Manual Therapy for Cervical Radiculopathy: Effects on Neck Disability and Pain - A Systematic Review and Network Meta-Analysis.

IF 2.5 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Pain Research Pub Date : 2025-04-14 eCollection Date: 2025-01-01 DOI:10.2147/JPR.S513428

Xueliang Xu, Yan Ling

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引用次数: 0

Abstract

Objective: To evaluate the application effects of different manual therapy approaches in the treatment of cervical radiculopathy using a network meta-analysis.

Methods: Prospective randomized controlled trials on manual therapy for cervical radiculopathy published in PubMed, the Cochrane Library, and Embase databases were retrieved. The neck disability index and visual analogue scale for neck pain were collected and subjected to network meta-analysis.

Results: A total of 8 eligible studies involving 632 participants with a mean age range of 40-47 years were included. The intervention duration ranged from 4 to 6 weeks. Three intervention groups were defined: Group C (exercise and other therapies without manual therapy), Group M (manual therapy without traction), and Group MT (manual therapy with traction). Larger circles indicate more patients, and thicker lines show more studies comparing interventions. Group M had the highest probability (68.1%) of improving the neck disability index, followed by Group MT (29.1%), with Group C the lowest (2.8%). Compared to Group C, neck disability index scores improved by 0.58 (95% CI: -0.17, 1.33) in Group M and by 0.36 (95% CI: -0.39, 1.11) in Group MT. The difference between Group M and Group MT was not significant (0.22, 95% CI: -0.59, 1.03). For neck pain (visual analogue scale score), Group M had the highest probability (59.5%) of improvement, followed by Group MT (39.6%), with Group C the lowest (0.9%). Compared to Group C, the visual analogue scale score improved by 0.74 (95% CI: -0.04, 1.52) in Group M and by 0.61 (95% CI: -0.18, 1.40) in Group MT. The difference between Group M and Group MT was not significant (0.13, 95% CI: -0.72, 0.98). Egger's regression test showed no apparent publication bias.

Conclusion: Manual therapy is an effective approach for improving neck pain and neck disability index in patients with cervical radiculopathy, but more evidence-based support is needed regarding the use of cervical traction.

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颈椎神经根病的手工治疗：对颈部残疾和疼痛的影响-系统回顾和网络荟萃分析。

目的：应用网络meta分析评价不同手法治疗颈神经根病的应用效果。方法：检索PubMed、Cochrane图书馆和Embase数据库中发表的颈椎神经根病手工治疗的前瞻性随机对照试验。收集颈部残疾指数和颈部疼痛视觉模拟量表并进行网络meta分析。结果：共纳入8项符合条件的研究，涉及632名参与者，平均年龄在40-47岁之间。干预时间为4 ~ 6周。我们定义了三个干预组：C组（运动和其他疗法，不需要手工治疗），M组（手工疗法，不需要牵引），MT组（手工疗法，有牵引）。较大的圆圈表示患者较多，较粗的线条表示比较干预的研究较多。M组改善颈部残疾指数的概率最高（68.1%），MT组次之（29.1%），C组最低（2.8%）。与C组相比，M组颈部残疾指数评分提高了0.58分（95% CI: -0.17, 1.33）， MT组提高了0.36分（95% CI: -0.39, 1.11）。M组与MT组的差异无统计学意义（0.22,95% CI: -0.59, 1.03）。对于颈部疼痛（视觉模拟量表评分），M组改善概率最高（59.5%），MT组次之（39.6%），C组最低（0.9%）。与C组相比，M组的视觉模拟量表评分提高了0.74 (95% CI: -0.04, 1.52)， MT组提高了0.61 （95% CI: -0.18, 1.40）。M组与MT组的差异无统计学意义（0.13,95% CI: -0.72, 0.98）。Egger回归检验未发现明显的发表偏倚。结论：手法治疗是改善颈神经根病患者颈部疼痛和颈部残疾指数的有效方法，但颈椎牵引的使用需要更多的循证支持。

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

Journal of Pain Research CLINICAL NEUROLOGY-

CiteScore

4.50

自引率

3.70%

发文量

411

审稿时长

16 weeks

期刊介绍： Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.