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经皮电刺激治疗颈痛:系统评价和荟萃分析。

Transcutaneous electrical stimulation in neck pain: A systematic review and meta-analysis.

机构信息

Physiotherapeutic Resources Laboratory/Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.

Rural Department of Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.

出版信息

Eur J Pain. 2022 Jan;26(1):18-42. doi: 10.1002/ejp.1845. Epub 2021 Aug 3.

Abstract

BACKGROUND AND OBJECTIVE

The objective of this systematic review was to investigate the effectiveness of electrical stimulation (ES) for neck pain (NP).

DATABASES AND DATA TREATMENT

The databases CINAHL, Embase, MEDLINE (via OVID), PEDro and Web of Science were searched, with no date restrictions. Two independent reviewers selected randomized controlled trials (RCTs) reporting pain, range of motion or psychosocial factors in people with NP, in which ES was applied. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. Thirty studies met eligibility criteria.

RESULTS

Main results showed evidence of moderate quality that ES combined with other intervention significantly decreases the pain intensity compared to other intervention immediately post-treatment and at short-term follow-up; evidence of low quality showed significant effects of ES combined with other intervention in decreasing neck disability compared to other intervention immediately post-treatment; evidence of very-low quality that ES increased the pressure pain threshold compared to placebo immediately post-treatment and that ES + other intervention also increased the pressure pain threshold compared to other intervention at short-term follow-up.

CONCLUSIONS

ES combined with other intervention seems to be useful to relieve pain and to improve disability in people with NP, however, more studies are needed.

SIGNIFICANCE

Electrical stimulation seems to be effective for improving pain intensity, immediately post-treatment in people with neck pain, mainly as an adjunct therapeutic modality. Nevertheless, high-quality RCTs are still needed to investigate the efficacy of electrical stimulation in neck pain.

摘要

背景与目的

本系统评价旨在研究电刺激(ES)治疗颈部疼痛(NP)的疗效。

资料来源与数据处理

检索了 CINAHL、Embase、MEDLINE(通过 OVID)、PEDro 和 Web of Science 数据库,未设置日期限制。两名独立评审员选择了报告 NP 患者疼痛、活动范围或心理社会因素,并应用 ES 的随机对照试验(RCT)。使用 PEDro 量表评估方法学质量。使用推荐评估、制定与评价(GRADE)分级评估证据质量。30 项研究符合纳入标准。

结果

主要结果显示,ES 联合其他干预措施与其他干预措施相比,在治疗后即刻和短期随访时可显著减轻疼痛强度,证据质量为中等;ES 联合其他干预措施与其他干预措施相比,在治疗后即刻时可显著降低颈部残疾程度,证据质量为低;ES 联合其他干预措施与其他干预措施相比,在治疗后即刻和短期随访时可显著提高压力疼痛阈值,证据质量为极低。

结论

ES 联合其他干预措施似乎可有效缓解 NP 患者的疼痛和改善残疾程度,但仍需要更多的研究。

意义

ES 似乎对改善颈部疼痛患者的疼痛强度有效,主要作为辅助治疗方式,在治疗后即刻有效。然而,仍需要高质量的 RCT 来研究 ES 在颈部疼痛中的疗效。

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