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改善与髋关节疼痛相关的人群的功能:物理治疗师主导的髋关节相关疼痛干预措施的系统评价和荟萃分析。

Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain.

机构信息

Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia

Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.

出版信息

Br J Sports Med. 2020 Dec;54(23):1382-1394. doi: 10.1136/bjsports-2019-101690. Epub 2020 May 6.

Abstract

OBJECTIVE

To report the effectiveness of physiotherapist-led interventions in improving pain and function in young and middle-aged adults with hip-related pain.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

A comprehensive, reproducible search strategy was performed on five databases in May 2019. Reference lists and grey literature were also searched.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Population: people aged ≥18 years with hip-related pain (with or without a diagnosis of femoroacetabular impingement syndrome).

INTERVENTION(S): physiotherapist-led interventions for hip pain. Comparators: sham treatment, no treatment or other treatment (eg, hip arthroscopic surgery).

OUTCOMES

primary outcomes included patient-reported hip pain and function. Secondary outcomes included physical function measures.

RESULTS

1722 papers were identified. After exclusion criteria were applied, 14 studies were included for analysis. They had varied risk of bias. There were no full-scale placebo-controlled randomised controlled trials (RCTs) of physiotherapist-led treatment. Pooled effects ranged from moderate effects (0.67 (95% CI 0.07 to 1.26)) favouring physiotherapist-led intervention over no treatment post-arthroscopy, to weak effects (-0.32 (95% CI 0.57 to 0.07)) favouring hip arthroscopy over physiotherapist-led treatment.

CONCLUSION

Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required.

PROSPERO REGISTRATION NUMBER

CRD42018089088.

摘要

目的

报告物理治疗师主导的干预措施在改善年轻和中年成年人髋关节相关疼痛的疼痛和功能方面的效果。

设计

系统评价和荟萃分析。

资料来源

2019 年 5 月,我们在五个数据库中进行了全面、可重复的搜索策略,并对参考文献和灰色文献进行了搜索。

研究入选标准

人群:年龄≥18 岁,髋关节相关疼痛(无论是否有髋关节撞击综合征的诊断)。

干预措施

物理治疗师主导的髋关节疼痛干预措施。对照组:假治疗、无治疗或其他治疗(如髋关节镜手术)。

主要结局

主要结局包括患者报告的髋关节疼痛和功能。次要结局包括身体功能测量。

结果

共确定了 1722 篇论文。应用排除标准后,纳入了 14 项研究进行分析。它们的偏倚风险各不相同。没有物理治疗师主导的治疗的全规模安慰剂对照随机对照试验(RCT)。荟萃分析的结果范围从适度的效果(0.67(95%置信区间 0.07 至 1.26)),即物理治疗师主导的干预措施优于关节镜手术后的无治疗,到微弱的效果(-0.32(95%置信区间 0.57 至 0.07)),即髋关节镜手术优于物理治疗师主导的治疗。

结论

物理治疗师主导的干预措施可能改善年轻和中年成年人髋关节相关疼痛的疼痛和功能,但需要进行全规模高质量 RCT 研究。

PROSPERO 注册号:CRD42018089088。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb65/7677471/6e5548f55124/bjsports-2019-101690f01.jpg

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