Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, c/Universidad s/n, 42004, Soria, Spain.
Department of Physiatrist and Nursey, Faculty of Health Sciencies, University of Zaragoza, c/Domingo Miral s/n, 50010, Zaragoza, Spain.
Complement Ther Med. 2019 Feb;42:214-222. doi: 10.1016/j.ctim.2018.11.021. Epub 2018 Nov 27.
The purpose of this review was to identify the effects of non-pharmacological conservative treatment on pain, range of motion and physical function in patients with mild to moderate hip osteoarthritis.
A systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
We searched MEDLINE, PEDro, Scopus and the Cochrane Library databases for randomized controlled trials related to non-pharmacological conservative treatments for hip osteoarthritis with the following keywords: "hip osteoarthritis," "therapeutics," "physical therapy modalities," and "combined physical therapy". The PEDro scale was used for methodological quality assessment and the Oxford Centre of Evidence-Based Medicine scale was used to assess the level of evidence. Outcomes measures related to pain, hip range of motion and physical function were extracted from these studies.
Twelve studies met the inclusion criteria. Most of the studies showed high level of evidence and only two showed low level of evidence. High quality of evidence showed that manual therapy and exercise therapy are effective in improving pain, hip range of motion and physical function. However, high quality studies based on combined therapies showed controversy in their effects on pain, hip range of motion and physical function.
Exercise therapy and manual therapy and its combination with patient education provides benefits in pain and improvement in physical function. The effects of combined therapies remain unclear. Further investigation is necessary to improve the knowledge about the effects of non-pharmacological conservative treatments on pain, hip range of motion and physical function.
本综述旨在确定非药物保守治疗对轻度至中度髋骨关节炎患者疼痛、活动范围和身体功能的影响。
基于系统评价和荟萃分析首选报告项目（PRISMA）指南的系统评价。
我们在 MEDLINE、PEDro、Scopus 和 Cochrane 图书馆数据库中搜索了与髋骨关节炎非药物保守治疗相关的随机对照试验，使用了以下关键词：“髋骨关节炎”、“治疗”、“物理治疗模式”和“联合物理治疗”。PEDro 量表用于方法学质量评估，牛津循证医学中心量表用于评估证据水平。从这些研究中提取与疼痛、髋关节活动范围和身体功能相关的结局指标。
符合纳入标准的研究有 12 项。大多数研究显示出高水平的证据，只有两项研究显示出低水平的证据。高质量的证据表明，手法治疗和运动疗法在改善疼痛、髋关节活动范围和身体功能方面是有效的。然而，基于联合治疗的高质量研究在其对疼痛、髋关节活动范围和身体功能的影响方面存在争议。
运动疗法和手法治疗及其与患者教育的结合在疼痛和身体功能改善方面提供了益处。联合治疗的效果仍不清楚。需要进一步的研究来提高对非药物保守治疗对疼痛、髋关节活动范围和身体功能影响的认识。
