Sammenligning af effekten af stabilitetstræning og afspænding til patienter med Modic-forandringer type 1 - et randomiseret, klinisk kontrolleret pilotprojekt
Master thesis
Permanent lenke
https://hdl.handle.net/1956/8152Utgivelsesdato
2011-05-13Metadata
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Sammendrag
Purpose: Patients with Modic changes type 1 often experience a lot of pain and it is still uncertain what kind of treatment these patients should be offered. That is why we in this project examined whether stability training using the Neurac concept was more effective than relaxation for these patients. Method: The study was carried out as a Randomized Controlled Pilot project with nine patients randomized to two groups (five in the stabilization group and four in the relaxation group). Both groups attended treatment twice a week for 12 weeks and the participants were tested before and after the treatment course and six months after the last treatment. The primary outcome measure was Oswestry Disability Index and the other outcome measures were Low Back Pain Rating Scale disability and pain, Pain Specific Functional Scale, EQ-VAS, Back Performance Scale, stability tests and UL-scans. Results: None of the outcome measures showed statistical significant differences between the groups. Within the stability group, but not within the relaxation group, the Back Performance Scale showed significant improvement both after the treatment course and six months after the last treatment. Overall the participants in the stability group achieved more improvements on outcome measures that could be interpreted as clinically important or larger than measurement errors, than the participants in the relaxation group. Conclusion: This pilot project showed a weak tendency towards better effect of stability training using the Neurac concept than relaxation for patients with Modic changes type 1. There was, however, no statistical significant difference in change between the groups, which can be due to the low number of participants. Formål: Patienter med Modic-forandringer type 1 er ofte meget smertepræget og det er endnu uvist hvilken form for behandling disse patienter bør tilbydes. Derfor ønskede man i dette projekt at undersøge om stabilitetstræning ud fra Neurac konceptet havde bedre effekt end afspænding til patienter med Modic-forandringer type 1. Metode: Projektet blev gennemført som et randomiseret, klinisk kontrolleret pilotprojekt med ni deltagere randomiseret til to grupper (fem i stabilitetsgruppen og fire i afspændingsgruppen). Begge grupper trænede to gange om ugen i 12 uger og deltagerne blev testet før og efter behandlingsforløbet, samt seks måneder efter endt behandling. Hovedeffektmålet var Oswestry Disability Index og de øvrige effektmål var Low Back Pain Rating Scale disability og pain, Pain Specific Functional Scale, EQ-VAS, Back Performance Scale, stabilitetstests og UL-scanning. Resultater: Ingen af effektmålene vist en statistisk signifikant forskel mellem grupperne. Indenfor stabilitetsgruppen, men ikke indenfor afspændings-gruppen, viste Back Performance Scale en signifikant forbedring både efter behandlingsforløbet og seks måneder efter endt behandling. Samlet set opnåede deltagerne i stabilitetsgruppen flere forbedringer på effektmål der kunne tolkes som klinisk vigtige eller var større end målefejl end deltagerne i afspændingsgruppen. Konklusion: Dette pilotprojekt viste en svag tendens til bedre effekt af stabilitetstræning ud fra Neurac konceptet end afspænding til patienter med Modic-forandringer type 1. Der var imidlertid ikke statistisk signifikante forskelle mellem grupperne, noget som kan skyldes det lave antal deltagere.