Mario Muñoz-Bustos, Adolfo Soto-Martínez, Andoni Carrasco-Uribarren, Luis Ceballos-Laita
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引用次数: 0
摘要
研究目的本研究旨在比较运动结合教育策略与单纯运动或单纯教育策略对WAD患者疼痛或残疾的影响：设计： 系统综述和 Meta 分析：方法：检索 MEDLINE、Cochrane、Scopus、PEDro 和 Web of Science 数据库。研究教育与锻炼相结合对确诊患有 WAD 的成人的疼痛和残疾的影响的临床试验。分别采用 PEDro、RoB2 和 GRADE 评估方法学质量、偏倚风险和证据的确定性。采用随机效应模型进行荟萃分析：最终审查纳入了六项试验。教育和锻炼与单纯的教育相比，在治疗后疼痛的变化具有统计学意义（MD = -1.00; 95%CI -1.29, -0.71；2 项研究，212 名患者）。在随访期间，疼痛没有明显的统计学变化。同样，在中长期随访中，教育和锻炼与单纯锻炼相比，疼痛的变化具有统计学意义（MD = -0.61；95%CI -1.00，-0.23；6 项研究，386 名患者）。在治疗后阶段，疼痛没有明显的统计学变化。因此，疼痛变量的显著变化与临床无关。结果显示，在任何时间段内，残疾程度都没有明显变化。所有比较的证据确定性都被降为非常低：结论：就 WAD 患者的疼痛和残疾程度而言，运动和教育联合疗法与单纯的教育疗法或单纯的运动疗法之间没有重要的临床差异。
Is the integration of education with exercise beneficial for whiplash-associated disorders? A systematic review and meta-analysis.
Objectives: The aim of this study was to compare the effectiveness of exercise combined with educational strategies to exercise alone or educational strategies alone in patients with WAD on pain or disability.
Design: Systematic Review and Meta-Analysis.
Methods: The MEDLINE, Cochrane, Scopus, PEDro, and Web of Science databases were searched. Clinical trials investigating the effects of education and exercise combined on pain and disability in adults diagnosed with WAD. PEDro, RoB2 and GRADE were used to assess methodological quality, risk of bias and certainty of evidence, respectively. Random-effects models were applied for meta-analysis.
Results: Six trials were included in the final review. Education and exercise compared to education alone showed a statistically significant change in pain (MD = -1.00; 95%CI -1.29, -0.71; 2 studies, 212 patients) in the post-treatment period . There was no statistically significant change in pain during the follow-up period. Likewise, education and exercise compared to exercise alone showed a statistically significant change in pain (MD = -0.61; 95%CI -1.00, -0.23; 6 studies, 386 patients), obtained from mid-long follow-up . There was no statistically significant change in pain in the post-treatment period. The resulting significant changes in the pain variable are not clinically relevant. The results show no significant change in disability over any time period. The certainty of the evidence was downgraded to very low for all comparisons.
Conclusion: There are no important clinical differences between a combined exercise and education treatment and an education alone or exercise alone treatment in terms of pain and disability in patients with WAD.
期刊介绍：
The Journal of Manual & Manipulative Therapy is an international peer-reviewed journal dedicated to the publication of original research, case reports, and reviews of the literature that contribute to the advancement of knowledge in the field of manual therapy, clinical research, therapeutic practice, and academic training. In addition, each issue features an editorial written by the editor or a guest editor, media reviews, thesis reviews, and abstracts of current literature. Areas of interest include: •Thrust and non-thrust manipulation •Neurodynamic assessment and treatment •Diagnostic accuracy and classification •Manual therapy-related interventions •Clinical decision-making processes •Understanding clinimetrics for the clinician
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