups (P>0.05). CONCLUSION: The single acupoint EA therapy has a significant effect in the treatment of LIDH, can quickly relieve the pain symptoms, and has the characteristics of simple operation and easy control, suitable for promotion and application in primary hospitals.


Assuntos
Eletroacupuntura , Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Disco Intervertebral , Pontos de Acupuntura , Humanos , Deslocamento do Disco Intervertebral/terapia
3.
Medicine (Baltimore) ; 100(12): e25199, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761703

RESUMO

INTRODUCTION: Lumbar disc herniation (LDH) is the most common cause of low back pain and severely affects people's quality of life and ability to work. Although many clinical trials and medical reports conducted over the years have shown that acupuncture treatments are effective for LDH, the comparative effectiveness of these different acupuncture therapies is still unclear. This protocol of a network meta-analysis was designed to compare the effects and safety of acupuncture treatment regimens on LDH using both direct and indirect evidence. METHODS AND ANALYSIS: This protocol is reported according to the 2015 PRISMA-P and PRISMA guidelines for acupuncture. Eight databases and two platforms will be searched for articles published from their establishment to 1 December 2020 with medical subject heading terms and keywords. Three reviewers will verify the eligible randomized controlled trials independently. NoteExpress (3.2.0) software will be utilized to manage the literature. The overall quality of evidence will be evaluated by Confidence In Network Meta-Analysis (CINeMA). Additionally, we will conduct a meta-analysis of the effectiveness, recurrence rate, and symptom score of acupuncture in treating LDH using Review Manager (RevManV.5.4.1) and R4.0.2 software (The R Foundation for Statistical Computing). RESULTS: The results of the study will be published in journals or relevant conferences. CONCLUSION: This proposed systematic review will evaluate the comparative efficacy and safety of various acupuncture methods and combination protocols for LDH.


Assuntos
Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , Deslocamento do Disco Intervertebral/terapia , Metanálise em Rede , Revisões Sistemáticas como Assunto , Humanos , Vértebras Lombares , Projetos de Pesquisa
4.
Medicine (Baltimore) ; 100(9): e24347, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655911

RESUMO

BACKGROUND: Lumbar disc herniation (LDH), as a disease with great disturbance to life and work, is known as the origin of the severe and disabling forms of nerve root pain. Recognized as an increasingly widely accepted treatment, the efficacy of moxibustion on LDH has been affirmed. However, clinical practice guidelines (CPG) for the treatment of LDH with moxibustion have not been developed. Therefore, we will carry out this work following the accepted methodological quality standards. METHODS: The new CPG will be developed according to the Institute of Medicine (IOM), the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and WHO guideline handbook. And then determine recommendations based on high-level evidence. We will set up a Guideline Working Group and define clinical issues according to the PICO principles (Population, Intervention, Comparison, Outcomes). After evidence syntheses and several rounds of Delphi process, we will reach the consensus. In making the guideline, Patient values or preferences, results of peer review, and interest statements are all within the bounds of what we must consider. RESULTS: As the study is not yet complete, no results can be reported. CONCLUSION: So far, we will develop the first CPG for moxibustion of LDH strictly based on systematic methodologies in China. This CPG will establish the standard of LDH in moxibustion therapy. REGISTRATION NUMBER: IPGRP-2020CN034.


Assuntos
Prática Clínica Baseada em Evidências/normas , Deslocamento do Disco Intervertebral/terapia , Moxibustão/normas , Guias de Prática Clínica como Assunto , Humanos , Vértebras Lombares , Moxibustão/métodos
5.
Zhongguo Gu Shang ; 34(1): 86-90, 2021 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-33666026

RESUMO

OBJECTIVE: To observe the clinical effect of lever positioning manipulation for the treatment of lumbar disc herniation and its effect on Cobb angle. METHODS: From December 2017 to November 2018, 67 patients with lumbar disc herniation were included in the study. The patients were randomly divided into treatment group and control group by digital table method. There were 34 cases in the treatment group, including 20 males and 14 females, with an average age of (36.09±8.26) years old and a course of (13.79±15.50) months. Treatment group was treated with lever positioning manipulation. There were 33 cases in the control group, including 18 males and 15 females, with an average age of(36.48±7.81) years old and a course of (12.82±15.68) months. Control group was treated with lumbar slanting manipulation. Two groups were treated 3 times a week, once every other day, 6 times for a course of treatment, after 2 courses of treatment, the changes of Cobb angle before and after treatment were compared between two groups by imaging. The symptoms and signs were scored with reference to clinical evaluation standard;overall efficacy was evaluated with reference to "Diagnostic Efficacy Criteria of Traditional Chinese Medicine Syndrome" issued by the State Administration of Traditional Chinese Medicine for lumbar disc herniation. RESULTS: One patient in each group dropped out. The symptom and sign scores of treatment group and control group before treatment were 18.56± 4.81, 18.61±3.72, while after treatment were 9.41±5.19, 13.55±3.68;treatment group was significantly lower than control group after treatment (P<0.05). The rate of overall efficacy of treatment group and control group were 97.06% and 75.76%, respectively, and treatment group was superiorto control group(P<0.05). Post treatment Cobb angle of both groups of patients became smaller(P<0.05). The Cobb angle of treatment group and control group were(17.95±4.45)°, (18.14±3.59)° before treatment, while after treatment were (18.14±3.59)°, (15.49±1.75)°, change of Cobb angle in treatment group was better than in controlgroup(P<0.05). CONCLUSION: Both the lever positioning manipulation and the lumbar slanting manipulation methods are effective for the treatment of lumbar disc herniation, but clinical effect of lever positioning method on lumbar disc herniation is more significant, and the effect on Cobb angle is more obvious. It is worthy of promotion.


Assuntos
Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Manipulação da Coluna , Adulto , Feminino , Humanos , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Masculino , Medicina Tradicional Chinesa , Resultado do Tratamento
6.
Medicine (Baltimore) ; 100(1): e24203, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429811

RESUMO

BACKGROUND: Lumbar disc herniation (LDH) is an important factor of causing leg pain and numbness. As a secondary discipline of Traditional Chinese Medicine, tuina is widely used for the treatment of LDH in China even in other nations while its clinical value is not acknowledged universally. So, we focus on this article aims to evaluate its efficacy and safety of LDH. METHODS: Electronic databases involving Cochrane Library, PubMed, Web of Science, EMBASE, China Science and Technology Journal, China National Knowledge Infrastructure, Wanfang and Chinese Biomedical Literature Database will be pertained with appropriate search strategy. And RevMan V.5.3.5 software will be conducted as the assessment tool for bias risk, data synthesis, subgroup analysis as well as meta-analyses. RESULTS: This systematic review will provide a high-quality synthesis of current evidence of tuina for LDH. CONCLUSION: This protocol will determine whether Tuina is an effective and safe treatment method for LDH.


Assuntos
Terapia por Acupuntura , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Humanos , Dor Lombar/terapia , Medicina Tradicional Chinesa
7.
Medicine (Baltimore) ; 99(50): e23751, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327365

RESUMO

BACKGROUND: A very large acceleration in clinical studies on the efficacy of fire needle to treat lumbar disc herniation (LDH) are increasing, while studies on the assessment of its efficacy are still lacking. Therefore, this study will demonstrate the efficacy of fire needle in the treatment of LDH combining with the meta-analysis. METHODS: The studies on randomized controlled trials (RCTs) will be searched at the databases of China National Knowledge Infrastructure (CNKI), WANFANG database (Chinese Medicine Premier), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature database (CBM), PubMed, EMBASE, and Cochrane Library from their inception to May 1, 2020. RESULTS: This authentic and multi-dimensional study will shed light on the referable information for the treatment of LDH with fire needle. CONCLUSION: This study will evaluate the efficacy of fire needle in the treatment of LDH. REGISTRATION: PROSPERO (registration number CRD42020158596).


Assuntos
Terapia por Acupuntura/métodos , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
8.
Medicine (Baltimore) ; 99(51): e23812, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371159

RESUMO

ABSTRACT: Ninety percent of elderly patients with lumbar disc herniation (LDH) have problems with the mechanics of the spine and muscle tissue. Shi-style spine balance manipulation combined with guidance (Daoyin) of muscle and bone as an alternative therapy for LDH can tone the muscle groups around the spine and maintain optimal mechanical and static sagittal balance of the spine. This study will be performed to investigate the effect of a combination of Shi-style spine balance manipulation and Daoyin therapy on LDH in middle-aged and elderly patients. In this non-blinded, randomized controlled trial, 72 eligible patients will be randomly divided into a treatment group (Shi-style spine balance manipulation combined with Daoyin therapy) and a control group (lumbar mechanical traction). Before and after the intervention, lumbar X-ray and magnetic resonance imaging examinations will be performed to observe the sagittal balance parameters of the spine and pelvis and the lumbar muscle strength. The visual analog scale score, Oswestry disability index score, and pressure pain threshold will be evaluated at baseline and at 2, 4, 12, and 24 weeks. During the treatment period, any signs of acute adverse events, such as paralysis of the lower extremities or cauda equina syndrome, will be recorded at each visit. Although Shi-style spine manipulation combined with Daoyin therapy has been used in the treatment of LDH in middle-aged and elderly people in China for many years, there is no consensus on its effectiveness. This experiment will provide convincing evidence of the efficacy of Shi-style spine manipulation combined with Daoyin therapy in the treatment of LDH in middle-aged and elderly people.


Assuntos
Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Manipulação da Coluna/normas , Adulto , Idoso , Feminino , Humanos , Degeneração do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/complicações , Dor Lombar/etiologia , Dor Lombar/terapia , Vértebras Lombares/fisiopatologia , Região Lombossacral/fisiopatologia , Imagem por Ressonância Magnética/métodos , Masculino , Manipulação da Coluna/métodos , Manipulação da Coluna/estatística & dados numéricos , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Medição da Dor/métodos , Resultado do Tratamento , Ultrassonografia/métodos
9.
Medicine (Baltimore) ; 99(46): e23000, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181664

RESUMO

BACKGROUND: Both acupoint injection and sacral canal injection are widely adopted in the treatment of lumbar disc herniation (LDH), but there are still doubts about the effectiveness and safety of the 2 methods. Therefore, the objective of the randomized controlled trial is to evaluate the effectiveness and safety of acupoint injection and sacral canal injection in the treatment of LDH. METHOD: This is a prospective randomized controlled trial to study the effectiveness and safety of acupoint injection and sacral canal injection in the treatment of LDH. With the approval by the clinical research ethics committee of our hospital, patients were randomly included into 1 of 2 treatment protocols:Patients, doctors, nurses, and research assistants responsible for collecting data were blinded to group allocation. Main outcome observation indicator: visual analogue scale; secondary outcome observation indicator: Oswestry disability index scores; paresthesia score; adverse reactions. Data were analyzed using the statistical software package SPSS version 25.0 (Chicago, IL). DISCUSSION: The effectiveness and safety of acupoint injection and sacral canal injection in the treatment of LDH were evaluated in this study, and the results of this trial would establish clinical evidence for the adoption of acupoint injection or sacral canal injection to treat LDH. TRIAL REGISTRATION NUMBER: DOI 10.17605 / OSF.IO / VTFUD.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura/métodos , Injeções Espinhais/métodos , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Adulto , Idoso , Protocolos Clínicos , Avaliação da Deficiência , Feminino , Humanos , Plexo Lombossacral , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
10.
Medicine (Baltimore) ; 99(41): e22520, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031293

RESUMO

BACKGROUND: There is no consensus in existing literature on the pulse power, application time, frequency and the dose of energy of laser therapy for the patients. Therefore, we conducted this research for the assessment of safety and efficiency of ultrasound and high-intensity laser therapy (HILT) in the lumbar disc herniation (LDH) patients. METHODS: Our present research was approved by the institutional review board in the West China-Guangan Hospital. All the participants would acquire the written informed consent. From December 2020 to December 2021, we will conduct a prospective evaluation via a senior surgeon for 1 hundred LDH patients who plan to undergo the conservative treatment at our hospital. In this research, the inclusion criteria contained: the patients with lumbar disc herniation diagnosed by lumbar MRI; the patients with no history of trauma or congenital abnormalities; and the patients with sufficient psychological ability to understand and then answer the questions raised in assessment scale. The participants were randomly divided into the control group or HILT group after performing the examination of baseline. The main outcome was the pain score of visual analog scale. The other results contained the adverse effects, back range of motion as well as functional scores. CONCLUSIONS: We assumed that the HILT is as effective as the ultrasound therapy in treating pain for LDH. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5975).


Assuntos
Deslocamento do Disco Intervertebral/cirurgia , Terapia a Laser/métodos , Humanos , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/terapia , Terapia a Laser/efeitos adversos , Dor Lombar/etiologia , Vértebras Lombares , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Terapia por Ultrassom/efeitos adversos
11.
Medicine (Baltimore) ; 99(31): e20614, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756076

RESUMO

BACKGROUND: Lumbar disc herniation, which affects the life quality of patients and the social security system adversely, is one of the common spinal diseases. Massage is used as an alternative therapy. Currently, there are no relevant articles for systematic review. METHODS: We will search the randomized controlled trials related to massage therapy lumbar disc herniation to January 2020. The following database is our focus area: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-Fang Database. All published randomized controlled trials in English or Chinese related to massage for lumbar disc herniation will be included. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide evidence to judge whether massage is an effective intervention in patients the lumbar intervertebral disci. PROSPERO REGISTRATION NUMBER: CRD42020157303.


Assuntos
Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Massagem , Humanos , Massagem/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
12.
Medicine (Baltimore) ; 99(27): e21069, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629737

RESUMO

Lumbar disc herniation (LDH) is a common, disabling musculoskeletal disorder. Magnetic resonance imaging has clarified the natural history of lumbar disc lesions and has documented that disc lesions can become smaller and can even be completely resorbed. Previous studies have confirmed that some traditional Chinese medicine (TCM) therapies can promote resorption of the protrusion. However, high-quality research evidence is needed to support the effectiveness of the protocol. OBJECTIVE: This clinical trial aims to establish whether TCM can promote the resorption of LDH and to assess the efficacy of such therapy for LDH, thereby evaluating its clinical effect. METHODS: The present study design is for a single-center, 2-arm, open-label randomized controlled trial. A total of 150 eligible LDH patients will be randomly assigned to either a TCM treatment group or a control group in a 1:1 ratio. Patients in the TCM group will be administered a TCM decoction for 4 weeks. Patients in the conventional drug control group will be instructed to take a specific daily dose of celecoxib. The primary outcome measure is the change from baseline in the volume of the protrusion, as assessed using MR images. Secondary outcome measures include visual analog scale pain scores and Japanese Orthopaedic Association scores assessed at 3 and 6 months. DISCUSSION: The design and methodological rigor of this trial will allow evaluation of the basic clinical efficacy and safety data for TCM in the treatment of patients with LDH. The trial will also assess whether TCM can promote the resorption of LDH. This research will therefore help provide a solid foundation for the clinical treatment of LDH and for future research in TCM therapy. TRIAL REGISTRATION: ChiCTR1900022377.


Assuntos
Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares/diagnóstico por imagem , Medicina Tradicional Chinesa/métodos , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Estudos de Casos e Controles , Celecoxib/uso terapêutico , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/patologia , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Medição da Dor/métodos , Remissão Espontânea , Projetos de Pesquisa , Segurança , Resultado do Tratamento , Escala Visual Analógica
13.
Spine (Phila Pa 1976) ; 45(14): 952-959, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609465

RESUMO

STUDY DESIGN: A prospective randomized multicenter trial. OBJECTIVE: To investigate the effects of surgery with either structured postoperative physiotherapy or standard postoperative approach on neck-related headache in patients with cervical radiculopathy. Secondary, to investigate associations between change in neck-related headache and change in neck muscle endurance, neck mobility, or neck pain. SUMMARY OF BACKGROUND DATA: The effect of physiotherapy on individuals with neck-related headache after surgery for cervical radiculopathy due to magnetic resonance imaging-verified disc disease is unknown. METHODS: One hundred six patients with neck-related headache and participating in a randomized controlled trial evaluating the additional effects of physiotherapy after surgery for cervical radiculopathy were included. Patients were randomized preoperatively to structured postoperative physiotherapy (n = 51) or the standard postoperative approach (n = 55). Outcome measures were headache intensity and neck pain intensity, neck muscle endurance, and neck mobility. Measures were obtained preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. RESULTS: Headache intensity significantly changed from baseline to 1 year postoperatively (P < 0.001) in both groups. Post-hoc tests showed a significant difference between baseline and 6 weeks (P ≤ 0.05). No significant differences were found between groups (P > 0.05) or between-group differences in changes over time (P > 0.05). The change in current headache intensity over time was associated with a change in current neck pain intensity over time (P = 0.003, ß = 0.40). CONCLUSION: There was a significant improvement in headache intensity 1 year postoperatively in patients with cervical radiculopathy and neck-related headache, but there were no differences between groups over time. Change in current headache intensity was only associated with a change in current neck pain intensity. LEVEL OF EVIDENCE: 2.


Assuntos
Vértebras Cervicais/cirurgia , Cefaleia , Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Modalidades de Fisioterapia , Complicações Pós-Operatórias , Seguimentos , Humanos , Degeneração do Disco Intervertebral/fisiopatologia , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/terapia , Imagem por Ressonância Magnética , Cervicalgia/cirurgia , Estudos Prospectivos , Radiculopatia/fisiopatologia , Radiculopatia/terapia , Amplitude de Movimento Articular , Resultado do Tratamento
14.
Health Qual Life Outcomes ; 18(1): 175, 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32522196

RESUMO

BACKGROUND: Although the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ), and Short Form 36 Health Survey (SF-36) has shown a preferable psychometric properties in patients with low back pain (LBP), but no study has yet determined these in conservative treatment of patients with lumbar disc herniation (LDH). Thus the current study aimed to compare those scales in LDH patients receiving conservative treatment to select the better option to assess the severity of disease. METHODS: LDH patients were invited to complete the JOABPEQ, NPRS, ODI, RMDQ, and SF-36 twice. The internal consistency was evaluated by the Cronbach's α. Test-retest reliability was tested by the intraclass correlation coefficient (ICC). The relationships of these scales were evaluated by the Pearson correlation coefficients (r). The responsiveness was operationalised using the receiver operating characteristic (ROC) curve, as well as the comparison of smallest detectable change (SDC), minimum important change (MIC). RESULTS: A total of 353 LDH patients were enrolled. Four subscales of the Chinese JOABPEQ were over 0.70, then the ICCs for the test-retest reliability were over 0.75. For functional status, remarked negative correlations could be seen between JOABPEQ Q2-Q4 and ODI, as well as RMDQ (r = - 0.634 to - 0.752). For general health status, remarkable positive correlations could also be seen between Q5 Mental health and SF-36 PCS (r = 0.724) as well as SF-36 MCS (r = 0.736). Besides, the area under of the curves (AUC) of the JOABPEQ ranged from 0.743 to 0.827, indicating acceptale responsiveness, as well as the NPRS, ODI, and RMDQ. CONCLUSION: NPRS, and ODI or RMDQ is recommended in studies related to LDH patients, while if the quality of life also is needed to observe, the NPRS, and JOABPEQ would be more appropriate rather than SF-36.


Assuntos
Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Dor Lombar/diagnóstico , Medição da Dor/normas , Inquéritos e Questionários/normas , Adulto , Tratamento Conservador , Feminino , Humanos , Degeneração do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/complicações , Dor Lombar/etiologia , Masculino , Pessoa de Meia-Idade , Diferença Mínima Clinicamente Importante , Qualidade de Vida , Reprodutibilidade dos Testes
15.
Medicine (Baltimore) ; 99(21): e20083, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481274

RESUMO

We developed a protocol for a prospective registry to prove the effectiveness and safety of integrative Korean medicine treatment for inpatients with sciatica due to lumbar intervertebral disc herniation. We plan on recruiting 1000 inpatients receiving integrative Korean medicine treatment for lumbar intervertebral disc herniation at four spine specialized Korean medical hospitals. Patients enrolled in the registry will be evaluated at the time of hospitalization, 2 weeks after hospitalization, at discharge, and 6 months after hospitalization on predefined outcome variables such as intensity of back and leg pain, Oswestry Disability Index, quality of life, Patient Global Impression of Change, and adverse effects. The protocol of this study was registered in CRIS (KCT0003709) and Clinical trial gov (NCT03750591). This study is significant in that it cannot only be a basis for safety-related evidence of complementary alternative medicine, which has been lacking, but it also gives clear evidence on the effectiveness and validity of treatment effects such as accompaniment of stenosis, sex, age, and type of disc herniation.


Assuntos
Medicina Integrativa/métodos , Deslocamento do Disco Intervertebral/terapia , Medicina Tradicional Coreana/métodos , Ciática/terapia , Terapia por Acupuntura/métodos , Adulto , Idoso , Humanos , Deslocamento do Disco Intervertebral/complicações , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Estudos Prospectivos , Sistema de Registros , República da Coreia , Ciática/etiologia , Resultado do Tratamento , Adulto Jovem
16.
J Clin Neurosci ; 76: 107-113, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32327378

RESUMO

Patients with lumbar intervertebral disc herniation classically trial a brief course of conservative management prior to microdiscectomy surgery. Gender differences have previously been identified in the selection and symptomatic response to commonly-utilized nonoperative treatments. However, whether gender differences exist in the degree and cost of nonoperative therapy in this cohort remains unknown. Therefore, the purpose of this study was to assess for gender differences in the utilization and costs of nonoperative therapy in patients diagnosed with symptomatic lumbar intervertebral disc herniation 3-months prior to undergoing microdiscectomy. Medical records from adult patients diagnosed with a lumbar intervertebral disc herniation undergoing index microdiscectomy procedures from 2007 to 2017 were collected retrospectively from a large insurance database. The utilization of nonoperative therapy within 3-months after initial lumbar herniation diagnosis was determined. A total of 13,106 patients (55.4% Males) underwent index microdiscectomy. Male patients were more likely to fail conservative management and opt for surgery (Males: 2.9% vs. Females: 1.8%, p < 0.0001). A greater percentage of female patients utilized muscle relaxants (p = 0.0049), lumbar epidural steroid injections (p = 0.0007), and emergency department services (p = 0.001). The total direct cost of conservative treatment prior to microdiscectomy was $13,205,924, with males accountable for $7,457,023 (56.5%). When normalized by number of patients utilizing the respective therapy, males used fewer units of NSAIDs (males: 84.2 pills/patient; females: 97.3 pills/patient) and muscle relaxants (males: 77.5 pills/patient; females: 89.0 pills/patient). These results suggest that gender differences exist in the utilization of nonoperative therapies for the management of a lumbar intervertebral herniated disc prior to microdiscectomy surgery.


Assuntos
Tratamento Conservador , Discotomia , Deslocamento do Disco Intervertebral/terapia , Fatores Sexuais , Adulto , Estudos de Coortes , Tratamento Conservador/economia , Tratamento Conservador/métodos , Tratamento Conservador/estatística & dados numéricos , Custos e Análise de Custo , Discotomia/economia , Discotomia/métodos , Discotomia/estatística & dados numéricos , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 99(17): e19867, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332651

RESUMO

BACKGROUND: This systematic review aims to evaluate the effectiveness of electroacupuncture in treatment of lumbar disc herniation (LDH). METHODS: Electronic databases of all electroacupuncture for LDH will be searched at PubMed, Cochrane Library, Springer, EMBASE, China National Knowledge Infrastructure (CNKI), Wan-Fang, and Chinese Biological Medical disc, (CBM) from inception to February 29, 2020, with language restricted in Chinese and English. The primary outcome is Japanese Orthopedic Association Scores, a quantification scale for a comprehensive assessment according to patients' subjects feeling and objective function. Secondary outcomes included visual analogue scale (VAS), Oswestry dysfunction index (ODI), Pittsburgh sleep quality index (PSQI), Self-rating anxiety scale (SAS), self-depression rating scale (SDS), follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for LDH. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference (MD), standard mean deviation (SMD) and binary data will be used to represent continuous results. RESULTS: This study will provide a comprehensive review and evaluation of the available evidence for the treatment of LDH with this therapy. CONCLUSION: This study will provide new evidence to evaluate the effectiveness and side effects of electroacupuncture for LDH. Due to the data is not personalized, no formal ethical approval is required.


Assuntos
Eletroacupuntura/normas , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Protocolos Clínicos , Eletroacupuntura/métodos , Humanos , Degeneração do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/fisiopatologia , Metanálise como Assunto , Literatura de Revisão como Assunto , Resultado do Tratamento
18.
Niger J Clin Pract ; 23(4): 498-502, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32246656

RESUMO

Background: Prolapsed lumbar intervertebral disc is one of the most prevalent causes of low back pain and traction is one of the most common physical therapy treatments offered to affected patients. Advancements in traction equipment are needed to ensure their effectiveness in clinical situations. Aims: The objective of the study was to find out the effect of patient-specific three-dimensional lumbar traction on pain and functional disability in individuals with lumbar intervertebral disc prolapse. Subjects and Methods: Original article and Experimental design. Twenty-five participants (age range: 34-67 years) diagnosed with lumbar intervertebral disc prolapse were included in this study. Patient-specific three-dimensional lumbar traction was given as three sessions per week for the duration of one month. All participants completed a 10-cm visual analog pain scale and pain pressure threshold to assess pain and the Oswestry disability index to assess the functional disability. Results: On pre to post interventions, a significant change in mean values were found for visual analog scale pain score, pain pressure threshold, and Oswestry disability index (P < 0.001). The pain intensity was reduced from 8.5 to 3.2, pain pressure threshold increased from 0.7 to 1.6 kg/cm2, and functional disability was reduced from 53.5% to 31.3%. Conclusion: Twelve sessions of patient-specific three-dimensional lumbar traction promoted a reduction in pain and improvement in functional disability among subjects with lumbar intervertebral disc prolapse.


Assuntos
Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/terapia , Dor Lombar/terapia , Tração/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia , Prolapso , Resultado do Tratamento , Escala Visual Analógica
19.
Ann Palliat Med ; 9(2): 388-393, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32233633

RESUMO

BACKGROUND: This study aims to quantify the effectiveness of knowledge, attitude, and practice (KAP)-based rehabilitation education on the KAP of patients with intervertebral disc herniation (IDH). METHODS: Seventy IDH patients undergoing conservative treatment in our center from February 2018 to December 2018 were randomly divided into the KAP group and control group by using a table of random numbers. The control group was given traditional health education, while the KAP group was offered with KAP-based rehabilitation education. Both groups were followed up for 3 months after their discharge from the hospital. A self-designed questionnaire form was used to evaluate the KAP quantities of patients. RESULTS: Before health education, the scores of knowledge in the control group and the KAP group were (15.12±3.12) and (15.20±3.28), respectively, showing no significant difference (P>0.05). After the health education, the total score of knowledge, the score of disease knowledge, the score of attitude, and the score of practice were (25.42±3.16), (7.66±0.73), (7.80±0.36), and (7.85±0.68), respectively, in the KAP group, which were significantly higher than those in the control group [(20.31±3.43), (6.83±0.92), (6.41±1.05), and (7.10±1.11), P<0.05]. After health education, the awareness rates of the disease, attitude, and behavior were significantly higher in the KAP group than in the control group (P<0.05). CONCLUSIONS: Rehabilitation education based on the KAP theory can effectively enhance the patients' awareness of the disease, increase their rehabilitation consciousness, and promote them to adopt positive rehabilitation behavior, thus achieving the goal of changing the patients' KAP.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/reabilitação , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Feminino , Educação em Saúde/métodos , Humanos , Degeneração do Disco Intervertebral/psicologia , Deslocamento do Disco Intervertebral/psicologia , Deslocamento do Disco Intervertebral/terapia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
20.
Spine (Phila Pa 1976) ; 45(14): E885-E891, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32118698

RESUMO

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA: Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce. METHODS: We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses. RESULTS: At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3-L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3-L4. Following internal validation, the explained variance (Nagelkerke R) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor. CONCLUSION: The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. LEVEL OF EVIDENCE: 3.


Assuntos
Discotomia , Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Vértebras Lombares/cirurgia , Modalidades de Fisioterapia , Discotomia/efeitos adversos , Discotomia/métodos , Discotomia/estatística & dados numéricos , Humanos , Degeneração do Disco Intervertebral/epidemiologia , Degeneração do Disco Intervertebral/terapia , Deslocamento do Disco Intervertebral/epidemiologia , Deslocamento do Disco Intervertebral/terapia , Modalidades de Fisioterapia/efeitos adversos , Modalidades de Fisioterapia/estatística & dados numéricos , Estudos Prospectivos , Resultado do Tratamento
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