Download PDF
VPT Magazin 2024; 10(01): 14-17
DOI: 10.1055/s-0044-1782126
Diskurs

Geringe Evidenz – was tun bei nicht spezifischen Rückenschmerzen?

Jochen Schomacher
› Further Information
    Permissions and Reprints

Zusammenfassung

Es gibt viele Krankheitsbilder und Symptome, bei denen Physiotherapeut*innen auf ihre Erfahrung oder kollegiale Beratung setzen müssen, weil es keine (klaren) Forschungsergebnisse und daraus abgeleitete Handlungsempfehlungen gibt. Oft mangelt es an nachgewiesener Evidenz für physiotherapeutische Maßnahmen. Das macht auch Empfehlungen in Leitlinien unmöglich. Wie gehen Physiotherapeut*innen damit um? Der Beitrag von Jochen Schomacher zu diesem Thema am Beispiel des nicht spezifischen Rückenschmerzes (nsLBP) lädt zur (Selbst-)Reflexion und zum fachlichen Diskurs ein. Die Diagnose nsLBP wird oft gestellt, was dieses Beispiel für das Thema prädestiniert.



Publication History

Article published online:
27 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Rubinstein SM, van Middelkoop M, Assendelft WJ. et al. Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review. Spine 2011; 36: E825-E846
    CrossrefPubMedSearch in Google Scholar
  • 2 Rubinstein SM, van Middelkoop M, Assendelft WJ. et al. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev 2011; CD008112
    CrossrefPubMedSearch in Google Scholar
  • 3 Thomas JS, Clark BC, Russ DW. et al. Effect of Spinal Manipulative and Mobilization Therapies in Young Adults With Mild to Moderate Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open 2020; 3: e2012589
    CrossrefPubMedSearch in Google Scholar
  • 4 Rubinstein SM, de Zoete A, van Middelkoop M. et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ 2019; 364: l689
    CrossrefPubMedSearch in Google Scholar
  • 5 Hebert JJ, Stomski NJ, French SD. et al. Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases. J Manipulative Physiol Ther 2015; 38: 677-691
    CrossrefPubMedSearch in Google Scholar
  • 6 Machado LAC, Maher CG, Herbert RD. et al. The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial. BMC Med 2010; 8: 10
    CrossrefPubMedSearch in Google Scholar
  • 7 Takasaki H, May S. Mechanical Diagnosis and Therapy has similar effects on pain and disability as ‘wait and see‘ and other approaches in people with neck pain: a systematic review. J Physiother 2014; 60: 78-84
    CrossrefPubMedSearch in Google Scholar
  • 8 Almeida MO, Narciso Garcia A, Menezes Costa LC. et al. The McKenzie method for (sub)acute non-specific low back pain. Cochrane Database Syst Rev 2023; 4: CD009711
    CrossrefPubMedSearch in Google Scholar
  • 9 Luomajoki H. Sechs Richtige: Mit der Testbatterie die lumbale Bewegungskontrolle untersuchen. manuelletherapie 2012; 16: 220-225
    CrossrefSearch in Google Scholar
  • 10 Saner J, Kool J, de Bie RA. et al. Movement control exercise versus general exercise to reduce disability in patients with low back pain and movement control impairment. A randomised controlled trial. BMC Musculoskelet Disord 2011; 12: 207
    CrossrefPubMedSearch in Google Scholar
  • 11 Saner J, Kool J, Sieben JM. et al. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up. Man Ther 2015; 20: 672-679
    CrossrefPubMedSearch in Google Scholar
  • 12 Saragiotto BT, Maher CG, Yamato TP. et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev. 2016; 2016: CD012004
    CrossrefPubMedSearch in Google Scholar
  • 13 Luomajoki HA, Beltran MBB, Careddu S. et al. Effectiveness of movement control exercise on patients with non-specific low back pain and movement control impairment: A systematic review and meta-analysis. Musculoskelet Sci Pract 2018; 36: 1-11
    CrossrefPubMedSearch in Google Scholar
  • 14 Airaksinen O, Hildebrandt J, Mannion AF. et al. European guidelines for the management of chronic non-specific low back pain. 2004 Im Internet: http://www.backpaineurope.org/web/html/wg2_results.html
    PubMedSearch in Google Scholar
  • 15 Airaksinen O, Brox JI, Cedraschi C. et al. Chapter 4. European guidelines for the management of chronic non-specific low back pain. Eur Spine J 2006; 15 (Suppl. 02) S192-S300
    CrossrefPubMedSearch in Google Scholar
  • 16 Luomajoki H. Evidence für Übungen und Training bei lumbalem Rückenschmerz (LBP). manuelletherapie 2002; 6: 33-46
    Search in Google Scholar
  • 17 Von Heyman W. Neck and back pain. Eine Übersicht über 30 Jahre Studienergebnisse. Manuelle Medizin 2002; 10: 188-192
    Search in Google Scholar
  • 18 Hayden JA, Ellis J, Ogilvie R. et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev 2021; 9: CD009790
    CrossrefPubMedSearch in Google Scholar
  • 19 Forssell MZ. The back school. Spine 1981; 6: 104-106
    CrossrefPubMedSearch in Google Scholar
  • 20 Forssell MZ. The swedish back school. Physiotherapy 1980; 66: 112-114
    PubMedSearch in Google Scholar
  • 21 Riley S, Swanson BT, Sawyer SF. et al. Should low-quality evidence dominate high-level evidence? A systematic review and meta-analysis of systematic reviews of musculoskeletal physical therapy interventions. J Man Manip Ther 2021; 29: 203-215
    CrossrefPubMedSearch in Google Scholar
  • 22 Kripa S, Kaur H. Identifying relations between posture and pain in lower back pain patients: a narrative review. Bull Fac Phys Ther 2021; 26: 1-4
    CrossrefSearch in Google Scholar
  • 23 Van Dillen LR, Lanier VM, Steger-May K. et al. Effect fo motor skill training in functional activities vs strength and flexibility exercise on function in people with chronic low back pain, A randomized clinical trial. JAMA Neurol 2021; 78: 385-395
    CrossrefPubMedSearch in Google Scholar
  • 24 Elkjær E, Mikkelsen MB, Michalak J. et al. Expansive and contractive postures and movement: A systematic review and meta-analysis of the effect of motor displays on affective and behavioral responses. Perspect Psychol Sci 2022; 17: 276-304
    CrossrefPubMedSearch in Google Scholar
  • 25 Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992; 5: 390-396
    CrossrefPubMedSearch in Google Scholar
  • 26 O‘Sullivan K, O‘Sullivan P, O‘Sullivan L. et al. What do physiotherapists consider to be the best sitting spinal posture?. Man Ther 2012; 17: 432-437
    CrossrefPubMedSearch in Google Scholar
  • 27 Powers CM, Beneck GJ, Kulig K. et al. Effects of a single session of posterior-to-anterior spinal mobilization and press-up exercise on pain response and lumbar spine extension in people with nonspecific low back pain. Phys Ther 2008 88: 485-493
    CrossrefPubMed
  • 28 Paatelma M, Kilpikoski S, Simonen R. et al. Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up. J Rehabil Med 2008; 40: 858-863
    CrossrefPubMedSearch in Google Scholar
  • 29 Bundesärztekammer (BAK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie (NVL). Nicht-spezifischer Kreuzschmerz – Langfassung, 2. Auflage. 2017 Version 1. Im Internet: Accessed December 11, 2023 at: www.leitlinien.de/themen/kreuzschmerz/2-auflage
    PubMedSearch in Google Scholar
  • 30 Schomacher J. Wissenschaftliche Gütekriterien in der Manuellen Therapie: Einige Antworten. pt_Zeitschrift für Physiotherapeuten 2021; 73: 44-47
    Search in Google Scholar
  • 31 Wikipedia. Phänomenologie. Im Internet: Accessed December 11, 2023 at: https://de.wikipedia.org/wiki/Ph%C3%A4nomenologie
  • 32 Schomacher J. Den Schmerzen auf der Spur – Symptomlokalisation am Beispiel Rückenschmerz. physiopraxis 2006; 4: 18-22
    CrossrefSearch in Google Scholar
  • 33 Schomacher J. Wer denkt, stellt Diagnosen – Plädoyer für die physiotherapeutische Diagnose. physiopraxis 2004; 2: 34-38
    CrossrefSearch in Google Scholar
  • 34 Schomacher J. Diagnostik und Therapie des Bewegungsapparates in der Physiotherapie. Thieme; Stuttgart: 2001
    Search in Google Scholar
  • 35 Zusman M. Belief reinforcement: one reason why costs for low back pain have not decreased. J Multidiscip Healthc 2013; 6: 197-204
    CrossrefPubMedSearch in Google Scholar
  • 36 Schomacher J. The Spine, 7.–9. Oktober 2005 in Rom (Kongressbericht). manuelletherapie 2005; 9: 199-201
    Search in Google Scholar