Hoskins Wayne, McHardy Andrew, Pollard Henry, Windsham Ross, Onley Rorey
Macquarie Injury Management Group, Department of Health and Chiropractic, Macquarie University, Australia.
J Manipulative Physiol Ther. 2006 Oct;29(8):658-71. doi: 10.1016/j.jmpt.2006.08.004.
The purpose of this study was to document the quantity and type of research conducted on the chiropractic management of lower extremity conditions.
A review of the literature was conducted using the CINAHL, MEDLINE, MANTIS, and Science Direct databases (each from inception to December 15, 2005). Search terms included chiropractic, hip, knee, ankle, foot, with Medical Subject Heading terms for each region. Inclusion criteria included studies with a lower extremity diagnosis, and the treatment was performed by doctors of chiropractic. Articles were excluded if pain was referred from spinal sites and if there was a duplicate publication; articles published in non-peer-reviewed literature and abstracts in conference proceedings were also excluded. Of the articles identified, an analysis was conducted assessing those including peripheral and/or spinal treatment. Clinical trials were assessed for quality using the Physiotherapy Evidence Database scale.
There was a total of 1652 citations. Of these, 76 were deemed relevant; 24 were related to the foot, 10 to the ankle, 25 to the knee, and 17 to the hip. Twenty-nine citations included spinal treatment, 47 solely peripheral, and 2 solely spinal. Ten citations were clinical trials and scored on the Physiotherapy Evidence Database scale.
Literature on the chiropractic management of lower extremity conditions has a large number of case studies (level 4 evidence) and a smaller number of higher-level publications (level 1-3 evidence). The management available in the peer-reviewed literature is predominantly multimodal and contains combined spinal and peripheral components. Future chiropractic research should use higher-level research designs, such as randomized controlled trials.
本研究旨在记录关于下肢疾病整脊治疗的研究数量和类型。
使用CINAHL、MEDLINE、MANTIS和科学Direct数据库（均从创建至2005年12月15日）进行文献综述。检索词包括整脊、髋、膝、踝、足，并为每个区域设置医学主题词。纳入标准包括下肢诊断的研究，且治疗由整脊医生进行。如果疼痛源自脊柱部位以及存在重复发表的文章则被排除；非同行评审文献中发表的文章以及会议论文摘要也被排除。在识别出的文章中，对包括外周和/或脊柱治疗的文章进行分析。使用物理治疗证据数据库量表评估临床试验的质量。
总共检索到1652条引用文献。其中，76条被认为相关；24条与足部相关，10条与踝部相关，25条与膝部相关，17条与髋部相关。29条引用文献包括脊柱治疗，47条仅为外周治疗，2条仅为脊柱治疗。10条引用文献为临床试验，并根据物理治疗证据数据库量表进行评分。
关于下肢疾病整脊治疗的文献有大量案例研究（4级证据），而高级别出版物数量较少（1 - 3级证据）。同行评审文献中的治疗方法主要是多模式的，包含脊柱和外周联合成分。未来整脊研究应采用更高级别的研究设计，如随机对照试验。
