Damgaard Pia, Bartels Else Marie, Ris Inge, Christensen Robin, Juul-Kristensen Birgit
Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Rehabilitation, Aeroe Municipality, 5970 Aeroeskoebing, Denmark.
The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, 2000 Frederiksberg, Copenhagen, Denmark.
ISRN Pain. 2013 Apr 15;2013:567175. doi: 10.1155/2013/567175. eCollection 2013.
Chronic neck pain (CNP) is common and costly, and the effect of physiotherapeutic interventions on the condition is unclear. We reviewed the literature for evidence of effect of physiotherapy interventions on patients with CNP. Five bibliographic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and PEDro) were systematically searched. Randomised, placebo and active-treatment-controlled trials including physiotherapy interventions for adults with CNP were selected. Data were extracted primary outcome was pain. Risk of bias was appraised. Effect of an intervention was assessed, weighted to risk of bias. 42 trials reporting on randomised comparisons of various physiotherapy interventions and control conditions were eligible for inclusion involving 3919 patients with CNP. Out of these, 23 were unclear or at high risk of bias, and their results were considered moderate- or low-quality evidence. Nineteen were at low risk of bias, and here eight trials found effect on pain of a physiotherapy intervention. Only exercise therapy, focusing on strength and endurance training, and multimodal physiotherapy, cognitive-behavioural interventions, massage, manipulations, laser therapy, and to some extent also TNS appear to have an effect on CNP. However, sufficient evidence for application of a specific physiotherapy modality or aiming at a specific patient subgroup is not available.
慢性颈痛（CNP）很常见且代价高昂，物理治疗干预对该病症的效果尚不清楚。我们检索了文献，以寻找物理治疗干预对CNP患者效果的证据。系统检索了五个文献数据库（MEDLINE、EMBASE、CINAHL、Cochrane图书馆和PEDro）。选取了包括针对成年CNP患者的物理治疗干预的随机、安慰剂和积极治疗对照试验。提取数据，主要结局为疼痛。评估偏倚风险。评估干预效果，并根据偏倚风险进行加权。42项报告各种物理治疗干预与对照条件随机比较的试验符合纳入标准，涉及3919例CNP患者。其中，23项试验的偏倚风险不明确或较高，其结果被视为中等质量或低质量证据。19项试验的偏倚风险较低，其中八项试验发现物理治疗干预对疼痛有效果。只有专注于力量和耐力训练的运动疗法、多模式物理治疗、认知行为干预、按摩、手法治疗、激光治疗，以及在一定程度上的经皮神经电刺激（TNS）似乎对CNP有效果。然而，对于应用特定的物理治疗方式或针对特定患者亚组，尚无充分证据。
