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远程康复锻炼对身体残疾者疼痛、身体功能和生活质量的有效性:基于 GRADE 建议的随机对照试验系统评价。

Effectiveness of exercises by telerehabilitation on pain, physical function and quality of life in people with physical disabilities: a systematic review of randomised controlled trials with GRADE recommendations.

机构信息

Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

出版信息

Br J Sports Med. 2021 Feb;55(3):155-162. doi: 10.1136/bjsports-2019-101375. Epub 2020 Oct 15.

Abstract

OBJECTIVE

Investigate whether exercise-based telerehabilitation improves pain, physical function and quality of life in adults with physical disabilities.

DESIGN

Systematic review of randomised controlled trials.

DATA SOURCES

Searches were performed in AMED, MEDLINE, CINAHL, SPORTDiscus, Embase, PEDro, Cochrane Library and PsycINFO.

ELIGIBILITY CRITERIA

Trials were considered if they evaluated exercise by telerehabilitation. The population included adults with physical disability. Comparisons were control and other interventions. The outcomes were pain, physical function and quality of life. Study selection, data extraction and analysis followed the protocol registered in PROSPERO (CRD42019122824). GRADE determined the strength of evidence.

RESULTS

Forty-eight trials were included in the quantitative analysis. When compared with other interventions, there was high-quality evidence that telerehabilitation was not different to other interventions for pain (95% CI: -0.4 to 0.1), physical function (95% CI: -0.2 to 0.2) and quality of life (95% CI: -0.1 to 0.5) at long-term. There was moderate-quality evidence that telerehabilitation was not different to other interventions for physical function (95% CI: -0.1 to 0.5) and quality of life (95% CI: -0.2 to 0.5) at short-term. However, due to the low-quality evidence and the small number of trials comparing exercise protocols offered by telerehabilitation with control groups, it is still not possible to state the efficacy of telerehabilitation on pain, function and quality of life at short-term and long-term.

CONCLUSIONS

Exercise by telerehabilitation may be an alternative to treat pain, physical function and quality of life in adults with physical disabilities when compared with other intervention.

摘要

目的

调查基于运动的远程康复是否能改善身体残疾成年人的疼痛、身体功能和生活质量。

设计

随机对照试验的系统评价。

资料来源

在 AMED、MEDLINE、CINAHL、SPORTDiscus、Embase、PEDro、Cochrane 图书馆和 PsycINFO 中进行了检索。

入选标准

如果试验评估了远程康复运动,则将其视为研究对象。研究人群包括身体残疾的成年人。对照和其他干预措施为比较。结局指标为疼痛、身体功能和生活质量。研究选择、数据提取和分析均按照 PROSPERO(CRD42019122824)中注册的方案进行。GRADE 确定了证据的强度。

结果

48 项试验纳入定量分析。与其他干预措施相比,远程康复在长期时对疼痛(95%CI:-0.4 至 0.1)、身体功能(95%CI:-0.2 至 0.2)和生活质量(95%CI:-0.1 至 0.5)没有差异,证据质量为高。证据质量为中,远程康复在短期时对身体功能(95%CI:-0.1 至 0.5)和生活质量(95%CI:-0.2 至 0.5)与其他干预措施没有差异。然而,由于低质量证据和比较远程康复提供的运动方案与对照组的试验数量较少,因此仍然无法确定远程康复在短期和长期时对疼痛、功能和生活质量的疗效。

结论

与其他干预措施相比,远程康复中的运动可能是治疗身体残疾成年人疼痛、身体功能和生活质量的一种替代方法。

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