Efficacia della Cura Osteopatica Centrata sulla Persona nel Low Back Pain e Neck Pain Studio Pilota

Abstract

Obiettivi. Lo scopo di questo studio preliminare è stato studiare l’efficacia e le modalità di erogazione di Cura Osteopatica Centrata sulla Persona (COCsP) in un campione di popolazione con Low Back Pain (LBP) e Neck Pain (NP) Metodi. Un disegno di studio pilota descrittivo con revisione retrospettiva di cartelle cliniche (CC) in un campione al basale di (N=220) CC presso il setting di pratica clinica privata osteopatica è stato progettato per la verifica delle seguenti variabili di interesse. End-points (clinico): variazioni punteggio medio campionario delle scale di misura dedicate per LBP e NP pre/post somministrazione di COCsP utilizzando l’analisi della varianza (ANOVA). End-points (surrogati): numero medio OMT, tipologie di tecniche osteopatiche somministrate e verifica combinazioni modelli osteopatici Struttura Funzione (SF) Risultati. Rispettando i prestabiliti criteri di inclusione ed esclusione è stato osservato un campione finale di N=128 CC di cui: NP N=40 (31%) età media 39 (ds±15,45) e LBP N=88 (69%) età media 45 (ds±14,25). End point clinico ANOVA NP scala Neck Pain and Disability Scale (NPDI-I) N=40: (media campionaria-pre 28 [IC 95%: 23.8424 - 32.1576] media campionaria-post 10 [IC 95%: 7.12167 - 12.8783]) variazione (-18 punti %; p=.00). ANOVA LBP scala Oswestry Disability Index (ODI-I) N=72 (media campionaria-pre 26 [IC 95%: 24.1201 - 27.8799] media campionaria-post 10 [IC: 7.41514 - 12.5849]) variazione (-16 punti %; p=.00). ANOVA sottogruppo LBP scala Roland Morris (RM) N=16: (media campionaria-pre 7 [IC: 5.4014 - 8.59858] media campionaria-post 1 [IC: 0.467139 - 1.53286]) variazione (-6 punti %; p=.00). End point surrogato minimo (N=2 OMT), massimo (N=5 OMT), tecniche somministrate indirette (N=105[82%]), combinazione modelli SF Biomeccanico/Neurologico (N=105[82%]) Discussione. I dati per l’end point (clinico) per la verifica dell’ipotesi di nessun effetto della COCsP è stata rifiutata e si può affermare che la cura è efficace con un effetto statisticamente significativo. I dati per l’end point (surrogato) registrano in media (N=3) sessioni di OMT con tecniche indirette e una maggiore combinazione dei modelli SF Biomeccanico/Neurologico Conclusione. I dati significativi ottenuti per l’end point clinico e la comprensione sulle modalità di COCsP giustificano la pianificazione di studi clinici controllati randomizzati

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Efficacia& della& Cura& Osteopatica& Centrata& sulla& Persona&
nel&Low&Back&Pain&e&Neck&Pain&:&Studio&Pilota&&
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Claudio&Civitillo&&1,2&&PT,&DO&
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Abstract&
Obiettivi!             di! erogazione! di! Cura!
Osteopatica!Centrata!sulla!Persona!(COCsP)!in!un!campione!di!popolazione!con!Low!Back!Pain!(LBP)!e!Neck!Pain!(NP)!
Metodi!Un!disegno!di!studio!pilota!descrittivo!con!revisione!retrospettiva!di!cartelle!cliniche!(CC)!in! un!campione! al!
basale!di!! (N=220)!CC!presso! il! setting! di!pratica!clinica!privata! osteopatica!è!stato! progettato! per!la!verifica! delle!
seguenti! variabili! di! interesse.! EndGpoints! (clinico):! variazioni! punteggio! medio! campionario! delle! scale! di! misura!
dedicate!per! LBP!e!NP! pre/post!somministrazione! di!COCsP!utilizz  Gpoints!
(surrogati):! numero! medio! OMT,! tipologie! di! tecniche! osteopatiche! somministrate! e! verifica! combinazioni! modelli!
osteopatici! Struttura! Funzione! (SF)! Risultati& Rispettando! i! prestabiliti! criteri! di! inclusione! ed! esclusione! è! stato!
osservato!un!campione!finale!di!N=128!CC!di!cui:!NP!N=40!(31%)!età!media!39!(ds±15,45)!e!LBP!N=88!(69%)!età!media!
45!(ds±14,25).!End! point!clinico!ANOVA! NP!scala!Neck!Pain!and!Disability!Scale!(NPDIGI)!N=40:!(media! campionariaG
pre!28![IC!95%:!23.8424!G!32.1576]!media!campionariaGpost!10![IC!95%:!7.12167!G!12.8783])!variazione!(G18!punti!%;!
p=.00).! ANOVA! LBP! scala! Oswestry! Disability! Index! (ODIGI)! N=72! (media! campionariaGpre! 26! [IC! 95%:! 24.1201! G!
27.8799]!media!campionariaGpost!10![IC:!7.41514!G!12.5849])!variazione!(G16!punti!%;!p=.00).!ANOVA!sottogruppo!LBP!
scala! Roland! Morris! (RM)! N=16:! (media! campionariaGpre! 7! [IC:! 5.4014! G! 8.59858]! media! campionariaGpost! 1! [IC:!
0.467139!G!1.53286])!variazione!(G6!punti!%;!p=.00).!!End!point! surrogato!minimo!(N=2!OMT),!massimo!(N=5!OMT),!
tecniche!somministrate!indirette!(N=105[82%]),!combinazione!modelli!SF!Biomeccanico/Neurologico!(N=105[82%])!
Discussione&!è!stata!rifiutata!e!si!
           
registrano! in! media! (N=3)! sessioni! di! OMT! con! tecniche! indirette! e! una! maggiore! combinazione! dei! modelli! SF!
Biomeccanico/Neurologico! ! Conclusione&            
modalità!di!COCsP!giustificano!la!pianificazione!di!studi!clinici!controllati!randomizzati!!
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456!
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References&
1. V(,&$M(,5!VP!*(%$,5!4P!85!15,+!i!5&!+'#P!<=>A#!X65!*&+'$+,!1(M$5&;!(0!96;3$M+'!+,8!456+7$'$&+&$(,!
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2. W(53!LmP! %+,!X.'85/!VP!m! X6(N+3!1#!R$+:,(3$3! +,8!&/5+&N5,&!(0!'(b! 7+Mh!2+$,#!LV-#! -.7!>GP!!!
<==?FAA<TGDDDUF>BA=F>BABA&&
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3. 6&&2FHHbbb#$M8C8+&+#M(NH<=>AH`('.N5>HG>=)GACHG<=)G<BHG<AHG<A#>#6&N&
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4. 6&&2FHHbbb#$M8C8+&+#M(NH<=>AH`('.N5>HG>=)GACHG<=)G<BHG<BHG<B#<#6&&&
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5. &V(,&$M(,5!VP!*(%$,5!4P!85!15,+!i!5&!+'#P!<=>A#!X65!*&+'$+,!1(M$5&;!(0!96;3$M+'!+,8!456+7$'$&+&$(,!
V58$M$,5!T1*V_^4U!/5M(NN5,8+&$(,3!0(/!,5Mh!2+$,#!i!*&+'!V58!O+%!^/:!<=>A@!ADF>P!A?)D=&
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6. W(53!LmP! %+,!X.'85/!VP!m! X6(N+3!1#!R$+:,(3$3!+,8! &/5+&N5,&!(0!'(b! 7+Mh!2+$,#!LV-#!-.7! >GP!
<==?FAA<TGDDDUF>BA=F>BABA&&
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7. V(/+,! 4#! 45M(:,$3$,:! 2+&$5,&)M5,&/58! M+/5! $,! M'$,$M+'! &/$+'3! (0! (3&5(2+&6;)&(b+/83! +! N(/5!
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9. L5,M6N+/h3!0(/!&/+$,$,:!$,!&/+8$&$(,+'HM(N2'5N5,&+/;!+,8!+'&5/,+&$%5!N58$M$,5F!75,M6N+/h3!0(/!
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6&&2FHHbbb#b6(#$,&HN58$M$,53H+/5+3H&/+8$&$(,+'H&/No75,M6N+/h3H5,H&&
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10. W(//!*V!<==A#!a,!5g2'$M+&$(,!(0!(3&5(2+&6$M!2/$,M$2'53#!m+/8!4"P!58#!_(.,8+&$(,3!0(/![3&5(2+&6$M!
V58$M$,5!.<,8!58#!96$'+85'26$+P!9+F!O$22$,M(&&!m$''$+N3!p!m$'h$,3@12)>G&
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11. V(,&$M(,5! VP! L+$+/8$! 9P! _5//+/$! 1! 5&! +'#! [3b53&/;! R$3+7$'$&;! *,85g! <#>)! *&+'$+,! `5/3$(,#12$,5!
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12. 4('+,8!VP!V(//$3!4#!a!3&.8;!(0!&65!,+&./+'!6$3&(/;!(0!7+Mh!2+$,#!12$,5!>CEA@ET<U!F>B>)>BB&
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13. V(,&$M(,5!V!PL+$+/8$! 9!I$8(!I! 5&!+'#!R5%5'(2N5,&!(0! &65! *&+'$+,!%5/3$(,!(0! &65!I5Mh!9+$,!+,8!
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458!
"#!"$%$&$''(!!
Efficacia&della&Cura&Osteopatica&Centrata&sulla&Persona&nel&Low&Back&Pain&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
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