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神经松动术治疗下腰痛和神经根痛:系统评价。

Neural mobilization in low back and radicular pain: a systematic review.

机构信息

Samuel Merritt University, Department of Physical Therapy, Oakland, CA, USA.

出版信息

J Man Manip Ther. 2023 Feb;31(1):4-12. doi: 10.1080/10669817.2022.2065599. Epub 2022 May 18.

Abstract

BACKGROUND

Low back pain can present with radicular pain caused by lumbosacral nerve root pathology. Neural mobilization (NM) is a treatment technique used to treat low back and radicular pain (LBRP).

PURPOSE

To evaluate the effectiveness of NM interventions in improving pain, disability, and function in adults with LBRP.

DATA SOURCES

CINAHL Plus, MEDLINE (Ovid), Physiotherapy Evidence Database, and Cochrane databases were searched.

STUDY SELECTION

Randomized controlled trials assessing the effect of NM on pain, disability, and/or function in adults with LBRP.

DATA EXTRACTION

Authors reviewed studies and used the PEDro scale and the revised Cochrane risk-of-bias tool to assess methodological quality and risk of bias.

DATA SYNTHESIS

Eight studies were included. Six of the eight studies found the addition of NM to conservative treatment improved all measured outcomes. One study found improvements in some but not all functional measures, and delayed improvements in pain. One study found improvements in measures of neural sensitivity, but not overall pain and disability.

CONCLUSIONS

NM may be an effective tool for short-term improvements in pain, function, and disability associated with LBRP. Additional high quality research is needed.

STUDY REGISTRATION

: This systematic review protocol was registered with PROSPERO (registration number: CRD42020192338).

摘要

背景

下腰痛可表现为腰骶神经根病变引起的根性疼痛。神经松动术(NM)是一种用于治疗下腰痛和根性疼痛(LBRP)的治疗技术。

目的

评估 NM 干预对改善成人 LBRP 疼痛、残疾和功能的有效性。

资料来源

CINAHL Plus、MEDLINE(Ovid)、物理治疗证据数据库和 Cochrane 数据库进行了检索。

研究选择

评估 NM 对成人 LBRP 疼痛、残疾和/或功能影响的随机对照试验。

资料提取

作者对研究进行了审查,并使用 PEDro 量表和修订后的 Cochrane 偏倚风险工具评估方法学质量和偏倚风险。

资料综合

共纳入 8 项研究。这 8 项研究中的 6 项研究发现,NM 联合保守治疗可改善所有测量结果。一项研究发现,一些但不是所有的功能指标都有所改善,疼痛改善延迟。一项研究发现,神经敏感性测量指标有所改善,但整体疼痛和残疾没有改善。

结论

NM 可能是治疗与 LBRP 相关的短期疼痛、功能和残疾的有效工具。需要更多高质量的研究。

研究注册

本系统评价方案已在 PROSPERO(注册号:CRD42020192338)中注册。

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