Extended Scope Physiotherapy Practitioner, Leeds Community Healthcare Musculoskeletal and Rehabilitation Services, Leeds, UK.
Physiotherapy, School of Health Sciences, University of East Anglia, Norwich, UK.
Rheumatol Int. 2018 Mar;38(3):331-341. doi: 10.1007/s00296-017-3876-1. Epub 2017 Nov 16.
To systematically review the evidence to determine the clinical outcomes and the important methodological quality features of interventional studies on adults with non-inflammatory multi-joint pain (MJP). Systematic search of published and unpublished literature using the databases: AMED, CINAHL, MEDLINE, EMBASE, psycINFO, SPORTDiscus, PEDro, OpenGrey, the EU Clinical Trials Register, World Health Organization International Clinical Trial Registry Platform, ClinicalTrials.gov and the ISRCTN registry (search: inception to 19th October 2017). All papers reporting the clinical outcomes of non-pharmacological interventions for people with non-inflammatory MJP were included. Studies were critically appraised using the Downs and Black Critical Appraisal and the TIDieR reporting checklists. Data were analysed using a Best Evidence Synthesis approach. From 3824 citations, four papers satisfied the eligibility criteria. Three studies reported outcomes from multidisciplinary rehabilitation programmes and one study reported the findings of a spa therapy intervention. All interventions significantly improved pain, function and quality of life in the short-term. There was limited reporting of measures for absenteeism, presenteeism and psychosocial outcomes. The evidence was 'weak', and due to a lack of controlled trials, there is limited evidence to ascertain treatment effectiveness. Design consideration for future trials surround improved reporting of participant characteristics, interventions and the standardisation of core outcome measures. There is insufficient high-quality trial data to determine the effectiveness of treatments for non-inflammatory MJP. Given the significant health burden which this condition presents on both individuals and wider society, developing and testing interventions and accurately reporting these, should be a research priority. Registration PROSPERO (CRD42013005888).
为了系统地评估证据，以确定非炎性多关节疼痛（MJP）成人介入性研究的临床结局和重要方法学质量特征。使用 AMED、CINAHL、MEDLINE、EMBASE、psycINFO、SPORTDiscus、PEDro、OpenGrey、欧盟临床试验注册处、世界卫生组织国际临床试验注册平台、ClinicalTrials.gov 和 ISRCTN 注册表（搜索：开始至 2017 年 10 月 19 日）对已发表和未发表的文献进行系统搜索。所有报告非炎性 MJP 患者非药物干预临床结局的论文均被纳入。使用 Downs 和 Black 批判性评价和 TIDieR 报告清单对研究进行批判性评价。使用最佳证据综合方法分析数据。从 3824 条引文中，有 4 篇论文符合入选标准。3 项研究报告了多学科康复计划的结果，1 项研究报告了温泉治疗干预的结果。所有干预措施在短期内均显著改善疼痛、功能和生活质量。关于旷工、在职和心理社会结局的测量指标报告有限。证据“较弱”，由于缺乏对照试验，因此确定治疗效果的证据有限。未来试验的设计考虑因素包括改善参与者特征、干预措施和核心结局测量标准化的报告。目前尚无足够的高质量试验数据来确定非炎性 MJP 治疗的有效性。鉴于这种疾病给个人和更广泛的社会带来的巨大健康负担，开发和测试干预措施并准确报告这些干预措施应该是研究的重点。注册 PROSPERO（CRD42013005888）。
