de Zoete Rutger M J, Chen Kenneth, Sterling Michele
RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia.
BMJ Open. 2020 Jul 6;10(7):e036151. doi: 10.1136/bmjopen-2019-036151.
Primary objectives: to investigate the central neurobiological effects (using MRI) of physical exercise in individuals with chronic pain. Secondary objectives: (1) to investigate the associations between central changes and clinical outcomes and (2) to investigate whether different types and dosages of physical exercise exert different central changes.
Systematic review searching four electronic databases up to September 2018: AMED, CINAHL, Embase and MEDLINE. Two reviewers independently assessed the methodological quality of included studies using the Cochrane Collaboration's Risk of Bias in Non-Randomised Studies-I tool. A standardised extraction table was used for data extraction, which was performed by two reviewers.
Studies reporting any physical exercise intervention in any chronic musculoskeletal pain condition were included. Eligibility of 4011 records was screened independently by two reviewers, and four studies were included in the review.
Primary outcome: any brain outcome assessed with any MR technique.
any self-reported clinical outcomes, and type and dosage of the exercise intervention.
All four studies had high risk of bias. There was heterogeneity between the brain areas studied and the types of exercise interventions delivered. All studies reported functional MRI changes in various brain areas following an exercise intervention. Insufficient data were available to conduct a meta-analysis or to answer the secondary aims.
Only a limited number of studies were available and all were at high risk of bias. None of the studies was randomised or included blinded assessment. Exercise may exert effects on brain neurobiology in people with chronic pain. Due to the high risk of bias, future studies should use a randomised study design. Investigation of morphological brain changes could be included.
CRD42018108179.
主要目的：研究体育锻炼对慢性疼痛患者的中枢神经生物学影响（使用磁共振成像）。次要目的：（1）研究中枢变化与临床结果之间的关联；（2）研究不同类型和剂量的体育锻炼是否会产生不同的中枢变化。
系统评价，检索截至2018年9月的四个电子数据库：医学教育数据库（AMED）、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（Embase）和医学文献数据库（MEDLINE）。两名评审员使用Cochrane协作网的非随机研究偏倚风险工具I独立评估纳入研究的方法学质量。使用标准化提取表进行数据提取，由两名评审员完成。
纳入报告了任何慢性肌肉骨骼疼痛状况下的体育锻炼干预的研究。两名评审员独立筛选4011条记录的合格性，该评价纳入了四项研究。
主要结局：使用任何磁共振成像技术评估的任何脑结局。
任何自我报告的临床结局，以及锻炼干预的类型和剂量。
所有四项研究均存在高偏倚风险。所研究的脑区和所实施的锻炼干预类型之间存在异质性。所有研究均报告了锻炼干预后不同脑区的功能磁共振成像变化。现有数据不足以进行荟萃分析或回答次要目的。
仅有数量有限的研究，且所有研究均存在高偏倚风险。没有一项研究是随机的或包括盲法评估。锻炼可能对慢性疼痛患者的脑神经生物学产生影响。由于偏倚风险高，未来研究应采用随机研究设计。可纳入对脑形态学变化的研究。
CRD42018108179。
