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短波疗法对膝骨关节炎患者的影响:一项系统评价和荟萃分析。

Effects of short-wave therapy in patients with knee osteoarthritis: a systematic review and meta-analysis.

作者信息

Wang Haiming, Zhang Chi, Gao Chengfei, Zhu Siyi, Yang Lijie, Wei Quan, He Chengqi

机构信息

1 Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Peoples' Republic of China.

2 Rehabilitation Key Laboratory of Sichuan Province, Chengdu, Peoples' Republic of China.

出版信息

Clin Rehabil. 2017 May;31(5):660-671. doi: 10.1177/0269215516683000. Epub 2016 Dec 16.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of short-wave therapy with sham or no intervention for the management of patients with knee osteoarthritis.

METHODS

We searched the following databases from their inception up to 26 October 2016: MEDLINE, CENTRAL, EMBASE, Physiotherapy Evidence Database, CINAHL and OpenGrey. Studies included randomized controlled trials compared with a sham or no intervention in patients with knee osteoarthritis. The results were calculated via standardized mean difference (SMD) and risk ratio for continuous variables outcomes as well as dichotomous variables, respectively. Heterogeneity was explored by the I test and inverse-variance random effects analysis was applied to all studies.

RESULTS

Eight trials (542 patients) met the inclusion criteria. The effect of short-wave therapy on pain was found positive (SMD, -0.53; 95% CI, -0.84 to -0.21). The pain subgroup showed that patients received pulse modality achieved clinical improvement (SMD, -0.83; 95% CI, -1.14 to -0.52) and the pain scale in female patients decreased (SMD, -0.53; 95% CI, -0.98 to -0.08). In terms of extensor strength, short-wave therapy was superior to the control group ( p < 0.05, I = 0%). There was no significant difference in the physical function (SMD, -0.16; 95% CI, -0.36 to 0.05). For adverse effects, there was no significant difference between the treatment and control group.

CONCLUSION

Short-wave therapy is beneficial for relieving pain caused by knee osteoarthritis (the pulse modality seems superior to the continuous modality), and knee extensor muscle combining with isokinetic strength. Function is not improved.

摘要

目的

评估短波疗法联合假干预或无干预措施治疗膝骨关节炎患者的疗效和安全性。

方法

检索了以下数据库自建库至2016年10月26日的数据:医学期刊数据库(MEDLINE)、考克兰系统评价数据库(CENTRAL)、荷兰医学文摘数据库(EMBASE)、物理治疗证据数据库(Physiotherapy Evidence Database)、护理学与健康领域数据库(CINAHL)和OpenGrey。纳入的研究为膝骨关节炎患者的随机对照试验,将其与假干预或无干预措施进行比较。分别通过标准化均数差(SMD)和风险比计算连续变量结局以及二分变量的结果。采用I²检验探索异质性,并对所有研究应用逆方差随机效应分析。

结果

八项试验(542例患者)符合纳入标准。发现短波疗法对疼痛有积极作用(SMD,-0.53;95%可信区间,-0.84至-0.21)。疼痛亚组显示,接受脉冲模式的患者实现了临床改善(SMD,-0.83;95%可信区间,-1.14至-0.52),女性患者的疼痛量表得分降低(SMD,-0.53;95%可信区间,-0.98至-0.08)。在伸肌力量方面,短波疗法优于对照组(p < 0.05,I² = 0%)。身体功能方面无显著差异(SMD,-0.16;95%可信区间,-0.36至0.05)。在不良反应方面,治疗组和对照组之间无显著差异。

结论

短波疗法有助于缓解膝骨关节炎引起的疼痛(脉冲模式似乎优于连续模式),并增强膝伸肌力量。功能未得到改善。

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