Oliver Martínez Pozas, Juan Nicolás Cuenca-Zaldívar, M Elena González-Alvarez, Francisco José Selva Sarzo, Hector Beltran-Alacreu, Josué Fernández Carnero, Eleuterio A Sánchez Romero
{"title":"一项随机对照试验：运动对成人慢性腰痛的条件性疼痛调节、机械性痛觉过敏和疼痛强度的影响。","authors":"Oliver Martínez Pozas, Juan Nicolás Cuenca-Zaldívar, M Elena González-Alvarez, Francisco José Selva Sarzo, Hector Beltran-Alacreu, Josué Fernández Carnero, Eleuterio A Sánchez Romero","doi":"10.1016/j.msksp.2024.103220","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain is associated with dysfunctions in endogenous analgesia mechanisms, as evaluated through conditioned pain modulation paradigms. Although mobilization with movement has demonstrated enhancements in conditioned pain modulation among patients with conditions such as knee osteoarthritis, its efficacy in chronic low back pain patients has yet to be established.</p><p><strong>Objectives: </strong>To investigate the effects of mobilization with movement compared to sham mobilization in conditioned pain modulation, mechanical hyperalgesia, and pain intensity in chronic low back pain patients.</p><p><strong>Design: </strong>Randomized controlled trial following CONSORT and TIDieR guidelines.</p><p><strong>Method: </strong>Fifty-eight patients with chronic low back pain (mean age 48.77 ± 13.92 years) were randomized into the experimental group, which received real mobilization with movement (n = 29), or the sham mobilization with movement group (n = 29). Only one intervention was performed. Patients were assessed before and after intervention. Conditioned pain modulation, mechanical hyperalgesia and pain intensity were assessed.</p><p><strong>Results: </strong>Mobilization with movement resulted in no statistically significant differences compared to sham mobilization for conditioned pain modulation (post-treatment difference: 0.023 [-0.299, 0.345], p = 0.158), mechanical hyperalgesia (post-treatment difference: -0.198 [-0.505, 0.109], p = 0.207), or movement-related pain intensity (post-treatment difference: 0.548 [-0.068, 1.236], p = 0.079) improvements post-intervention. Effect sizes were small for conditioned pain modulation (r = 0.126), mechanical hyperalgesia (r = 0.101), and pain intensity (r = 0.208).</p><p><strong>Conclusions: </strong>Mobilization with movement resulted in no significant differences compared to sham mobilization with movement after one intervention for conditioned pain modulation, mechanical hyperalgesia or pain intensity, with small effect sizes. However, the findings should be interpreted with caution due to absence of screening for appropriately eligible patients.</p>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"75 ","pages":"103220"},"PeriodicalIF":2.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of mobilization with movement on conditioned pain modulation, mechanical hyperalgesia, and pain intensity in adults with chronic low back pain: A randomized controlled trial.\",\"authors\":\"Oliver Martínez Pozas, Juan Nicolás Cuenca-Zaldívar, M Elena González-Alvarez, Francisco José Selva Sarzo, Hector Beltran-Alacreu, Josué Fernández Carnero, Eleuterio A Sánchez Romero\",\"doi\":\"10.1016/j.msksp.2024.103220\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic low back pain is associated with dysfunctions in endogenous analgesia mechanisms, as evaluated through conditioned pain modulation paradigms. Although mobilization with movement has demonstrated enhancements in conditioned pain modulation among patients with conditions such as knee osteoarthritis, its efficacy in chronic low back pain patients has yet to be established.</p><p><strong>Objectives: </strong>To investigate the effects of mobilization with movement compared to sham mobilization in conditioned pain modulation, mechanical hyperalgesia, and pain intensity in chronic low back pain patients.</p><p><strong>Design: </strong>Randomized controlled trial following CONSORT and TIDieR guidelines.</p><p><strong>Method: </strong>Fifty-eight patients with chronic low back pain (mean age 48.77 ± 13.92 years) were randomized into the experimental group, which received real mobilization with movement (n = 29), or the sham mobilization with movement group (n = 29). Only one intervention was performed. Patients were assessed before and after intervention. Conditioned pain modulation, mechanical hyperalgesia and pain intensity were assessed.</p><p><strong>Results: </strong>Mobilization with movement resulted in no statistically significant differences compared to sham mobilization for conditioned pain modulation (post-treatment difference: 0.023 [-0.299, 0.345], p = 0.158), mechanical hyperalgesia (post-treatment difference: -0.198 [-0.505, 0.109], p = 0.207), or movement-related pain intensity (post-treatment difference: 0.548 [-0.068, 1.236], p = 0.079) improvements post-intervention. Effect sizes were small for conditioned pain modulation (r = 0.126), mechanical hyperalgesia (r = 0.101), and pain intensity (r = 0.208).</p><p><strong>Conclusions: </strong>Mobilization with movement resulted in no significant differences compared to sham mobilization with movement after one intervention for conditioned pain modulation, mechanical hyperalgesia or pain intensity, with small effect sizes. However, the findings should be interpreted with caution due to absence of screening for appropriately eligible patients.</p>\",\"PeriodicalId\":56036,\"journal\":{\"name\":\"Musculoskeletal Science and Practice\",\"volume\":\"75 \",\"pages\":\"103220\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Musculoskeletal Science and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.msksp.2024.103220\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Musculoskeletal Science and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.msksp.2024.103220","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Effectiveness of mobilization with movement on conditioned pain modulation, mechanical hyperalgesia, and pain intensity in adults with chronic low back pain: A randomized controlled trial.
Background: Chronic low back pain is associated with dysfunctions in endogenous analgesia mechanisms, as evaluated through conditioned pain modulation paradigms. Although mobilization with movement has demonstrated enhancements in conditioned pain modulation among patients with conditions such as knee osteoarthritis, its efficacy in chronic low back pain patients has yet to be established.
Objectives: To investigate the effects of mobilization with movement compared to sham mobilization in conditioned pain modulation, mechanical hyperalgesia, and pain intensity in chronic low back pain patients.
Design: Randomized controlled trial following CONSORT and TIDieR guidelines.
Method: Fifty-eight patients with chronic low back pain (mean age 48.77 ± 13.92 years) were randomized into the experimental group, which received real mobilization with movement (n = 29), or the sham mobilization with movement group (n = 29). Only one intervention was performed. Patients were assessed before and after intervention. Conditioned pain modulation, mechanical hyperalgesia and pain intensity were assessed.
Results: Mobilization with movement resulted in no statistically significant differences compared to sham mobilization for conditioned pain modulation (post-treatment difference: 0.023 [-0.299, 0.345], p = 0.158), mechanical hyperalgesia (post-treatment difference: -0.198 [-0.505, 0.109], p = 0.207), or movement-related pain intensity (post-treatment difference: 0.548 [-0.068, 1.236], p = 0.079) improvements post-intervention. Effect sizes were small for conditioned pain modulation (r = 0.126), mechanical hyperalgesia (r = 0.101), and pain intensity (r = 0.208).
Conclusions: Mobilization with movement resulted in no significant differences compared to sham mobilization with movement after one intervention for conditioned pain modulation, mechanical hyperalgesia or pain intensity, with small effect sizes. However, the findings should be interpreted with caution due to absence of screening for appropriately eligible patients.
期刊介绍：
Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.
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