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使用头颈部前屈练习进行运动控制与其他治疗方法治疗非特异性慢性颈痛的效果比较:系统评价和荟萃分析。

Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: A systematic review and meta-analysis.

机构信息

Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala, Crta. de Madrid-Barcelona, Km. 33,600, Alcalá de Henares, Madrid, Spain.

Rehabilitación San Fernando, Alcala de Henares, Madrid, Spain.

出版信息

Musculoskelet Sci Pract. 2019 Jul;42:52-59. doi: 10.1016/j.msksp.2019.04.010. Epub 2019 Apr 20.

Abstract

BACKGROUND

Chronic neck pain affects a significant percentage of the adult population. Commonly, the pain is of unknown origin. In those cases, some alterations in motor control (MC) can appear in the deep cervical muscles. The specific training of these muscles could improve muscular function and reduce pain and disability.

OBJECTIVE

To determine whether MC, using cranio-cervical flexion (CCF), is more effective than other treatments for non-specific chronic neck pain (NSCNP).

DESIGN

Systematic review with meta-analysis.

METHODS

A search was done in journals and in a variety of databases, between December 2017 and March 2018. Randomized clinical trials (RCTs) and systematic reviews of RCTs comparing MC with other treatments in adults with NSCNP, regarding pain and disability, were included. Risk of bias was analysed using the Cochrane risk of bias tool. Data was analysed using a random effects model. Heterogeneity was evaluated using the Istatistic. The quality of the evidence was measured using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

Ten articles were included for qualitative review; nine were used for a quantitative analysis about the effect of MC on pain and eight for the analysis regarding disability. The meta-analysis comparing MC versus other treatments showed significant differences regarding pain and disability.

CONCLUSIONS

MC interventions for NSCNP patients reduces pain and disability. MC seems to be more effective to reduce pain and disability than other treatments.

摘要

背景

慢性颈痛影响了很大一部分成年人。通常,疼痛的原因不明。在这种情况下,深部颈肌的运动控制(MC)可能会出现一些改变。这些肌肉的特定训练可以改善肌肉功能,减轻疼痛和残疾。

目的

确定使用颅颈屈曲(CCF)的 MC 是否比其他治疗方法更能有效治疗非特异性慢性颈痛(NSCNP)。

设计

系统评价与荟萃分析。

方法

在 2017 年 12 月至 2018 年 3 月期间,在期刊和各种数据库中进行了检索。纳入了比较 MC 与其他治疗方法治疗成人 NSCNP 时疼痛和残疾的随机临床试验(RCT)和 RCT 的系统评价。使用 Cochrane 偏倚风险工具分析偏倚风险。使用随机效应模型分析数据。使用 Istatistic 评估异质性。使用推荐评估、制定和评估(GRADE)方法评估证据质量。

结果

对 10 篇文章进行了定性综述;9 篇文章用于对 MC 对疼痛影响的定量分析,8 篇文章用于对残疾的分析。与其他治疗方法相比,MC 治疗慢性颈痛的荟萃分析显示疼痛和残疾有显著差异。

结论

MC 干预治疗 NSCNP 患者可以减轻疼痛和残疾。MC 似乎比其他治疗方法更能有效减轻疼痛和残疾。

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