Abbas Tabatabaei, Farzan Molaei, Tobia Zanotto, Sharon G Lynch, Jacob Sosnoff
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引用次数: 0
Abstract
Objective: Dry needling (DN) has recently been investigated as an alternative strategy to reduce muscle spasticity and improve mobility in people with multiple sclerosis (pwMS). The aim of the present review was to identify any available literature on the potential benefits of DN in pwMS.
Methods: A systematic literature search was conducted in the PubMed, Scopus, ScienceDirect, Embase/Ovid, CINAHL, CENTRAL, Web of Science and PEDro databases and at ClinicalTrials.gov. The search results were limited to studies published between 2000 and 2023 without language restrictions. All articles reporting on the application of DN (defined as the use of a needle to target myofascial trigger point(s) without injection) in pwMS were included. Studies related to traditional medicine were excluded. Two reviewers independently investigated the quality of reporting based on Joanna Briggs Institute critical appraisal tools. Data on the effects of DN on muscle spasticity, pain intensity, mobility and other reported outcomes in pwMS were extracted and analyzed.
Results: Four original articles (two case reports and two case series) and one conference paper reporting the findings of a randomized controlled trial randomized controlled trial (RCT) were included. The RCT was small (n = 16 participants) and sham-controlled with no significant differences between groups. In all four case reports/series, reduced spasticity was observed following DN treatment in pwMS. Findings with respect to other outcomes (including pain intensity, mobility, quality of life, manual dexterity and disability reduction) were mixed.
Conclusion: Although no firm conclusions can be drawn from these uncontrolled case reports/series, DN for pwMS appears feasible and (based on limited clinical observation) may have potential as an adjunct therapeutic method to address spasticity in pwMS. However, the quantity and quality of available data are extremely limited. There is a need for high-quality studies of DN (ideally adequately sized RCTs with a low risk of bias) to further explore its effectiveness in the MS population.
目的：干针（DN）最近被研究作为多发性硬化症（pwMS）患者减少肌肉痉挛和改善活动能力的替代策略。本综述的目的是确定任何关于DN在pwMS中的潜在益处的现有文献。方法：在PubMed、Scopus、ScienceDirect、Embase/Ovid、CINAHL、CENTRAL、Web of Science和PEDro数据库以及ClinicalTrials.gov进行系统文献检索。搜索结果仅限于2000年至2023年间发表的无语言限制的研究。所有报道DN（定义为使用针靶肌筋膜触发点，无需注射）在pwMS中的应用的文章均被纳入。与传统医学相关的研究被排除在外。两位审稿人独立调查了基于乔安娜布里格斯研究所关键评估工具的报告质量。提取并分析DN对pwMS中肌肉痉挛、疼痛强度、活动能力和其他报告结果的影响数据。结果：纳入了四篇原创文章（两篇病例报告和两篇病例系列）和一篇报告随机对照试验（RCT）结果的会议论文。该RCT规模较小（n = 16名参与者），采用假对照，组间无显著差异。在所有4个病例报告/系列中，在pwMS中观察到DN治疗后痉挛减轻。其他结果（包括疼痛强度、活动能力、生活质量、手灵巧性和残疾减少）的研究结果好坏参半。结论：虽然不能从这些未控制的病例报告/系列中得出确切的结论，但DN治疗pwMS似乎是可行的，并且（基于有限的临床观察）可能有潜力作为解决pwMS痉挛的辅助治疗方法。然而，现有数据的数量和质量都极为有限。需要对DN进行高质量的研究（理想情况下，适当规模的低偏倚风险随机对照试验），以进一步探索其在多发性硬化症人群中的有效性。
期刊介绍：
Acupuncture in Medicine aims to promote the scientific understanding of acupuncture and related treatments by publishing scientific investigations of their effectiveness and modes of action as well as articles on their use in health services and clinical practice. Acupuncture in Medicine uses the Western understanding of neurophysiology and anatomy to interpret the effects of acupuncture.
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