Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
J Physiother. 2010;56(2):73-85. doi: 10.1016/s1836-9553(10)70037-0.
QUESTION: Which interventions for non-specific neck pain are effective in reducing pain or disability? DESIGN: Systematic review with meta-analysis of randomised controlled trials. PARTICIPANTS: Adults with non-specific neck pain. INTERVENTION: All interventions for neck pain that were evaluated in trials with a placebo, minimal- or no-intervention control. OUTCOME MEASURES: Pain and disability outcomes (0-100 scale) at the conclusion of a course of treatment (short term), and in the medium (3 to 9 months) and long (> 9 months) term. RESULTS: 33 trials were identified. The interventions with significant short-term effects on pain were manipulation (MD -22, 95% CI -32 to -11), multimodal intervention (MD -21, 95% CI -34 to -7), specific exercise (MD -12, 95% CI -22 to -2), combination orphenadrine/paracetamol (MD -17, 95% CI -32 to -2), and manual therapy (MD -12, 95% CI -16 to -7). There was a significant short-term effect on disability for acupuncture (MD -8, 95% CI -13 to -2) and manual therapy (MD -6, 95% CI -11 to -2). Treatment with laser therapy resulted in better pain outcomes at medium-term follow-up but not at short-term follow-up. No other intervention demonstrated medium- or long-term effects. CONCLUSION: Some conservative interventions for neck pain are effective in the short term. Few interventions that have been investigated have shown longer term effects that are better than placebo or minimal intervention.
问题:哪些针对非特异性颈痛的干预措施能有效减轻疼痛或残疾?
设计:随机对照试验的系统评价和荟萃分析。
参与者:患有非特异性颈痛的成年人。
干预措施:所有在试验中接受安慰剂、最小或无干预对照评估的颈痛干预措施。
结局指标:治疗结束时(短期)以及中(3 至 9 个月)和长(>9 个月)期的疼痛和残疾结局(0-100 分)。
结果:确定了 33 项试验。在短期对疼痛有显著影响的干预措施包括手法治疗(MD-22,95%CI-32 至-11)、多模式干预(MD-21,95%CI-34 至-7)、特定运动(MD-12,95%CI-22 至-2)、组合扑热息痛/对乙酰氨基酚(MD-17,95%CI-32 至-2)和手法治疗(MD-12,95%CI-16 至-7)。针刺(MD-8,95%CI-13 至-2)和手法治疗(MD-6,95%CI-11 至-2)对残疾也有显著的短期影响。激光治疗在中期随访时疼痛结果更好,但在短期随访时则不然。没有其他干预措施显示出中、长期效果优于安慰剂或最小干预。
结论:一些针对颈痛的保守干预措施在短期内是有效的。已研究的少数干预措施显示出优于安慰剂或最小干预的长期效果。
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