Gillespie W J, Grant I
Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
Cochrane Database Syst Rev. 2000(2):CD000450. doi: 10.1002/14651858.CD000450.
Stress reaction in bone, which may proceed to a fracture, is a significant problem in military recruits and in athletes, particularly long distance runners.
To evaluate the evidence from controlled trials of treatments and programmes for prevention or management of lower limb stress fractures and stress reactions of bone in active young adults.
We searched the Cochrane Musculoskeletal Injuries Group Trials Register, The Cochrane Library, MEDLINE, EMBASE, Current Contents, Dissertation Abstracts, Index to UK Theses and the bibliographies of identified articles. Date of last search: December 1997
Any randomised or quasi-randomised trial evaluating a programme or treatment to prevent or treat lower limb stress reactions of bone or stress fractures in active young adults.
Searching, a decision on inclusion or exclusion, methodological assessment, and data extraction were carried out according to a predetermined protocol included in the body of the review. Analysis using Review Manager software allowed pooling of data and calculation of Peto odds ratios and absolute risk reductions, each with 95% confidence intervals.
The use of "shock absorbing" insoles, evaluated in four trials, appears to reduce the incidence of stress fractures and stress reactions of bone (Peto odds ratio 0.47, 95% confidence interval 0. 30 to 0.76). Incomplete data from one trial indicated that reduction of running and jumping intensity may also be effective. The use of pneumatic braces in the rehabilitation of tibial stress fractures significantly reduces the time to recommencing training (weighted mean difference -42.6 days, 95% confidence interval -55.8 to -29.4 days).
REVIEWER'S CONCLUSIONS: The use of shock absorbing insoles in footwear reduces the incidence of stress fractures in athletes and military personnel. Rehabilitation after tibial stress fracture is aided by the use of pneumatic bracing.
骨骼中的应激反应可能发展为骨折，这在新兵和运动员中，尤其是长跑运动员中是一个重大问题。
评估关于预防或治疗活跃的年轻成年人下肢应力性骨折和骨骼应激反应的治疗方法及方案的对照试验证据。
我们检索了Cochrane肌肉骨骼损伤组试验注册库、Cochrane图书馆、MEDLINE、EMBASE、《现刊目次》、《学位论文文摘》、《英国论文索引》以及已识别文章的参考文献。末次检索日期：1997年12月
任何评估预防或治疗活跃的年轻成年人下肢骨骼应激反应或应力性骨折的方案或治疗方法的随机或半随机试验。
根据综述正文中包含的预定方案进行检索、纳入或排除决策、方法学评估以及数据提取。使用Review Manager软件进行分析可汇总数据并计算Peto比值比和绝对风险降低率，二者均带有95%置信区间。
四项试验评估了“减震”鞋垫的使用，其似乎可降低应力性骨折和骨骼应激反应的发生率（Peto比值比0.47，95%置信区间0.30至0.76）。一项试验的不完整数据表明，降低跑步和跳跃强度可能也有效。在胫骨应力性骨折康复中使用气动支具可显著缩短重新开始训练的时间（加权平均差 -42.6天，95%置信区间 -55.8至 -29.4天）。
鞋类中使用减震鞋垫可降低运动员和军人应力性骨折的发生率。胫骨应力性骨折后的康复可借助气动支具。
