{"title":"I级和II级急性踝关节扭伤的物理治疗与传统治疗:试验序贯分析和荟萃分析","authors":"Changsen Yang, Weilu Gao, Zhengfeng Jia, Jiantao Li, Miaotian Tang","doi":"10.1186/s13018-025-06272-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis evaluated the effectiveness of physiotherapy compared with conventional therapies for grade I and II acute ankle sprains.</p><p><strong>Methods: </strong>Randomized controlled trials were identified through a comprehensive search of PubMed, Embase, and Web of Science databases. Eligibility criteria were defined using the PICOS framework. Analyses included forest plot analysis, subgroup analysis, sensitivity analysis, publication bias analysis, and Trial Sequential Analysis (TSA) using Review Manager (version 5.4), StataMP 17, and TSA 0.9.5.10 beta software.</p><p><strong>Results: </strong>Ten RCTs involving 565 participants met the inclusion criteria. The physical therapy group had significantly lower post-treatment visual analog scale (VAS) scores for pain compared to the conventional treatment group (weighted mean difference [WMD] = -0.46, 95% CI = -0.90 to -0.01, P = 0.04). On subgroup analysis, VAS scores at rest were also significantly lower in the physical therapy group compared to the conventional treatment group (WMD = -0.34, 95% CI = -0.67 to -0.01, P = 0.04).</p><p><strong>Conclusions: </strong>Physical therapy may offer superior pain relief compared with conventional treatment for grade I and II acute ankle sprains. Further high-quality, adequately powered RCTs are warranted to obtain more robust evidence.</p><p><strong>Level of evidence: </strong>level 1.</p><p><strong>Registration: </strong>CRD42025640304.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"861"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481793/pdf/","citationCount":"0","resultStr":"{\"title\":\"Physical therapy versus conventional treatment for grade I and II acute ankle sprains: trial sequential analysis and meta-analysis.\",\"authors\":\"Changsen Yang, Weilu Gao, Zhengfeng Jia, Jiantao Li, Miaotian Tang\",\"doi\":\"10.1186/s13018-025-06272-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This systematic review and meta-analysis evaluated the effectiveness of physiotherapy compared with conventional therapies for grade I and II acute ankle sprains.</p><p><strong>Methods: </strong>Randomized controlled trials were identified through a comprehensive search of PubMed, Embase, and Web of Science databases. 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引用次数: 0
摘要
背景:本系统综述和荟萃分析评估了物理治疗与常规治疗相比治疗I级和II级急性踝关节扭伤的有效性。方法:随机对照试验通过PubMed, Embase和Web of Science数据库的综合搜索确定。使用PICOS框架定义资格标准。使用Review Manager (version 5.4)、StataMP 17和TSA 0.9.5.10 beta软件进行分析,包括森林样图分析、亚组分析、敏感性分析、发表偏倚分析和试验序列分析(TSA)。结果:10项rct共565名受试者符合纳入标准。与常规治疗组相比,物理治疗组治疗后疼痛视觉模拟量表(VAS)评分明显降低(加权平均差[WMD] = -0.46, 95% CI = -0.90 ~ -0.01, P = 0.04)。在亚组分析中,物理治疗组休息时的VAS评分也显著低于常规治疗组(WMD = -0.34, 95% CI = -0.67 ~ -0.01, P = 0.04)。结论:与常规治疗相比,物理治疗可以更好地缓解I级和II级急性踝关节扭伤的疼痛。进一步的高质量、充分有力的随机对照试验有必要获得更有力的证据。证据等级:一级。注册:CRD42025640304。
Physical therapy versus conventional treatment for grade I and II acute ankle sprains: trial sequential analysis and meta-analysis.
Background: This systematic review and meta-analysis evaluated the effectiveness of physiotherapy compared with conventional therapies for grade I and II acute ankle sprains.
Methods: Randomized controlled trials were identified through a comprehensive search of PubMed, Embase, and Web of Science databases. Eligibility criteria were defined using the PICOS framework. Analyses included forest plot analysis, subgroup analysis, sensitivity analysis, publication bias analysis, and Trial Sequential Analysis (TSA) using Review Manager (version 5.4), StataMP 17, and TSA 0.9.5.10 beta software.
Results: Ten RCTs involving 565 participants met the inclusion criteria. The physical therapy group had significantly lower post-treatment visual analog scale (VAS) scores for pain compared to the conventional treatment group (weighted mean difference [WMD] = -0.46, 95% CI = -0.90 to -0.01, P = 0.04). On subgroup analysis, VAS scores at rest were also significantly lower in the physical therapy group compared to the conventional treatment group (WMD = -0.34, 95% CI = -0.67 to -0.01, P = 0.04).
Conclusions: Physical therapy may offer superior pain relief compared with conventional treatment for grade I and II acute ankle sprains. Further high-quality, adequately powered RCTs are warranted to obtain more robust evidence.
期刊介绍:
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.