French H P, Brennan A, White B, Cusack T
School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Man Ther. 2011 Apr;16(2):109-17. doi: 10.1016/j.math.2010.10.011. Epub 2010 Dec 13.
The aim of this systematic review was to determine if manual therapy improves pain and/or physical function in people with hip or knee OA. Eight databases were searched for randomised controlled trials (RCTs). Data were extracted and risk of bias assessed by independent reviewers. Four RCTs were eligible for inclusion (280 subjects), three of which studied people with knee OA and one studied those with hip OA. One study compared manual therapy to no treatment, one compared to placebo intervention, whilst two compared to alternative interventions. Meta-analysis was not possible due to clinical heterogeneity of the studies. One study had a low risk of bias and three had high risk of bias. All studies reported short-term effects, and long-term effects were measured in one study. There is silver level evidence that manual therapy is more effective than exercise for those with hip OA in the short and long-term. Due to the small number of RCTs and patients, this evidence could be considered to be inconclusive regarding the benefit of manual therapy on pain and function for knee or hip OA.
本系统评价的目的是确定手法治疗是否能改善髋或膝骨关节炎患者的疼痛和/或身体功能。检索了八个数据库以查找随机对照试验（RCT）。数据由独立评审员提取并评估偏倚风险。四项RCT符合纳入标准（280名受试者），其中三项研究膝骨关节炎患者，一项研究髋骨关节炎患者。一项研究将手法治疗与不治疗进行比较，一项与安慰剂干预进行比较，而两项与替代干预进行比较。由于研究的临床异质性，无法进行荟萃分析。一项研究偏倚风险低，三项研究偏倚风险高。所有研究均报告了短期效果，一项研究测量了长期效果。有银级证据表明，手法治疗在短期和长期对髋骨关节炎患者比运动更有效。由于RCT和患者数量较少，关于手法治疗对膝或髋骨关节炎疼痛和功能的益处，这一证据可能被认为是不确定的。
