Haussler Kevin K, Hesbach Amie L, Romano Laura, Goff Lesley, Bergh Anna
Equine Orthopaedic Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80535, USA.
EmpowerPhysio, 2585CW The Hague, The Netherlands.
Animals (Basel). 2021 Sep 24;11(10):2787. doi: 10.3390/ani11102787.
Mobilization and manipulation techniques are often used in small animal and equine practice; however, questions remain concerning indications, dosing and efficacy. A bibliographic search was performed to identify peer-reviewed publications from 1980 to 2020 that evaluated the clinical effects of musculoskeletal mobilization and manipulation techniques in dogs, cats and horses. The search strategy identified 883 papers for review. Inclusion and exclusion criteria were applied. The clinical indications, dosages, outcome parameters, and reported efficacy within each publication were recorded and categorized for comparison with scientific quality assessed according to a standardized grading system. Fourteen articles were included in this systematic review of which 13 were equine and one was a canine study. Seven of these were cohort studies and seven were randomized controlled clinical trials. The canine study involved carpal immobilization-remobilization and all equine studies focused on the effects of passive mobilization ( = 5) or manipulation ( = 8) of the axial skeleton. Study quality was low ( = 4), moderate ( = 7), and high ( = 3) and included a wide array of outcome parameters with varying levels of efficacy and duration of therapeutic effects, which prevented further meta-analysis. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Optimal technique indications and dosages need to be determined to improve the standardization of these treatment options.
松动术和整复技术常用于小动物和马的临床实践中；然而，关于其适应症、剂量和疗效仍存在疑问。进行了文献检索，以确定1980年至2020年期间评估肌肉骨骼松动术和整复技术对犬、猫和马临床效果的同行评审出版物。检索策略确定了883篇论文以供评审。应用了纳入和排除标准。记录并分类每个出版物中的临床适应症、剂量、结果参数和报告的疗效，以便与根据标准化分级系统评估的科学质量进行比较。本系统评价纳入了14篇文章，其中13篇是关于马的研究，1篇是关于犬的研究。其中7篇是队列研究，7篇是随机对照临床试验。犬的研究涉及腕关节固定-再活动，所有马的研究都集中在轴向骨骼的被动松动（n = 5）或整复（n = 8）的效果上。研究质量低（n = 4）、中等（n = 7）和高（n = 3），包括一系列结果参数，疗效水平和治疗效果持续时间各不相同，这妨碍了进一步的荟萃分析。因此，尽管所有研究都报告了积极效果，但仍难以得出确凿结论。需要确定最佳技术适应症和剂量，以提高这些治疗选择的标准化程度。
