腰背痛和腰骶神经根综合征的治疗:荷兰皇家物理治疗学会 (KNGF) 指南。

IF 3.3 3区 医学 Q1 REHABILITATION
Adri T Apeldoorn, Nynke M Swart, Daniëlle Conijn, Guus A Meerhoff, Raymond W Ostelo
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引用次数: 0

摘要

背景:目的:为荷兰物理治疗师以及Cesar和Mensendieck治疗师更新和制定一份循证指南,用于综合治疗无严重特殊情况(红旗)的腰背痛和腰骶部神经根综合征(LRS):设计:临床实践指南:住院和门诊患者:人群:患有LBP和/或LRS的成年人:根据当前物理治疗实践中存在的障碍,确定了与临床相关的问题。所有临床问题均通过已出版的指南、系统综述、叙述性综述或项目组进行的系统综述来回答。根据 "建议评估、发展和评价分级"(GRADE)的 "从证据到决策"(Evidence-to-Decision)框架,基于证据和其他考虑因素制定建议。患者参与了每个阶段的工作:该指南描述了基于国际功能、残疾和健康分类(ICF)核心组的枸杞多糖症和腰椎间盘突出症综合评估,包括警报症状和警示信号的识别。根据持续性腰椎间盘突出症的预后因素,将患者分配到三种治疗方案中(持续性症状的低风险、中度风险和高风险)。该指南建议为有可能很快康复的患者(低风险患者)提供简单且强度较低的支持,而为有中度或高度持续症状风险的患者提供更复杂且强度更高的支持。该指南明确规定了开始和停止物理治疗以及转诊给全科医生的标准。对信息和建议、测量工具、主动和被动干预以及行为导向治疗提出了建议:结论:为理疗师、塞萨尔和门兴迪克理疗师制定了以证据为基础的理疗指南,用于管理腰椎间盘突出症和轻度腰椎间盘突出症患者,且无红旗。理疗评估和治疗的基石是风险分层、共同决策、信息和建议以及锻炼:本指南为临床医生和患者提供指导,以优化枸杞多糖综合症和慢阻肺患者的治疗效果,并为其他医疗服务提供者和利益相关者提供透明度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of low back pain and lumbosacral radicular syndrome: the Guideline of the Royal Dutch Society for Physical Therapy (KNGF).

Background: Significant progress and new insights have been gained since the Dutch Physical Therapy guideline on low back pain (LBP) in 2013 and the Cesar en Mensendieck guideline in 2009, necessitating an update of these guidelines.

Aim: To update and develop an evidence-based guideline for the comprehensive management of LBP and lumbosacral radicular syndrome (LRS) without serious specific conditions (red flags) for Dutch physical therapists and Cesar and Mensendieck Therapists.

Design: Clinical practice guideline.

Setting: Inpatient and outpatient.

Population: Adults with LBP and/or LRS.

Methods: Clinically relevant questions were identified based on perceived barriers in current practice of physical therapy. All clinical questions were answered using published guidelines, systematic reviews, narrative reviews or systematic reviews performed by the project group. Recommendations were formulated based on evidence and additional considerations, as described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework. Patients participated in every phase.

Results: The guideline describes a comprehensive assessment based on the International Classification of Functioning, Disability and Health (ICF) Core Set for LBP and LRS, including the identification of alarm symptoms and red flags. Patients are assigned to three treatment profiles (low, moderate and high risk of persistent symptoms) based on prognostic factors for persistent LBP. The guideline recommends offering simple and less intensive support to people who are likely to recover quickly (low-risk profile) and more complex and intensive support to people with a moderate or high risk of persistent complaints. Criteria for initiating and discontinuing physical therapy, and referral to a general practitioner are specified. Recommendations are formulated for information and advice, measurement instruments, active and passive interventions and behavior-oriented treatment.

Conclusions: An evidence based physical therapy guideline for the management of patients with LBP and LRS without red flags for physical therapists and Cesar and Mensendieck therapists was developed. Cornerstones of physical therapy assessment and treatment are risk stratification, shared decision-making, information and advice, and exercises.

Clinical rehabilitation impact: This guideline provides guidance for clinicians and patients to optimize treatment outcomes in patients with LBP and LRS and offers transparency for other healthcare providers and stakeholders.

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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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