Arthrose et appareil locomoteur

Le 14/10/2021 de 14:30 à 16:00

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Effets des manipulations ostéopathiques versus placebo sur les limitations d'activité chez les patients ayant une lombalgie non-spécifique subaiguë ou chronique : essai clinique randomisé (LC-OSTEO)

Christelle Nguyen (Paris, France), Isabelle Boutron (Paris, France), Rafael Zegarra-Parodi (Pescara, Italie), Gabriel Baron (Paris, France), Sophie Alami (Paris, France), Katherine Sanchez (Paris, France), Camille Daste (Paris, France), Margaux Boisson (Paris, France), Laurent Fabre (Pescara, Italie), Peggy Krief (Lausanne, Suisse), Guillaume Krief (Fribourg, Suisse), Marie-Martine Lefèvre-Colau (Paris, France), Serge Poiraudeau (Paris, France), François Rannou (Paris, France)

Objective : To compare the efficacy of osteopathic manipulative treatment (OMT) vs sham OMT for reducing low back pain (LBP)-specific activity limitations at 3 months in persons with nonspecific subacute or chronic LBP.

Material / Patients and Methods : This prospective, single-blind, sham-controlled randomized clinical trial (NCT02034864) recruited participants with nonspecific subacute or chronic LBP from a tertiary care center. Interventions consisted in six sessions (1 every 2 weeks) of OMT or sham OMT delivered by nonphysician, nonphysiotherapist osteopathic practitioners. The primary end point was mean reduction in LBP-specific activity limitations at 3 months as measured by the self-administered Quebec Back Pain Disability Index (score range, 0-100). Secondary outcomes were pain, health-related quality of life and consumption of analgesics and nonsteroidal anti-inflammatory drugs.

Results : Overall, 200 participants were randomly allocated to OMT and 200 to sham OMT. The median (range) age at inclusion was 49.8 (40.7-55.8) years and 359 of 393 (91.3%) participants were currently working. The mean reduction in LBP-specific activity limitations at 3 months was −4.7 (95%CI, −6.6 to −2.8) and −1.3 (95%CI, −3.3 to 0.6) for the OMT and sham OMT groups, respectively (mean difference, −3.4; 95%CI, −6.0 to −0.7; P = .01). At 3 and 12 months, the mean difference in mean reduction in pain was −1.0 (95%CI, −5.5 to 3.5; P = .66) and −2.0 (95%CI, −7.2 to 3.3; P = .47), respectively. There were no statistically significant differences in other secondary outcomes.

Discussion - Conclusion : OMT had a small effect on LBP-specific activity limitations vs sham OMT. However, the clinical relevance of this effect is questionable.

Keywords : Low back pain; osteopathy

Disclosure of interest : Not applicable