Gross A R, Aker P D, Goldsmith C H, Peloso P
School of Rehabilitation Science, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5.
Cochrane Database Syst Rev. 2000;1998(2):CD000961. doi: 10.1002/14651858.CD000961.
Multiple physical medicine modalities are commonly included as part of therapeutic interventions for mechanical neck disorders (neck pain). The objective of this review was to assess the effects of physical medicine modalities for pain in adults with mechanical neck disorders.
We searched Medline, Embase, Chirolars, Index to Chiropractic Literature, Cinahl, Science Citation Index, Conference Proceedings Index, National Technical Information Services and reference lists of the retrieved articles from 1985 to December 1993 and we contacted content experts.
Randomised trials and controlled trials of physical medicine modalities in adults with mechanical neck disorder.
Three reviewers independently assessed trial quality and two reviewers independently extracted data. Investigators were contacted to obtain information or data that could not be found in the published reports.
Thirteen trials were included. The overall quality of the included trials was generally good. Two trials using electromagnetic therapy produced a significant reduction in pain (p <0.01) with three to four weeks of daily (eight hours per day) therapy sessions; and three using laser therapy did not differ significantly from a placebo (p=0.20) for six to 10 sessions of treatment. Not enough scientific testing exists to clearly determine the effectiveness of other therapies. This includes treatments such as exercise, traction, acupuncture, heat / cold applications, electrotherapies, cervical orthoses and chronic pain / cognitive behavioural rehabilitation strategies.
REVIEWER'S CONCLUSIONS: There is little information available from trials to support the use of physical medicine modalities for mechanical neck pain. There is some support for the use of electromagnetic therapy and against the use of laser therapy with respect to pain reduction.
多种物理医学方式通常被纳入机械性颈部疾病（颈部疼痛）治疗干预措施之中。本综述的目的是评估物理医学方式对患有机械性颈部疾病的成年人疼痛的影响。
我们检索了1985年至1993年12月期间的医学文献数据库（Medline）、荷兰医学文摘数据库（Embase）、脊椎按摩疗法文献索引数据库（Chirolars）、脊椎按摩疗法文献索引（Index to Chiropractic Literature）、护理学与健康领域数据库（Cinahl）、科学引文索引（Science Citation Index）、会议论文索引（Conference Proceedings Index）、美国国家技术信息服务处数据库（National Technical Information Services）以及检索到文章的参考文献列表，并且联系了相关领域的专家。
针对患有机械性颈部疾病的成年人进行物理医学方式的随机试验和对照试验。
三位评价者独立评估试验质量，两位评价者独立提取数据。若在已发表报告中无法找到相关信息或数据，则联系研究者获取。
共纳入13项试验。纳入试验的总体质量一般良好。两项使用电磁疗法的试验，经过三至四周每日（每天八小时）的治疗疗程后，疼痛显著减轻（p<0.01）；而三项使用激光疗法的试验，在进行六至十次治疗后，与安慰剂相比差异无统计学意义（p = 0.20）。尚无足够的科学测试能明确确定其他疗法的有效性。这包括运动、牵引、针灸、热/冷疗法、电疗法、颈部矫形器以及慢性疼痛/认知行为康复策略等治疗方法。
试验提供的信息几乎无法支持使用物理医学方式治疗机械性颈部疼痛。在减轻疼痛方面，有一些证据支持使用电磁疗法，而反对使用激光疗法。
