Ebraheem Albazee MD, Hemail M. Alsubaie MD, Justin M. Hintze MBMCh, MSc, FRCS, Isobel O'Riordan MBMCh, MSc, FRCS, Conrad Timon MD, FRCS, John Kinsella MSc, FRCS, Paul Lennon MSc, FRCS, Conall W. R. Fitzgerald MBMCh, MSc, FRCS
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Our specific outcomes were the severity of neck pain and self-reported disability after thyroidectomy. The results were synthesized using risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) in a random-effects model using Stata software. Nine clinical trials, comprising five randomized and four non-randomized trials, were included, with a total of 1026 patients. Neck stretching exercises were significantly associated with improved mean pain scores both after 1 week (<i>n</i> = 625 patients, SMD = −2.43, 95% CI [−4.65, −0.22], <i>p</i> = 0.03, <i>I</i><sup>2</sup> = 98%) and 1 month (<i>n</i> = 545 patients, SMD = −4.11, 95% CI [−8.12, −0.11], <i>p</i> = 0.04, <i>I</i><sup>2</sup> = 99%). Similarly, neck stretching exercises were significantly associated with improved mean self-reported disability scores both after 1 week (<i>n</i> = 298 patients, SMD = −0.70, 95% CI [−1.36, −0.04], <i>p</i> = 0.04, <i>I</i><sup>2</sup> = 87%) and 1 month (<i>n</i> = 298 patients, SMD = −0.42, 95% CI [−0.65, −0.19], <i>p</i> = 0.0004, <i>I</i><sup>2</sup> = 0%). The pooled analysis showed heterogeneity (chi-square <i>p</i> < 0.01, <i>I</i><sup>2</sup> > 80%), except for the mean self-reported neck disability score after 1 month, which showed homogeneity (chi-square <i>p</i> > 0.01, <i>I</i><sup>2</sup> = 0%). This systematic review and meta-analysis, involving 1026 patients, revealed the potential benefits of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy. 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引用次数: 0
摘要
甲状腺切除术会导致颈部疼痛、残疾和活动范围受限等重大挑战。因此，我们的目标是对临床试验进行系统回顾和荟萃分析，研究颈部伸展运动在缓解甲状腺切除术后颈部疼痛和自我报告的残疾方面的临床效果。我们系统地检索了从开始到 2023 年 7 月 28 日的 PubMed、CENTRAL、Scopus 和 Web of Science。我们使用 RoB-2 和 ROBINS-I 工具评估了所选试验的偏倚风险。我们的具体结果是甲状腺切除术后颈部疼痛的严重程度和自我报告的残疾程度。在Stata软件的随机效应模型中，使用风险比（RR）和标准化平均差（SMD）以及95%置信区间（CI）对结果进行综合分析。九项临床试验（包括五项随机试验和四项非随机试验）共纳入了 1026 名患者。颈部拉伸运动与一周后（n = 625 名患者，SMD = -2.43，95% CI [-4.65, -0.22]，p = 0.03，I2 = 98%）和一个月后（n = 545 名患者，SMD = -4.11，95% CI [-8.12, -0.11]，p = 0.04，I2 = 99%）平均疼痛评分的改善有明显相关性。同样，颈部伸展运动与1周后（n = 298 名患者，SMD = -0.70，95% CI [-1.36，-0.04]，p = 0.04，I2 = 87%）和1个月后（n = 298 名患者，SMD = -0.42，95% CI [-0.65，-0.19]，p = 0.0004，I2 = 0%）平均自我报告残疾评分的改善有显著相关性。汇总分析显示存在异质性（秩和 p 2 > 80%），但 1 个月后自我报告的平均颈部残疾评分显示存在同质性（秩和 p > 0.01，I2 = 0%）。该系统综述和荟萃分析涉及1026名患者，揭示了颈部伸展运动在缓解甲状腺切除术后颈部疼痛和自我报告的残疾方面的潜在益处。然而，还需要进一步的研究来解决方法学上的局限性、评估长期结果、调查潜在的调节因素（即锻炼计划的持续时间或强度）以及探究患者的镇痛药用量。
The effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy: A systematic review and meta-analysis of clinical trials
Thyroidectomy can lead to significant challenges such as neck pain, disability, and limited range of motion. Therefore, our objective is to conduct a systematic review and meta-analysis of clinical trials to investigate the clinical effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability immediately after thyroidectomy. We systematically searched PubMed, CENTRAL, Scopus, and Web of Science from inception until July 28th, 2023. We assessed the selected trials for the risk of bias using both the RoB-2 and ROBINS-I tools. Our specific outcomes were the severity of neck pain and self-reported disability after thyroidectomy. The results were synthesized using risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) in a random-effects model using Stata software. Nine clinical trials, comprising five randomized and four non-randomized trials, were included, with a total of 1026 patients. Neck stretching exercises were significantly associated with improved mean pain scores both after 1 week (n = 625 patients, SMD = −2.43, 95% CI [−4.65, −0.22], p = 0.03, I2 = 98%) and 1 month (n = 545 patients, SMD = −4.11, 95% CI [−8.12, −0.11], p = 0.04, I2 = 99%). Similarly, neck stretching exercises were significantly associated with improved mean self-reported disability scores both after 1 week (n = 298 patients, SMD = −0.70, 95% CI [−1.36, −0.04], p = 0.04, I2 = 87%) and 1 month (n = 298 patients, SMD = −0.42, 95% CI [−0.65, −0.19], p = 0.0004, I2 = 0%). The pooled analysis showed heterogeneity (chi-square p < 0.01, I2 > 80%), except for the mean self-reported neck disability score after 1 month, which showed homogeneity (chi-square p > 0.01, I2 = 0%). This systematic review and meta-analysis, involving 1026 patients, revealed the potential benefits of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy. However, further research is required to address methodological limitations, evaluate long-term outcomes, investigate potential moderators (i.e., the duration or intensity of the exercise program), and explore patients' analgesic consumption.
期刊介绍：
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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