Buechter Roland Brian, Fechtelpeter Dennis
Institute for Quality and Efficiency in Health Care (IQWiG), Köln, Germany.
Ger Med Sci. 2011;9:Doc19. doi: 10.3205/000142. Epub 2011 Aug 9.
To summarize the best available evidence on effectiveness of therapeutic or sport climbing in preventing or treating health problems.
We searched Medline, Embase, CENTRAL, PsycINFO, PEDro, OTseeker and SportDiscus for randomized controlled trials published up to December 26, 2010. We included all trials assessing patient-relevant outcomes. Two reviewers independently selected relevant studies, assessed their methodological quality and extracted data. Quality of evidence was rated using the GRADE system. Data were entered into RevMan 5 to calculate effect sizes and 95% confidence intervals where appropriate.
Eligible for inclusion were four RCTs studying the effectiveness of climbing in (a) geriatric patients, (b) adults with multiple sclerosis, (c) adults with chronic low-back pain and (d) children with disabilities and poor motor function. The sample sizes ranged between 20 and 95. All trials had major methodological limitations. We found very low quality evidence that therapeutic climbing may improve activities of daily living in geriatric patients compared to physiotherapy as measured by the Barthel index (difference in mean change score: 2.32 [95%-CI: 0.45 to 4.19]). We found very low quality evidence that therapeutic climbing compared to standard exercise therapy may improve physical functioning (difference in mean change score: 16.15 [95%-CI: 4.45 to 27.85]) and general physical health (13.14 [95%-CI: 3.61 to 22.67]) as measured by the SF-36 in adults with chronic low back-pain.
Evidence for the effectiveness of therapeutic climbing is limited to small trials at high risk of bias. The effects of therapeutic climbing are therefore unclear.
总结关于治疗性或运动性攀岩在预防或治疗健康问题有效性的最佳现有证据。
我们检索了截至2010年12月26日发表的随机对照试验的Medline、Embase、CENTRAL、PsycINFO、PEDro、OTseeker和SportDiscus数据库。我们纳入了所有评估与患者相关结局的试验。两名评审员独立选择相关研究，评估其方法学质量并提取数据。使用GRADE系统对证据质量进行评级。数据输入RevMan 5以计算效应量和适当的95%置信区间。
符合纳入标准的有四项随机对照试验，研究攀岩在以下方面的有效性：（a）老年患者；（b）患有多发性硬化症的成年人；（c）患有慢性下背痛的成年人；（d）残疾且运动功能差的儿童。样本量在20至95之间。所有试验都存在主要的方法学局限性。我们发现证据质量极低，与物理治疗相比，治疗性攀岩可能改善老年患者的日常生活活动能力，以Barthel指数衡量（平均变化得分差异：2.32 [95%置信区间：0.45至4.19]）。我们发现证据质量极低，与标准运动疗法相比，治疗性攀岩可能改善患有慢性下背痛的成年人的身体功能（平均变化得分差异：16.15 [95%置信区间：4.45至27.85]）和总体身体健康状况（13.14 [95%置信区间：3.61至22.67]），以SF-36衡量。
治疗性攀岩有效性的证据仅限于存在高偏倚风险的小型试验。因此，治疗性攀岩的效果尚不清楚。
