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肌筋膜松解技术治疗腰痛患者的效果:系统评价和荟萃分析。

The effects of myofascial release technique for patients with low back pain: A systematic review and meta-analysis.

机构信息

Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.

出版信息

Complement Ther Med. 2021 Jun;59:102737. doi: 10.1016/j.ctim.2021.102737. Epub 2021 May 10.

Abstract

OBJECTIVE

The purpose of this meta-analytic review was to quantitatively examine the effects of myofascial release technique (MFR) on pain intensity, back disability, lumbar range of motion, and quality of life in patients with low back pain (LBP).

METHODS

Potential articles were retrieved using five electronic databases (Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang). The search period was from inception to January 27, 2021. Two researchers independently completed record retrieval and selection, data extraction, and methodological quality assessment. Randomized controlled trials (RCTs) assessing the effect of MFR on pain intensity, back disability, lumbar range of motion, and quality of life in LBP patients were included. Pooled effect sizes were calculated using random effects models and 95 % confidence interval (95 % CI).

RESULTS

Data from eight RCTs (386 patients with back pain) meeting the inclusion criteria were extracted for meta-analysis with methodological quality assessment scores ranging from 6 to 10. Compared to the control intervention, MFR induced significant decrease in back disability (SMD = -0.35, 95 % confidence interval [CI] = -0.68, -0.02, P = 0.04, I² = 46 %, n = 284). MFR induced non-significant decrease in the pain intensity (SMD = -0.12, 95 % confidence interval[CI] = -0.35, 0.11, P = 0.32, I² = 0%, n = 294), non-significant improvement in quality of life (SMD = -0.09, 95 % confidence interval [CI] = -0.46, 0.28, P = 0.62, I² = 0%, n = 114), and non-significant improvement in lumbar range of motion (Flexion SMD = 0.57,95 % confidence interval [CI] = -0.09, 1.24, P = 0.09, I² = 54 %, n = 80) (Extension SMD = 0.68, 95 % confidence interval[CI] = -0.72, 2.08, P = 0.34, I² = 89 %, n = 80) (Right flexion SMD = 0.05, 95 % confidence interval[CI] = -0.90, 0.99, P = 0.92, I² = 78 %, n = 80) (Left flexion SMD = 0.14, 95 % confidence interval[CI] = -0.59, 0.88, P = 0.70, I² = 64 %, n = 80).

CONCLUSION

The findings suggest that MFR can improve the effect of physical therapy alone and exercise therapy alone, and that MFR can be an effective adjuvant therapy. Meta-analysis showed that MFR has a significant effect on reducing back disability in patients with low back pain, but no significant effect on reducing pain intensity, improving quality of life, and improving lumbar range of motion.

摘要

目的

本荟萃分析旨在定量研究肌筋膜松解技术(MFR)对腰痛患者疼痛强度、腰背功能障碍、腰椎活动度和生活质量的影响。

方法

使用五个电子数据库(Web of Science、PubMed、Scopus、中国知网和万方)检索潜在文章。检索时间为从开始到 2021 年 1 月 27 日。两名研究人员独立完成记录检索和选择、数据提取以及方法学质量评估。纳入评估 MFR 对腰痛患者疼痛强度、腰背功能障碍、腰椎活动度和生活质量影响的随机对照试验(RCT)。使用随机效应模型和 95%置信区间(95%CI)计算汇总效应大小。

结果

纳入的八项 RCT(386 名腰痛患者)符合纳入标准,进行荟萃分析,方法学质量评估得分为 6-10 分。与对照组干预相比,MFR 可显著降低腰背功能障碍(SMD=-0.35,95%CI=-0.68,-0.02,P=0.04,I²=46%,n=284)。MFR 对疼痛强度(SMD=-0.12,95%CI=-0.35,0.11,P=0.32,I²=0%,n=294)、生活质量(SMD=-0.09,95%CI=-0.46,0.28,P=0.62,I²=0%,n=114)和腰椎活动度(屈伸 SMD=0.57,95%CI=-0.09,1.24,P=0.09,I²=54%,n=80)(伸展 SMD=0.68,95%CI=-0.72,2.08,P=0.34,I²=89%,n=80)(右侧前屈 SMD=0.05,95%CI=-0.90,0.99,P=0.92,I²=78%,n=80)(左侧前屈 SMD=0.14,95%CI=-0.59,0.88,P=0.70,I²=64%,n=80)无显著改善。

结论

研究结果表明,MFR 可增强物理治疗和运动治疗的效果,MFR 可作为一种有效的辅助治疗方法。荟萃分析显示,MFR 对降低腰痛患者的腰背功能障碍有显著效果,但对降低疼痛强度、改善生活质量和提高腰椎活动度无显著效果。

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