Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
Nuffield Department for Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
J Pain. 2022 Nov;23(11):1833-1855. doi: 10.1016/j.jpain.2022.06.007. Epub 2022 Jun 26.
The purpose of this systematic review was to evaluate the effects of physiotherapeutic interventions on biomarkers of neuropathic pain in preclinical models of peripheral neuropathic pain (PNP). The search was performed in Pubmed, Web of Science, EMBASE, Cochrane, Cinhal, Psycinfo, Scopus, Medline, and Science Direct. Studies evaluating any type of physiotherapy intervention for PNP (systemic or traumatic) were included. Eighty-one articles were included in this review. The most common PNP model was chronic constriction injury, and the most frequently studied biomarkers were related to neuro-immune processes. Exercise therapy and Electro-acupuncture were the 2 most frequently studied physiotherapy interventions while acupuncture and joint mobilization were less frequently examined. Most physiotherapeutic interventions modulated the expression of biomarkers related to neuropathic pain. Whereas the results seem promising; they have to be considered with caution due to the high risk of bias of included studies and high heterogeneity of the type and anatomical localization of biomarkers reported. The review protocol is registered on PROSPERO (CRD42019142878). PERSPECTIVE: This article presents the current evidence about physiotherapeutic interventions on biomarkers of neuropathic pain in preclinical models of peripheral neuropathic pain. Existing findings are reviewed, and relevant data are provided on the effectiveness of each physiotherapeutic modality, as well as its certainty of evidence and clinical applicability.
本次系统评价的目的是评估物理治疗干预措施对周围神经病理性疼痛（PNP）临床前模型中神经病理性疼痛生物标志物的影响。检索了 Pubmed、Web of Science、EMBASE、Cochrane、Cinhal、Psycinfo、Scopus、Medline 和 Science Direct。纳入了评估任何类型的物理治疗干预（全身性或创伤性）对 PNP 的研究。本综述共纳入 81 篇文章。最常见的 PNP 模型是慢性缩窄性损伤，最常研究的生物标志物与神经免疫过程有关。运动疗法和电针是研究最多的两种物理治疗干预措施，而针灸和关节松动术则较少被研究。大多数物理治疗干预措施调节了与神经病理性疼痛相关的生物标志物的表达。虽然结果看起来很有希望，但由于纳入研究的偏倚风险高，以及报告的生物标志物的类型和解剖定位存在高度异质性，因此必须谨慎考虑这些结果。综述方案已在 PROSPERO（CRD42019142878）上注册。观点：本文介绍了目前关于周围神经病理性疼痛临床前模型中物理治疗干预对神经病理性疼痛生物标志物影响的证据。对现有研究结果进行了回顾，并就每种物理治疗方式的有效性提供了相关数据，以及其证据的确定性和临床适用性。
