RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Queensland, Australia
School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia.
BMJ Open. 2020 May 17;10(5):e034846. doi: 10.1136/bmjopen-2019-034846.
Neck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.
Nine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.
This work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.
CRD42019126523.
颈部疼痛是一个全球性的负担问题，很大一部分颈部疼痛病例会变成慢性疼痛。虽然运动锻炼是一种常用的治疗方法，但孤立运动干预的有效性证据仍然有限。传统的两两随机对照试验（RCT）和荟萃分析仅限于比较两种干预措施。本方案描述了网络荟萃分析的设计，该分析能够对所有可进行 RCT 的运动干预措施进行比较性研究。我们旨在系统比较慢性非特异性颈部疼痛患者接受不同类型运动干预的效果。
从建库到 2019 年 3 月 12 日，我们在 9 个电子数据库（AMED、CINAHL、Cochrane 中央对照试验注册库、Embase、MEDLINE、物理治疗证据数据库、PsycINFO、Scopus 和 SPORTDiscus）中搜索 RCTs。首先筛选标题和摘要，然后筛选全文。两位评审员将提取数据。主要结局指标是干预措施的有效性。两位评审员将使用 PEDro 量表评估纳入研究的方法学质量。使用改编的网络荟萃分析 GRADE 框架评估证据的总体质量，该框架已适用于网络荟萃分析。将使用网络图总结可用证据。将呈现贡献矩阵，以评估直接和间接证据。将构建森林图以可视化所有纳入运动干预的效果。通过纳入网络中所有可用证据，计算成对效果大小。对于尚未在两两 RCT 中进行比较的治疗措施，可以通过对比与共同比较器的比较效果大小来间接比较治疗效果。
这项工作综合了先前发表的研究证据，不需要伦理审查或批准。将提交一份描述研究结果的手稿，供同行评议的科学期刊发表。
PROSPERO 注册号：CRD42019126523。
