Gross A R, Aker P D, Goldsmith C H, Peloso P
McMaster University, School of Rehabilitation Science, IAHS, Room 440, 1400 Main Street West, 4th Fl, Hamilton, Ontario, Canada, L8S 1C7.
Cochrane Database Syst Rev. 2007 Jul 18(2):CD000961. doi: 10.1002/14651858.CD000961.
Twenty-six to 71 percent of the adult population can recall experiencing an episode of neck pain or stiffness in their lifetime. The treatments that patients receive for neck pain are varied, as are the perceptions of the benefits of these treatments. In this age of increasing accountability, governmental agencies, third party payers and patients are demanding evidence-based practice performance. To track down the best estimate of efficacy of the various conservative management strategies for mechanical neck disorders, a four-part systematic review was prepared. Part two investigates and reports on the efficacy of physical medicine modalities.
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.
AUTHORS' 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.
26%至71%的成年人在其一生中经历过颈部疼痛或僵硬。患者接受的颈部疼痛治疗方法多种多样，对这些治疗效果的看法也各不相同。在这个问责制日益增强的时代，政府机构、第三方付款人和患者都要求基于证据的医疗实践。为了探寻各种保守治疗策略对机械性颈部疾病的最佳疗效评估，我们进行了一项分为四个部分的系统综述。第二部分调查并报告物理医学治疗方法的疗效。
多种物理医学治疗方法通常被纳入机械性颈部疾病（颈部疼痛）治疗干预的一部分。本综述的目的是评估物理医学治疗方法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（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）、国家技术信息服务处（National Technical Information Services）以及所检索文章的参考文献列表，并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的物理医学治疗方法的随机试验和对照试验。
三位评审员独立评估试验质量，两位评审员独立提取数据。若在已发表报告中无法找到相关信息或数据，我们会与研究者联系获取。
共纳入13项试验。所纳入试验的总体质量普遍良好。两项使用电磁疗法的试验，在每日（每天8小时）治疗三至四周后，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）。目前尚无足够的科学测试来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、颈椎矫形器以及慢性疼痛/认知行为康复策略等治疗方法。
从试验中获得的信息几乎无法支持使用物理医学治疗方法来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。
