周围神经损伤后结果测量的现状:系统回顾

Q3 Medicine
Abigail G. Carey-Ewend BS , Jake H. Goldfarb BA , Zachary D. Randall BS , David M. Brogan MD, MSc , Christopher J. Dy MD, MPH
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引用次数: 0

摘要

目的周围神经损伤(PNI)后的预后报告方式差异很大,通常集中在手术-手工肌肉测试上。我们系统回顾的目的是量化当代文献(发表于2008年及以后)在PNI之后的结果测量方法的使用,并评估哪些恢复领域最常被评估。方法在医学图书管理员的协助下,我们对2008年或之后发表的上肢PNI患者的文献进行了系统的回顾(代表最近15年)。我们排除了有5名受试者、未成年人、臂丛或指神经损伤、压迫性神经病变或随访6个月的文章。提取数据以确定在每项研究中使用了哪些结果测量,并将结果测量分为运动、感觉、功能和疼痛。结果在4个结果域(疼痛、运动、感觉和功能)中,运动是最常见的,其次是功能。在运动类别中,超过三分之二的研究使用手动肌肉测试进行评估。一半的文章报告了4个评估领域中的2个领域的结果。疼痛是最少被评估的领域,68篇文章中有11篇报道。虽然已经纳入了功能结果,但过去15年的大多数文献仍然集中在外科医生报告的肌肉测试上,并没有充分反映受PNI影响的多个领域。疼痛是最不常被报道的领域,尽管这是一个经常困扰PNI患者的问题。临床相关性临床医生和研究人员需要就PNI的一套共同的结果测量方法达成一致,该方法(a)包含临床医生和患者的观点,(B)反映受PNI影响的多个领域。这将提高结果报告的质量,并促进未来的比较有效性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Current State of Outcome Measurements After Peripheral Nerve Injury: A Systematic Review

Purpose

The manner in which outcomes are reported after peripheral nerve injury (PNI) varies tremendously and often centers on surgeon-manual muscle testing. The purpose of our systematic review was to quantify the use of outcome measures after PNI in the contemporary literature (published in 2008 and beyond) and to evaluate which domains of recovery are assessed most frequently.

Methods

With the assistance of a medical librarian, we performed a systematic review of the literature published in or after 2008 (to represent the last 15 years) for patients with upper-extremity PNI. We excluded articles with <5 participants, minors, brachial plexus or digital nerve injuries, compressive neuropathies, or <6 months of follow-up. Data were extracted to identify which outcome measures were used in each study, categorizing the outcome measures under the domains of motor, sensory, function, and pain.

Results

Of the 4 outcome domains (pain, motor, sensory, and function), motor was reported the most frequently, followed by function. Within the motor category, more than two-thirds of the studies used manual muscle testing for assessment. Half of the articles reported outcomes in 2 of the 4 assessed domains. Pain was the least assessed domain, reported in 11 of 68 articles.

Conclusion

While there has been incorporation of functional outcomes, the majority of the literature in the last 15 years remains focused on surgeon-reported muscle testing and does not adequately reflect the multiple domains affected by PNI. Pain is the least frequently reported domain, despite being an issue that frequently vexes PNI patients.

Clinical Relevance

There is a need for clinicians and researchers to agree upon a common set of outcome measures for PNI that (A) encompass perspectives of clinicians and patients and (B) reflect multiple domains affected by PNI. This will improve the quality of outcome reporting and facilitate future comparative effectiveness studies.
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
111
审稿时长
12 weeks
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