Physical Medicine and Rehabilitation, Elisabeth-Bruyère Hospital, Ottawa, Ontario, Canada
Physical Medicine and Rehabilitation, Bruyère Research Institute, Ottawa, Ontario, Canada.
BMJ Open. 2019 Jul 30;9(7):e028177. doi: 10.1136/bmjopen-2018-028177.
Many patients with osteoarthritis (OA) develop restrictions in passive range of motion (ROM) of their affected joints (called contractures), leading to increased pain and reduced function. Effective treatment to reverse OA-associated contractures is lacking. Our aim is to evaluate the effectiveness of stretching and bracing on native (non-operated) joint contractures in people with radiographically diagnosed OA.
We will search the following databases without time restriction: Cochrane Library (CENTRAL, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database), MEDLINE, Embase, CINAHL, SCI-EXPANDED (ISI Web of Knowledge) and PEDro. Other sources will include WHO International Clinical Trials Registry Platform, reference lists of included studies, relevant systematic reviews and textbooks. We will include randomised controlled trials (RCTs), controlled clinical trials, controlled before-and-after studies, cohort studies and case-control studies that include participants ≥18 years of age with radiographic evidence of OA. Participants with inflammatory arthropathies or those that have undergone joint arthroplasty will be excluded. Interventions will include therapist-administered or patient-administered stretching, use of an orthosis (static or dynamic), use of serial casting and/or adjunctive modalities. Outcomes will include joint ROM (active and passive), pain (rest and/or activity related), stiffness, activity limitations, participation restrictions, quality of life and adverse events. Studies will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study inclusion, data extraction and quality assessment will be performed independently by two reviewers. Risk of bias will be assessed using appropriate tools for each study design. Data synthesis will be performed using Cochrane Review Manager software. If sufficient data are available, meta-analysis will be conducted. We will summarise the quality of evidence using Grading of Recommendations Assessment, and the effect size of interventions for RCT and non-RCT studies.
Ethics approval not required because individual patient data are not included. Findings will be disseminated in a peer-reviewed journal.
CRD42019127244.
许多骨关节炎（OA）患者的受影响关节（称为挛缩）的被动活动范围（ROM）受限，导致疼痛增加和功能下降。缺乏有效的治疗方法来逆转 OA 相关的挛缩。我们的目的是评估伸展和支具对放射学诊断为 OA 的患者的非手术关节挛缩的效果。
我们将在没有时间限制的情况下搜索以下数据库：Cochrane 图书馆（CENTRAL、评论摘要数据库、卫生技术评估数据库）、MEDLINE、Embase、CINAHL、科学引文索引扩展版（ISI Web of Knowledge）和 PEDro。其他来源将包括世界卫生组织国际临床试验注册平台、纳入研究的参考文献列表、相关系统评价和教科书。我们将纳入随机对照试验（RCT）、对照临床试验、对照前后研究、队列研究和病例对照研究，纳入年龄≥18 岁且有放射学 OA 证据的参与者。将排除患有炎症性关节炎或已行关节置换术的参与者。干预措施将包括治疗师或患者进行的伸展运动、使用矫形器（静态或动态）、使用连续铸造和/或辅助方式。结局将包括关节 ROM（主动和被动）、疼痛（休息时和/或活动相关）、僵硬、活动受限、参与受限、生活质量和不良事件。研究将根据系统评价和荟萃分析的首选报告项目进行报告。两名审查员将独立进行研究纳入、数据提取和质量评估。将使用适用于每种研究设计的工具评估偏倚风险。如果有足够的数据，将使用 Cochrane 评论管理软件进行荟萃分析。我们将使用推荐评估、分级和研究的 RCT 和非 RCT 研究的干预效果大小来总结证据质量。
由于不包括个体患者数据，因此不需要伦理批准。研究结果将在同行评议的期刊上发表。
PROSPERO 注册号：CRD42019127244。
