Tatsios Petros I, Grammatopoulou Eirini, Dimitriadis Zacharias, Papandreou Maria, Paraskevopoulos Eleftherios, Spanos Savvas, Karakasidou Palina, Koumantakis George A
Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece.
Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece.
Diagnostics (Basel). 2022 Jun 30;12(7):1598. doi: 10.3390/diagnostics12071598.
Patients with nonspecific chronic neck pain (NSCNP) exhibit respiratory dysfunction. This systematic review aimed to analyze randomized controlled trials (RCTs) investigating the effect of spinal and/or diaphragmatic and/or specific stabilization exercise manual therapy and/or respiratory exercises on musculoskeletal and respiratory diagnostic outcomes in patients with NSCNP. A systematic search and selection of RCTs was performed in three scientific databases (Pubmed, Scopus, and Physiotherapy Evidence Database (PEDro)) and one search engine (Google Scholar) from inception to April 2022. Relevant studies published in the English language were extracted, evaluated, and independently rated for methodological quality (PEDro scale). The quality of the evidence was assessed with the GRADE approach. Out of 1089 studies collected in total, 1073 were excluded (i.e., did not meet the inclusion criteria or were duplicates). Sixteen RCTs were finally included, rated on 5.62/10 (PEDro score) on average for methodological quality. Overall, there was sparse evidence that spinal and/or diaphragmatic manual therapy and/or trunk stabilization exercises and/or respiratory exercises significantly improved pain, disability, and respiratory outcomes in patients with NSCNP immediately post-treatment. However, the clinical heterogeneity between studies was significant, and the level of certainty of the evidence was low to very low. More, high-quality RCTs are required, contributing to the holistic diagnostic monitoring and management of patients with NSCNP.
非特异性慢性颈部疼痛（NSCNP）患者存在呼吸功能障碍。本系统评价旨在分析随机对照试验（RCT），这些试验研究了脊柱和/或膈肌和/或特定稳定运动手法治疗和/或呼吸锻炼对NSCNP患者肌肉骨骼和呼吸诊断结果的影响。从创刊至2022年4月，在三个科学数据库（PubMed、Scopus和物理治疗证据数据库（PEDro））和一个搜索引擎（谷歌学术）中进行了RCT的系统检索和筛选。提取并评估以英文发表的相关研究，并对其方法学质量进行独立评分（PEDro量表）。采用GRADE方法评估证据质量。在总共收集的1089项研究中，排除了1073项（即不符合纳入标准或为重复研究）。最终纳入16项RCT，方法学质量的平均PEDro评分为5.62/10。总体而言，仅有少量证据表明，脊柱和/或膈肌手法治疗和/或躯干稳定锻炼和/或呼吸锻炼在治疗后即刻能显著改善NSCNP患者的疼痛、功能障碍和呼吸结果。然而，各研究之间的临床异质性显著，证据的确定性水平低至极低。需要更多高质量的RCT，以促进对NSCNP患者的整体诊断监测和管理。
