运动想象对全膝关节置换术后功能恢复的有效性：系统评价与荟萃分析。

Effectiveness of motor imagery for improving functional performance after total knee arthroplasty: a systematic review with meta-analysis.

机构信息

Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, 45# Chang Chun Street, Beijing, 100000, China.

Department of Rehabilitation Center, Fuxing Hospital, Capital Medical University, 20# Fu Xing Men Wai Street, Beijing, 100000, China.

出版信息

J Orthop Surg Res. 2022 Feb 2;17(1):65. doi: 10.1186/s13018-022-02946-4.

BACKGROUND

The aim of this study was to appraise the effects of motor imagery on the functional performance improvement among total knee arthroplasty patients systematically. We hypothesized a relatively greater recovery in the motor imagery group.

METHODS

Medline (Ovid), Embase and Cochrane Controlled Register of Trials (CENTRAL) were searched from inception to October 1st, 2021. We included randomized controlled trials evaluating the effects of motor imagery on the functional recovery among total knee arthroplasty patients. Measurements included range of motion, strength intensity, Visual Analogue Scale, Time Up and Go Test, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, all of which were evaluated before and after intervention. Mean differences (MD) or standard mean differences (SMD) and 95% confidence intervals (CI) were calculated. The Cochrane risk of bias tool was used to assess the risk of bias.

RESULTS

Six studies with 168 patients were included for the meta-analysis. The SMD of strength intensity was increased (SMD = 0.90, 95% CI = [0.47]-[1.32], P < 0.001). The SMD of Visual Analogue Scale was reduced (SMD = - 0.91; 95% CI = [- 1.29]-[- 0.52], P < 0.001). The SMD of Time Up and Go Test was reduced (SMD = - 0.56, 95% CI = [- 0.94]-[- 0.19], P = 0.003). The MD of Oxford Knee Score was slightly increased (MD = 0.79-point, 95% CI = [- 0.31]-[1.88], P = 0.159). The outcomes of range of motion, Western Ontario and McMaster Universities Osteoarthritis Index were described according to the original data.

CONCLUSION

Compared with control therapy, motor imagery in the intervention group achieved an effective treatment for strength enhancement, pain reduction and physical activities improvement. More large-scale, prospective researches are needed in the future.

TRIAL REGISTRATION

The PROSPERO trial registration number is CRD42021250996.

背景

本研究旨在系统评估运动想象对全膝关节置换患者功能表现改善的影响。我们假设运动想象组会有相对更大的恢复。

方法

从建库至 2021 年 10 月 1 日，我们检索了 Medline（Ovid）、Embase 和 Cochrane 对照试验注册库（CENTRAL）。我们纳入了评估运动想象对全膝关节置换患者功能恢复影响的随机对照试验。测量指标包括关节活动度、力量强度、视觉模拟评分（VAS）、起立-行走计时测试（TUGT）、牛津膝关节评分（OKS）、西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC），所有指标均在干预前后进行评估。计算均数差（MD）或标准化均数差（SMD）和 95%置信区间（CI）。使用 Cochrane 偏倚风险工具评估偏倚风险。

结果

纳入 6 项研究共 168 例患者进行荟萃分析。力量强度的 SMD 增加（SMD=0.90，95%CI=[0.47]-[1.32]，P<0.001）。VAS 的 SMD 降低（SMD=-0.91；95%CI=[-1.29]-[-0.52]，P<0.001）。TUGT 的 SMD 降低（SMD=-0.56，95%CI=[-0.94]-[-0.19]，P=0.003）。OKS 的 MD 略有增加（MD=0.79 分，95%CI=[-0.31]-[1.88]，P=0.159）。关节活动度、WOMAC 的结果根据原始数据进行描述。