全身振动运动治疗慢性肌肉骨骼疼痛:一项随机对照试验的系统评价和荟萃分析。
Whole Body Vibration Exercise for Chronic Musculoskeletal Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
机构信息
Department of Treatment, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.
Rehabilitation Medical Department, Hua Dong Hospital, Shanghai, China.
出版信息
Arch Phys Med Rehabil. 2019 Nov;100(11):2167-2178. doi: 10.1016/j.apmr.2019.03.011. Epub 2019 Apr 17.
OBJECTIVE
This study systematically reviews previous work on the effects of whole body vibration exercise (WBVE) on pain associated with chronic musculoskeletal disorders.
DATA SOURCES
Seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Cochrane, Physiotherapy Evidence Database [PEDro], and the China National Knowledge Infrastructure) were searched for articles published between January 1980 and September 2018.
STUDY SELECTION
Randomized controlled trials involving adults with chronic low back pain (CLBP), osteoarthritis (OA), or fibromyalgia were included. Participants in the WBVE intervention group were compared with those in the nontreatment and non-WBVE control groups.
DATA EXTRACTION
Data were independently extracted using a standardized form. Methodological quality was assessed using PEDro.
DATA SYNTHESIS
Suitable data from 16 studies were pooled for meta-analysis. A random effects model was used to calculate between-groups mean differences at 95% confidence interval (CI). The data were analyzed depending on the duration of the follow-up, common disorders, and different control interventions.
RESULTS
Alleviation of pain was observed at medium term (standardized mean difference [SMD], -0.67; 95% CI, -1.14 to -0.21; I, 80%) and long term (SMD, -0.31; 95% CI, -0.59 to -0.02; I, 0%). Pain was alleviated in osteoarthritis (OA) (SMD, -0.37; 95% CI, -0.64 to -0.10; P<.05; I, 22%) and CLBP (SMD, -0.44; 95% CI, -0.75 to -0.13; P<.05; I, 12%). Long-term WBVE could relieve chronic musculoskeletal pain conditions of OA (SMD, -0.46; 95% CI, -0.80 to -0.13; P<.05; I, 0%). WBVE improved chronic musculoskeletal pain compared with the treatment "X" control (SMD, -0.37; 95% CI, -0.61 to -0.12; P<.05; I, 26%), traditional treatment control (SMD, -1.02; 95% CI, -2.44 to 0.4; P>.05; I, 94%) and no treatment control (SMD, -1; 95% CI, -1.76 to -0.24; P<.05; I, 75%).
CONCLUSIONS
Evidence suggests positive effects of WBVE on chronic musculoskeletal pain, and long durations of WBVE could be especially beneficial. However, WBVE does not significantly relieve chronic musculoskeletal pain compared with the traditional treatment. Further work is required to identify which parameters of WBVE are ideal for patients with chronic musculoskeletal pain.
目的
本研究系统回顾了全身振动训练(WBVE)对慢性肌肉骨骼疾病相关疼痛的影响的既往研究。
资料来源
检索了 1980 年 1 月至 2018 年 9 月期间发表的 7 个电子数据库(PubMed、Embase、CINAHL、Web of Science、Cochrane、Physiotherapy Evidence Database [PEDro]和中国国家知识基础设施)的文章。
研究选择
纳入了涉及慢性下背痛(CLBP)、骨关节炎(OA)或纤维肌痛的成年人的随机对照试验。比较了 WBVE 干预组与未治疗和非 WBVE 对照组的参与者。
数据提取
使用标准化表格独立提取数据。使用 PEDro 评估方法学质量。
数据综合
根据随访时间、常见疾病和不同的对照干预措施,对 16 项研究的合适数据进行了汇总分析。使用随机效应模型计算 95%置信区间(CI)的组间平均差异。
结果
在中期(标准化均数差 [SMD],-0.67;95%CI,-1.14 至-0.21;I²,80%)和长期(SMD,-0.31;95%CI,-0.59 至-0.02;I²,0%)观察到疼痛缓解。OA(SMD,-0.37;95%CI,-0.64 至-0.10;P<.05;I²,22%)和 CLBP(SMD,-0.44;95%CI,-0.75 至-0.13;P<.05;I²,12%)中疼痛缓解。长期 WBVE 可缓解 OA(SMD,-0.46;95%CI,-0.80 至-0.13;P<.05;I²,0%)的慢性肌肉骨骼疼痛状况。WBVE 改善慢性肌肉骨骼疼痛与“X”治疗对照(SMD,-0.37;95%CI,-0.61 至-0.12;P<.05;I²,26%)、传统治疗对照(SMD,-1.02;95%CI,-2.44 至 0.4;P>.05;I²,94%)和无治疗对照(SMD,-1.00;95%CI,-1.76 至-0.24;P<.05;I²,75%)相比有差异。
结论
证据表明 WBVE 对慢性肌肉骨骼疼痛有积极影响,WBVE 的持续时间较长可能特别有益。然而,WBVE 与传统治疗相比,对慢性肌肉骨骼疼痛的缓解并不显著。需要进一步研究以确定 WBVE 的哪些参数对慢性肌肉骨骼疼痛患者最理想。