鞭打损伤后预后不良是否与物理因素有关？：一项系统评价和数据综合的方案

Are physical factors associated with poor prognosis following a whiplash trauma?: a protocol for a systematic review and data synthesis.

作者信息

Alalawi Ahmed, Gallina Alessio, Sterling Michele, Falla Deborah

机构信息

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK

Physical Therapy Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.

出版信息

BMJ Open. 2019 Nov 19;9(11):e033298. doi: 10.1136/bmjopen-2019-033298.

DOI:10.1136/bmjopen-2019-033298

PMID:31748312

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6887082/

Abstract

INTRODUCTION

Mitigating the transition from acute to chronic whiplash-associated disorders (WAD) is fundamental, and this could be achieved through early identification of individuals at risk. Several physical factors such as angular velocity, smoothness of neck movement and coactivation of neck flexors and extensors, have been observed in patients with WAD, but their predictive ability after a whiplash injury have not been considered in previous reviews. Therefore, the aim of the current protocol is to outline the protocol for a systematic review that synthesises the current evidence of which physical factors can predict ongoing pain and disability following a whiplash trauma.

METHODS AND ANALYSIS

Two independent reviewers will search for studies in several electronic databases including MEDLINE, Embase, CINAHL, PsycINFO, Scopus and Web of Science as well as grey literature. Observational cohort studies will be considered if they involve participants with acute WAD followed for at least 3 months post-injury. Studies will be required to assess the prognostic ability of one or more physical factors that directly involve a body function and/or structure and can be measured objectively. Further, patient-reported outcomes of physical function will be considered. The primary outcome for this review is Neck Disability Index, while all other validated measures will be considered as secondary outcomes. Risk of bias across individual studies will be assessed using the Quality In Prognostic Studies tool along with the Grades of Recommendation, Assessment, Development and Evaluation method to assess the quality of evidence. A meta-analysis will be conducted depending on homogeneity and the number of available studies. If appropriate, data will be pooled and presented as odds ratios, otherwise, a qualitative synthesis will be conducted.

ETHICS AND DISSEMINATION

Ethical approval is not required for this systematic review. The result from this review will be published in peer-reviewed journals.

PROSPERO REGISTRATION NUMBER

CRD42019122559.

摘要

引言

减轻急性鞭打相关疾病（WAD）向慢性疾病的转变至关重要，这可通过早期识别高危个体来实现。在WAD患者中已观察到一些身体因素，如角速度、颈部运动的平滑度以及颈部屈肌和伸肌的共同激活，但先前的综述未考虑这些因素在鞭打损伤后的预测能力。因此，本方案的目的是概述一项系统评价的方案，该评价综合了当前关于哪些身体因素可预测鞭打创伤后持续疼痛和残疾的证据。

方法与分析

两名独立的评审员将在多个电子数据库中检索研究，包括MEDLINE、Embase、CINAHL、PsycINFO、Scopus和Web of Science以及灰色文献。如果观察性队列研究涉及急性WAD患者且在受伤后至少随访3个月，则将其纳入考虑。研究需评估一个或多个直接涉及身体功能和/或结构且可客观测量的身体因素的预后能力。此外，还将考虑患者报告的身体功能结果。本综述的主要结局是颈部残疾指数，而所有其他经过验证的测量指标将被视为次要结局。将使用预后研究质量工具以及推荐分级、评估、制定和评价方法来评估个体研究的偏倚风险，以评估证据质量。将根据同质性和可用研究的数量进行荟萃分析。如果合适，将汇总数据并以比值比呈现，否则将进行定性综合分析。