| Abstract | Cilj: Analiziranje učinkovitosti prvog tretmana specifično primijenjene manualne terapije u bolesnika s kroničnom križoboljom i njegova usporedba s tretmanom terapijskih vježbi, s obzirom na evaluirane mjere ishoda intenziteta boli, funkcionalnosti i pokretljivosti.
Metode: U randomiziranom kontroliranom istraživanju je sudjelovalo 80 bolesnika s kroničnom križoboljom podijeljenih u dvije homogene skupine. Pokusna je skupina za intervenciju imala manualnu terapiju, dok je kontrolna skupina radila terapijske vježbe. Glavne se mjere ishoda, koje su se pratile u istraživanju, intenzitet boli mjeren vizualno-analognom skalom, razina funkcionalne onesposobljenosti bodovana Roland Morris upitnikom i pokretljivost kralježnice za fleksiju i lateralnu fleksije. Podatci su se prikupljali od svibnja do rujna 2016. godine na Zavodu za fizikalnu medicinu i rehabilitaciju s reumatologijom KBC-a Split i u Centru za manualnu terapiju Majce & Stojanović u Splitu.
Rezultati: Statističkom analizom ponovljenih testiranja, pri rasponu pouzdanosti od 95%, utvrđeno je: intenzitet boli mjeren VAS-om u ponovljenom testiranju pokusne skupine pokazao je pad za 25,23 boda u prosjeku, dok je u kontrolnoj skupine pokazao rast, prosječno za 3,73 boda; rezultati Roland Moriss upitnika u pokusnoj su skupini pokazali manje vrijednosti za prosječno 4,35 boda nakon tretmana, dok su bolesnici kontrolne skupine prijavili veći stupanj fizičke onesposobljenosti nakon tretmana terapijskim vježbama za prosječno 0,55 boda; pokretljivost slabinske kralježnice u fleksiji bila je bolja za prosječno 11,23 cm u pokusne skupine, dok je u kontrolne skupine bila lošija za 2,85 cm; pokret lateralne fleksije udesno pokusne skupine bio je bolji za prosječno 1,75 cm, dok je kontrolnoj skupini bio lošiji za 1,50 cm; pokret lateralne fleksije ulijevo pokusne skupine bio je bolji za prosječno 2,68 cm, dok u kontrolnoj skupini nije bilo statistički značajne promjene
Zaključak: Manualna terapija, koju je kao intervenciju imala pokusna skupina bolesnika s kroničnom križoboljom, pokazala je značajno bolje rezultate od terapijskih vježbi koje je kao intervenciju imala kontrolna skupina bolesnika. Potonji zaključak donesen je na temelju rezultata 24 sata nakon praktične primjene te analize glavnih mjera ishoda: intenziteta boli, pokretljivosti kralježnice i funkcionalne onesposobljenosti. |
| Abstract (english) | Objective: Analyzing the effectiveness of the first treatment of specifically applied manual therapy for patients with chronic low back pain and comparing it to the treatment of therapeutic exercises, considering the evaluated outcome measures of pain intensity, functionality and mobility.
Methods: A randomized controlled study included 80 patients with chronic low back pain, divided into two homogenous groups. The experimental group was treated with manual therapy, while the control group was doing therapeutic exercises. The main outcome measures that were followed in this study were the pain intensity measured by visual analogue scale, the level of functional disability according to Roland Morris questionnaire and the mobility of spine in flexion and in lateral flexion. The data were collected from May to September 2016 at the Department for Physical Medicine and Rehabilitation with rheumatology, Clinical Hospital Center Split and at the Center for Manual Therapy Majce & Stojanović in Split.
Results: According to the statistical analysis of repeated testings, with a confidence interval of 95%, it has been determined: the intensity of pain measured by VAS in the repeated testing of the experimental group has shown a decline of 25.23 points on average, while in the control group it has shown a slight increase in pain, with an average of 3,73 points; the results of Roland Morris questionnaire have shown a lower value in the experimental group after the treatment, with an average of 4.53 points, while the patients in control group expressed a greater degree of physical disability after the treatment of therapeutic exercises for an average of 0.55 points; the mobility of the lumbar spine in flexion was improved on average of 11.23 cm in comparison to the experimental group, while on the contrary, in the control group it has declined for 2.85 cm; movement of the lateral flexion to the right of the experimental group was better for an average of 1.75 cm, while the same movement for the control group was worse for 1.50 cm; movement of the lateral flexion to the left of the experimental group was better on average for 2.68 cm, while the same movement for control group resulted with no statistically significant changes.
Conclusion: Manual therapy, which was used as an intervention for the experimental group with chronic low back pain, has shown significantly better results than the therapeutic exercises which were used as an intervention for the control group of patients. The conclusion was made based on the results obtained 24 hours after the application of the treatment and after analyzing the main outcome measures: pain intensity, mobility of the spine and functional disability. |
