Quatman-Yates Catherine, Cupp Amanda, Gunsch Cherryanne, Haley Tonya, Vaculik Steve, Kujawa David
C. Quatman-Yates, PT, DPT, PhD, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 (USA), and Division of Sports Medicine, Cincinnati Children's Hospital Medical Center.
A. Cupp, PT, DPT, Doctor of Physical Therapy Program, University of Toledo, Toledo, Ohio.
Phys Ther. 2016 Nov;96(11):1753-1763. doi: 10.2522/ptj.20150557. Epub 2016 May 19.
Heightened awareness of the lasting effects of mild traumatic brain injury (mTBI) has amplified interest in interventions that facilitate recovery from persistent post-mTBI symptoms.
The purpose of this study was to systematically review the literature to identify potential physical rehabilitation interventions that are safe, feasible, and appropriate for physical therapists to utilize with patients with persistent mTBI-related symptoms.
The electronic databases PubMed, Cochrane Library, CINAHL, Scopus, SPORTDiscus, and Web of Science were systematically searched from database inception until June 2015.
Studies were included if they utilized physical rehabilitation interventions and the study's participants had a diagnosis of mTBI, a mean age of 8 years or older, and symptoms persisting an average of 2 weeks or longer. Exclusion criteria included blast injuries, diagnosis of moderate or severe TBI, or psychosis.
Data extraction and methodological risk of bias assessments were performed for each study.
Eight studies with a range of study designs, intervention types, and outcome measures were included. The interventions investigated by the included studies were categorized into 3 types: physiological, vestibulo-ocular, and cervicogenic.
The identified studies had several significant limitations including: small sample sizes and low-level study designs.
The results of this systematic review indicate that several physical rehabilitation options with minimal risk for negative outcomes are available for treating patients experiencing persistent post-mTBI symptoms. These options include: vestibular, manual, and progressive exercise interventions. Conclusions surrounding efficacy and ideal dosing parameters for these interventions are limited at this time due to the small number of studies, the range of interventional protocols, and lower levels of study design.
对轻度创伤性脑损伤（mTBI）长期影响的认识不断提高，这激发了人们对促进从持续性mTBI后症状中恢复的干预措施的兴趣。
本研究的目的是系统回顾文献，以确定对物理治疗师而言安全、可行且适用于患有持续性mTBI相关症状患者的潜在物理康复干预措施。
从数据库建立至2015年6月，对电子数据库PubMed、Cochrane图书馆、CINAHL、Scopus、SPORTDiscus和Web of Science进行了系统检索。
如果研究采用了物理康复干预措施，且研究参与者被诊断为mTBI，平均年龄8岁或以上，症状持续平均2周或更长时间，则纳入研究。排除标准包括爆炸伤、中度或重度TBI诊断或精神病。
对每项研究进行数据提取和方法学偏倚风险评估。
纳入了八项研究，这些研究具有一系列研究设计、干预类型和结局指标。纳入研究调查的干预措施分为三种类型：生理型、前庭眼型和颈源性。
所确定的研究有几个重大局限性，包括：样本量小和研究设计水平低。
本系统评价的结果表明，有几种负面结果风险最小的物理康复选择可用于治疗患有持续性mTBI后症状的患者。这些选择包括：前庭、手法和渐进性运动干预措施。由于研究数量少、干预方案范围广以及研究设计水平较低，目前关于这些干预措施的疗效和理想剂量参数的结论有限。
