Effectiveness and reporting quality of blood flow restriction training in the rehabilitation of patients with upper limb musculoskeletal disorders: A systematic review.
Felipe Ponce-Fuentes, Iván Cuyul-Vásquez, Joaquín Salazar-Méndez, José Casaña, Joaquín Calatayud, Enrique Lluch, Eoin Ó Conaire, Filip Struyf
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引用次数: 0
Abstract
Background: Blood flow restriction training (BFRT) is a widely studied strategy in lower limb pathology; however, BFRT research in upper limb disorders is limited.
Objective: To evaluate the effectiveness of BFRT programs on skeletal muscle mass, strength, pain, and function in upper limb musculoskeletal disorders rehabilitation and to analyze the reporting quality of the exercise content.
Methods: A literature search of the PubMed, Web of Science, Scopus, Scientific Electronic Library Online, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from inception to May 2023. The results included randomized controlled trials (RCTs) and non-RCTs, prospective and retrospective cohort studies, case series, and case report studies of patients with upper limb musculoskeletal disorders treated with resistance exercise enhanced with BFRT and reporting at least one outcome related to skeletal muscle mass, strength, pain or function/disability. The risk of bias of the included studies was assessed using the Risk of Bias 2.0, and the reporting quality was evaluated with the Consensus on Exercise Reporting Template (CERT).
Results: Four RCTs, one case series, and four case report studies were included. Very low-quality studies showed a pattern of clinical improvements surpassing the minimal clinically important difference in most patient-reported outcome and physical function measures. The risk of bias in the included studies was high. The CERT revealed poor description of the BFRT programs.
Conclusions: This systematic review identified limited and low-quality evidence that BFRT is effective in the physical rehabilitation of patients with upper limb musculoskeletal disorders. Additionally, the reporting of BFRT content in patients with upper limb disorders is poor. We recommend that authors use the CERT guideline when reporting the exercise protocols and results of trials investigating BFRT interventions.
背景：血流限制训练（BFRT）是一种被广泛研究的下肢病理策略；然而，BFRT在上肢疾病中的研究是有限的。目的：评价BFRT方案对上肢肌肉骨骼疾病康复中骨骼肌质量、力量、疼痛和功能的影响，并分析运动内容的报告质量。方法：根据系统评价和荟萃分析指南的首选报告项目，检索PubMed、Web of Science、Scopus、Science Electronic Library Online、SPORTDiscus、Cumulative Index to Nursing and Allied Health literature、physical therapy Evidence Database，检索时间自成立至2023年5月。结果包括随机对照试验（rct）和非随机对照试验、前瞻性和回顾性队列研究、病例系列和病例报告研究，研究对象是接受BFRT增强阻力运动治疗的上肢肌肉骨骼疾病患者，并报告了至少一项与骨骼肌质量、力量、疼痛或功能/残疾相关的结果。采用risk of bias 2.0评估纳入研究的偏倚风险，采用Consensus on Exercise reporting Template （CERT）评估报告质量。结果：纳入4项随机对照试验、1项病例系列研究和4项病例报告研究。非常低质量的研究显示，在大多数患者报告的结果和身体功能测量中，临床改善的模式超过了最小的临床重要差异。纳入研究的偏倚风险很高。CERT揭示了对BFRT程序的糟糕描述。结论：本系统综述确定了有限和低质量的证据，证明BFRT对上肢肌肉骨骼疾病患者的物理康复有效。此外，关于上肢疾病患者BFRT含量的报道很少。我们建议作者在报告演习方案和调查BFRT干预措施的试验结果时使用CERT指南。
期刊介绍：
Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.
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