{"title":"脊柱推拿疗法治疗近期和持续性非特异性颈部疼痛的益处和危害:荟萃分析的系统综述。","authors":"Silvia Minnucci, Tiziano Innocenti, Stefano Salvioli, Silvia Giagio, Marzia Stella Yousif, Francesca Riganelli, Chiara Carletti, Daniel Feller, Fabrizio Brindisino, Agostino Faletra, Alessandro Chiarotto, Firas Mourad","doi":"10.2519/jospt.2023.11708","DOIUrl":null,"url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to estimate the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. <b>DESIGN:</b> Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). <b>LITERATURE SEARCH:</b> We searched the MEDLINE, Cochrane CENTRAL, Embase, CINAHL, PEDro, Chiropractic Literature Index bibliographic databases, and grey literature sources, up to June 6, 2022. <b>STUDY SELECTION CRITERIA:</b> RCTs evaluating SMT compared to guideline-recommended and nonrecommended interventions, sham SMT, and no intervention for adults with neck pain were eligible for our systematic review. Prespecified outcomes included pain, range of motion, disability, health-related quality of life. <b>DATA SYNTHESIS:</b> Random-effects meta-analysis for clinically homogenous RCTs at short-term and long-term outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool. We used the Grading of Recommendations, Assessment, Development, and Evaluations approach to judge the certainty of evidence. <b>RESULTS:</b> We included 28 RCTs. There was very low to low certainty evidence that SMT was more effective than recommended interventions for improving pain at short term (standardized mean difference [SMD], 0.66; 95% confidence interval [CI]: 0.35, 0.97) and long term (SMD, 0.73; 95% CI: 0.31, 1.16), and for reducing disability at short-term (SMD, 0.95; 95% CI: 0.48, 1.42) and long term (SMD, 0.65; 95% CI: 0.23, 1.06). Transient side effects only were found (eg, muscle soreness). <b>CONCLUSION:</b> There was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain. <i>J Orthop Sports Phys Ther 2023;53(9):510-528. Epub: 10 August 2023. doi:10.2519/jospt.2023.11708</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Benefits and Harms of Spinal Manipulative Therapy for Treating Recent and Persistent Nonspecific Neck Pain: A Systematic Review With Meta-analysis.\",\"authors\":\"Silvia Minnucci, Tiziano Innocenti, Stefano Salvioli, Silvia Giagio, Marzia Stella Yousif, Francesca Riganelli, Chiara Carletti, Daniel Feller, Fabrizio Brindisino, Agostino Faletra, Alessandro Chiarotto, Firas Mourad\",\"doi\":\"10.2519/jospt.2023.11708\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>OBJECTIVE:</b> We aimed to estimate the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. <b>DESIGN:</b> Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). <b>LITERATURE SEARCH:</b> We searched the MEDLINE, Cochrane CENTRAL, Embase, CINAHL, PEDro, Chiropractic Literature Index bibliographic databases, and grey literature sources, up to June 6, 2022. <b>STUDY SELECTION CRITERIA:</b> RCTs evaluating SMT compared to guideline-recommended and nonrecommended interventions, sham SMT, and no intervention for adults with neck pain were eligible for our systematic review. Prespecified outcomes included pain, range of motion, disability, health-related quality of life. <b>DATA SYNTHESIS:</b> Random-effects meta-analysis for clinically homogenous RCTs at short-term and long-term outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool. We used the Grading of Recommendations, Assessment, Development, and Evaluations approach to judge the certainty of evidence. <b>RESULTS:</b> We included 28 RCTs. There was very low to low certainty evidence that SMT was more effective than recommended interventions for improving pain at short term (standardized mean difference [SMD], 0.66; 95% confidence interval [CI]: 0.35, 0.97) and long term (SMD, 0.73; 95% CI: 0.31, 1.16), and for reducing disability at short-term (SMD, 0.95; 95% CI: 0.48, 1.42) and long term (SMD, 0.65; 95% CI: 0.23, 1.06). Transient side effects only were found (eg, muscle soreness). <b>CONCLUSION:</b> There was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain. <i>J Orthop Sports Phys Ther 2023;53(9):510-528. Epub: 10 August 2023. doi:10.2519/jospt.2023.11708</i>.</p>\",\"PeriodicalId\":50099,\"journal\":{\"name\":\"Journal of Orthopaedic & Sports Physical Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic & Sports Physical Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2519/jospt.2023.11708\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic & Sports Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2519/jospt.2023.11708","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Benefits and Harms of Spinal Manipulative Therapy for Treating Recent and Persistent Nonspecific Neck Pain: A Systematic Review With Meta-analysis.
OBJECTIVE: We aimed to estimate the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. DESIGN: Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). LITERATURE SEARCH: We searched the MEDLINE, Cochrane CENTRAL, Embase, CINAHL, PEDro, Chiropractic Literature Index bibliographic databases, and grey literature sources, up to June 6, 2022. STUDY SELECTION CRITERIA: RCTs evaluating SMT compared to guideline-recommended and nonrecommended interventions, sham SMT, and no intervention for adults with neck pain were eligible for our systematic review. Prespecified outcomes included pain, range of motion, disability, health-related quality of life. DATA SYNTHESIS: Random-effects meta-analysis for clinically homogenous RCTs at short-term and long-term outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool. We used the Grading of Recommendations, Assessment, Development, and Evaluations approach to judge the certainty of evidence. RESULTS: We included 28 RCTs. There was very low to low certainty evidence that SMT was more effective than recommended interventions for improving pain at short term (standardized mean difference [SMD], 0.66; 95% confidence interval [CI]: 0.35, 0.97) and long term (SMD, 0.73; 95% CI: 0.31, 1.16), and for reducing disability at short-term (SMD, 0.95; 95% CI: 0.48, 1.42) and long term (SMD, 0.65; 95% CI: 0.23, 1.06). Transient side effects only were found (eg, muscle soreness). CONCLUSION: There was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain. J Orthop Sports Phys Ther 2023;53(9):510-528. Epub: 10 August 2023. doi:10.2519/jospt.2023.11708.
期刊介绍:
The Journal of Orthopaedic & Sports Physical Therapy® (JOSPT®) publishes scientifically rigorous, clinically relevant content for physical therapists and others in the health care community to advance musculoskeletal and sports-related practice globally. To this end, JOSPT features the latest evidence-based research and clinical cases in musculoskeletal health, injury, and rehabilitation, including physical therapy, orthopaedics, sports medicine, and biomechanics.
With an impact factor of 3.090, JOSPT is among the highest ranked physical therapy journals in Clarivate Analytics''s Journal Citation Reports, Science Edition (2017). JOSPT stands eighth of 65 journals in the category of rehabilitation, twelfth of 77 journals in orthopedics, and fourteenth of 81 journals in sport sciences. JOSPT''s 5-year impact factor is 4.061.