腰痛症対処のガイドラインの系統的総説


腰痛症対処のガイドラインの系統的総説。2504の引用を選別し; 13のガイドラインが批判的な審査に該当し, 10は偏りの危険性が低い. 質の高いガイドラインによると: (1)急性と慢性の腰痛症(LBP)の全患者は教育、再確認および自己対処の指示を受けるべき; (2)急性LBP患者は活動に戻ることを奨励されるべきでありparacetamol, NSAIDs, 又は脊椎マニピュレーションで恩恵を受けるかも; (3)慢性LBPの対処には訓練, paracetamol or NSAIDs, 徒手治療、鍼、および組み合わせリハビリテーション(理学療法と精神治療)が含まれるかも; そして(4) 神経根症を合併した腰椎椎間板ヘルニア患者は脊椎マニピュレーションで恩恵を受けるかも。10のガイドラインは方法論の質が高いが、最新のいくつかの方法論の改善が必要。全体では、大部分のガイドラインは非特異的なLB Pを目標にしており、教育、従事/訓練への重視、徒手訓練、およびparacetamol 又はNSAIDを第一選択治療として推奨する。急性LBPへのparacetamolの推奨は最近のエビデンスによって異議が申し立てられており、再検討が必要。まとめ:大部分の質の高いガイドラインは、教育、活動/訓練への従事、徒手訓練およびparacetamol/NSAIDsを第一選択の治療として推奨。急性LBPへのparacetamolの推奨は最近のエビデンスによって異議が申し立てられており、更新が必要。
Eur J Pain. 2016 Oct 6. doi: 10.1002/ejp.931. [Epub ahead of print]
Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.
Wong JJ1,2, Côté P3,4,5, Sutton DA3,6, Randhawa K3,6,7, Yu H3,6,7, Varatharajan S3,6,7, Goldgrub R8, Nordin M9, Gross DP10,11, Shearer HM3,6, Carroll LJ12, Stern PJ13, Ameis A14, Southerst D3,15, Mior S6,5, Stupar M3, Varatharajan T3,16, Taylor-Vaisey A3.
•1UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada. jessica.wong@uoit.ca.
•2Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada. jessica.wong@uoit.ca.
•3UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.
•4Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, ON, Canada.
•5Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.
•6Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
•7Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
•8Masters Program, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.
•9Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, USA.
•10Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.
•11Rehabilitation Research Centre, University of Alberta, Edmonton, AB, Canada.
•12Injury Prevention Centre and School of Public Health, University of Alberta, Edmonton, AB, Canada.
•13Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
•14Certification Program in Insurance Medicine and Medico-legal Expertise, Faculty of Medicine, University of Montreal, QC, Canada.
•15Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, ON, Canada.
•16Masters Program, University of Saskatchewan, Saskatoon, SK, Canada.
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by fibromyalgia11 | 2016-10-16 19:16 | その他の疼痛
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世界標準の線維筋痛症を専門家が説明します


by fibromyalgia11
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