The effectiveness of neuromuscular spinal manipulation- an updated systematic review and meta-analysis

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine Pub Date : 2024-08-06 DOI:10.1016/j.ijosm.2024.100731

Chi Ngai Lo , Eric W. Tsang , Shirley Pui Ching Ngai

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引用次数: 0

Abstract

Background

Spinal manipulation has been increasingly researched over the past two decades for its potential to enhance motor function. In our review, we use the term Neuromuscular Spinal Manipulation (NSM) to specifically identify studies focused on the motor facilitation effects of spinal manipulation.

Objective

To evaluate the efficacy of NSM in increasing muscle strength among healthy individuals through a systematic review and meta-analysis.

Design

Systematic Review and Meta-Analysis.

Methods

Databases including PubMed Central, Virtual Health Library, Cochrane Library, OSTMED.DR, and Google Scholar were searched up to September 2023. Eligible studies were randomized controlled trials and crossover studies on adults aged 18–65, assessing high-velocity, low-amplitude thrusts and Maitland grade III or IV mobilizations. Exclusions were studies on patients with pain/pathology, peripheral joint interventions, instrumental mobilizations, or co-interventions. Quality was appraised using the PEDro scale, and evidence graded with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. This review was registered with PROSPERO (CRD42022351923).

Results

Of 7308 records, 10 articles met inclusion criteria, with 8 undergoing meta-analysis. A significant pooled effect on isometric muscle strength was observed (standardized mean difference +0.95, 95 % CI + 0.62 to +1.29) between NSM and controls, with heterogeneity I2 = 38 %. A high level of GRADE recommendation was; proposed according to the quality of evidence.

Conclusion

NSM significantly enhances short-term isometric muscle strength in asymptomatic individuals, underscoring its potential clinical utility. Future research should aim to address the limitations noted, particularly regarding the long-term effects and underlying mechanisms of NSM.

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神经肌肉脊柱手法的有效性--最新系统回顾和荟萃分析

背景在过去二十年中，脊柱手法因其增强运动功能的潜力而受到越来越多的研究。在我们的综述中，我们使用神经肌肉脊柱手法（NSM）这一术语来专门识别专注于脊柱手法运动促进效果的研究。Objective To evaluate the efficacy of NSM in increasing muscle strength among healthy individuals through a systematic review and meta-analysis.DesignSystematic Review and Meta-Analysis.MethodsDatabases including PubMed Central, Virtual Health Library, Cochrane Library, OSTMED.DR, and Google Scholar were searched up to September 2023.符合条件的研究均为随机对照试验和交叉研究，研究对象为 18-65 岁的成年人，评估内容为高速度、低振幅推举和麦特兰 III 级或 IV 级动员。不包括对疼痛/病理患者、外周关节干预、工具性动员或联合干预的研究。研究质量采用PEDro评分法进行评估，证据采用推荐、评估、发展和评价分级法（GRADE）进行分级。本综述已在 PROSPERO（CRD42022351923）注册。在 NSM 和对照组之间观察到了对等长肌力的显着集合效应（标准化平均差异 +0.95，95 % CI + 0.62 至 +1.29），异质性 I2 = 38 %。结论NSM能显著增强无症状人群的短期等长肌力，强调了其潜在的临床实用性。未来的研究应着眼于解决所指出的局限性，特别是有关 NSM 的长期效果和潜在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Osteopathic Medicine 医学-医学：内科

CiteScore

2.20

自引率

36.80%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Osteopathic Medicine is a peer-reviewed journal that provides for the publication of high quality research articles and review papers that are as broad as the many disciplines that influence and underpin the principles and practice of osteopathic medicine. Particular emphasis is given to basic science research, clinical epidemiology and health social science in relation to osteopathy and neuromusculoskeletal medicine. The Editorial Board encourages submission of articles based on both quantitative and qualitative research designs. The Editorial Board also aims to provide a forum for discourse and debate on any aspect of osteopathy and neuromusculoskeletal medicine with the aim of critically evaluating existing practices in regard to the diagnosis, treatment and management of patients with neuromusculoskeletal disorders and somatic dysfunction. All manuscripts submitted to the IJOM are subject to a blinded review process. The categories currently available for publication include reports of original research, review papers, commentaries and articles related to clinical practice, including case reports. Further details can be found in the IJOM Instructions for Authors. Manuscripts are accepted for publication with the understanding that no substantial part has been, or will be published elsewhere.