Universitat Politècnica de València, Valencia, Spain.
Departamento de Diseño, Universidad del Norte, Barranquilla, Colombia.
PLoS One. 2021 Mar 18;16(3):e0248484. doi: 10.1371/journal.pone.0248484. eCollection 2021.
INTRODUCTION: People with ulnar, radial or median nerve injuries can present significant impairment of their sensory and motor functions. The prescribed treatment for these conditions often includes electrophysical therapies, whose effectiveness in improving symptoms and function is a source of debate. Therefore, this systematic review aims to provide an integrative overview of the efficacy of these modalities in sensorimotor rehabilitation compared to placebo, manual therapy, or between them. METHODS: We conducted a systematic review according to PRISMA guidelines. We perform a literature review in the following databases: Biomed Central, Ebscohost, Lilacs, Ovid, PEDro, Sage, Scopus, Science Direct, Semantic Scholar, Taylor & Francis, and Web of Science, for the period 1980-2020. We include studies that discussed the sensorimotor rehabilitation of people with non-degenerative ulnar, radial, or median nerve injury. We assessed the quality of the included studies using the Risk of Bias Tool described in the Cochrane Handbook of Systematic Reviews of Interventions and the risk of bias across studies with the GRADE approach described in the GRADE Handbook. RESULTS: Thirty-eight studies were included in the systematic review and 34 in the meta-analysis. The overall quality of evidence was rated as low or very low according to GRADE criteria. Low-level laser therapy and ultrasound showed favourable results in improving symptom severity and functional status compared to manual therapy. In addition, the low level laser showed improvements in pinch strength compared to placebo and pain (VAS) compared to manual therapy. Splints showed superior results to electrophysical modalities. The clinical significance of the results was assessed by effect size estimation and comparison with the minimum clinically important difference (MCID). CONCLUSIONS: We found favourable results in pain relief, improvement of symptoms, functional status, and neurophysiological parameters for some electrophysical modalities, mainly when applied with a splint. Our results coincide with those obtained in some meta-analyses. However, none of these can be considered clinically significant. TRIAL REGISTRATION: PROSPERO registration number CRD42020168792; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168792.
简介:尺神经、桡神经或正中神经损伤的患者可能会出现明显的感觉和运动功能障碍。这些病症的常规治疗通常包括电物理疗法,但其在改善症状和功能方面的有效性存在争议。因此,本系统综述旨在综合评估这些方法在感觉运动康复方面相对于安慰剂、手动治疗或两者之间的疗效。
方法:我们根据 PRISMA 指南进行了系统综述。我们在以下数据库中进行文献综述:Biomed Central、Ebscohost、Lilacs、Ovid、PEDro、Sage、Scopus、Science Direct、Semantic Scholar、Taylor & Francis 和 Web of Science,时间范围为 1980 年至 2020 年。我们纳入了讨论非退行性尺神经、桡神经或正中神经损伤患者感觉运动康复的研究。我们使用 Cochrane 干预系统评价手册中描述的风险偏倚工具和 GRADE 手册中描述的偏倚风险 across studies 方法评估纳入研究的质量。
结果:系统综述纳入了 38 项研究,荟萃分析纳入了 34 项研究。根据 GRADE 标准,总体证据质量被评为低或极低。低水平激光治疗和超声波治疗在改善症状严重程度和功能状态方面优于手动治疗。此外,低水平激光治疗在握力方面优于安慰剂,在疼痛(VAS)方面优于手动治疗。夹板的结果优于电物理治疗。通过效应量估计和与最小临床重要差异(MCID)的比较来评估结果的临床意义。
结论:我们发现一些电物理治疗方法在缓解疼痛、改善症状、功能状态和神经生理参数方面有较好的结果,主要是在应用夹板的情况下。我们的结果与一些荟萃分析的结果一致。然而,这些结果都不能被认为具有临床意义。
试验注册:PROSPERO 注册号 CRD42020168792;https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168792。
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