Juliane Mueller, Jonas Weinig, Daniel Niederer, Sarah Tenberg, Steffen Mueller
{"title":"抵抗、运动控制和以正念为基础的练习对治疗慢性非特异性颈部疼痛有效:一项荟萃分析和剂量-反应荟萃回归的系统综述。","authors":"Juliane Mueller, Jonas Weinig, Daniel Niederer, Sarah Tenberg, Steffen Mueller","doi":"10.2519/jospt.2023.11820","DOIUrl":null,"url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. <b>STUDY SELECTION CRITERIA:</b> We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. <b>DATA SYNTHESIS:</b> Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's <i>g</i>, standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. <b>RESULTS:</b> We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; |<sup>2</sup> = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; |<sup>2</sup> = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; |<sup>2</sup> = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; |<sup>2</sup> = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; |<sup>2</sup> = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; |<sup>2</sup> = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; |<sup>2</sup> = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; |<sup>2</sup> = 98%). There was no dose-response relationship for resistance exercise (<i>R</i><sup>2</sup> = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain (<i>R</i><sup>2</sup> = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability (<i>R</i><sup>2</sup> = 0.61). <b>CONCLUSION:</b> Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. <i>J Orthop Sports Phys Ther 2023;53(8):1-41. Epub: 20 June 2023. doi:10.2519/jospt.2023.11820</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.0000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression.\",\"authors\":\"Juliane Mueller, Jonas Weinig, Daniel Niederer, Sarah Tenberg, Steffen Mueller\",\"doi\":\"10.2519/jospt.2023.11820\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>OBJECTIVE:</b> We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. <b>STUDY SELECTION CRITERIA:</b> We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. <b>DATA SYNTHESIS:</b> Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's <i>g</i>, standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. <b>RESULTS:</b> We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; |<sup>2</sup> = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; |<sup>2</sup> = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; |<sup>2</sup> = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; |<sup>2</sup> = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; |<sup>2</sup> = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; |<sup>2</sup> = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; |<sup>2</sup> = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; |<sup>2</sup> = 98%). There was no dose-response relationship for resistance exercise (<i>R</i><sup>2</sup> = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain (<i>R</i><sup>2</sup> = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability (<i>R</i><sup>2</sup> = 0.61). <b>CONCLUSION:</b> Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. <i>J Orthop Sports Phys Ther 2023;53(8):1-41. Epub: 20 June 2023. doi:10.2519/jospt.2023.11820</i>.</p>\",\"PeriodicalId\":50099,\"journal\":{\"name\":\"Journal of Orthopaedic & Sports Physical Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2023-08-01\",\"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.2023.11820\",\"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.2023.11820","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression.
OBJECTIVE: We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. STUDY SELECTION CRITERIA: We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. DATA SYNTHESIS: Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's g, standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. RESULTS: We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; |2 = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; |2 = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; |2 = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; |2 = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; |2 = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; |2 = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; |2 = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; |2 = 98%). There was no dose-response relationship for resistance exercise (R2 = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain (R2 = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability (R2 = 0.61). CONCLUSION: Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. J Orthop Sports Phys Ther 2023;53(8):1-41. Epub: 20 June 2023. doi:10.2519/jospt.2023.11820.
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.