Physical Therapy Intervention Effects on Alteration of Spinal Excitability in Patients With Chronic Ankle Instability: A Systematic Review and Meta-analysis.
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Abstract
Context: Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability.
Objective: The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI.
Data sources: Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022.
Study selection: A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis.
Study design: Systematic review and meta-analysis.
Level of evidence: Level 3a.
Data extraction: A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale.
Results: The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus (P = 0.44, I2 = 0%) and soleus (P = 0.56,I2 = 22%) muscles were not changed by physical therapy in patients with CAI.
Conclusion: The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy.
背景：慢性踝关节不稳定（CAI）是运动员的常见损伤。不同形式的物理疗法已应用于 CAI 患者，以评估其对脊柱兴奋性的影响：本系统综述和荟萃分析旨在研究各种物理治疗干预对 CAI 患者脊柱兴奋性改变的有效性：对四个数据库（EMBASE、MEDLINE、Cochrane CENTRAL 和 Scopus）进行了检索，检索时间从开始到 2022 年 11 月：研究设计：系统综述和荟萃分析：研究设计：系统综述和荟萃分析：数据提取共提取并总结了11项研究的数据，这些研究包括腓肠肌和比目鱼肌的最大霍夫曼反射与最大肌肉反应（H/M比值）的归一化。研究质量采用 PEDro 量表进行评估：结果：所提取研究的平均 PEDro 得分为 4.7 ± 1.4，表明大多数研究的质量为中等至良好。物理治疗干预措施包括冷冻疗法、拍打、移动、本体感觉训练和干针疗法。总体效果显示，CAI患者腓肠肌（P = 0.44，I2 = 0%）和比目鱼肌（P = 0.56，I2 = 22%）的H/M比值并未因物理治疗而改变：荟萃分析表明，冷冻疗法、拍打、活动、本体感觉训练和干针疗法等物理治疗干预措施不会改变 CAI 患者的脊柱兴奋性。鉴于只有一项研究报告称干针疗法对脊柱兴奋性的改变无效，因此必须开展更多的研究来确定和验证其疗效：CRD42022372998。
期刊介绍：
Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals.
Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor.
Topics include:
-Sports Injury and Treatment
-Care of the Athlete
-Athlete Rehabilitation
-Medical Issues in the Athlete
-Surgical Techniques in Sports Medicine
-Case Studies in Sports Medicine
-Images in Sports Medicine
-Legal Issues
-Pediatric Athletes
-General Sports Trauma
-Sports Psychology
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