Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, USA.
Complement Ther Clin Pract. 2022 Nov;49:101655. doi: 10.1016/j.ctcp.2022.101655. Epub 2022 Aug 11.
The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP).
A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the "13 items Cochrane risk of bias (RoB) tool". Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.
Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = -1.57 [-2.50, -0.65]; P = 0.0008) and functional status (ES = -1.71 [-3.12, -0.31]; P = 0.02). The quality of evidence was "very low" for all the assessed outcomes. Other results were presented in a qualitative synthesis.
Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.
本系统评价和荟萃分析的目的是评估整骨手法干预是否可以降低非特异性颈痛（NS-NP）患者的疼痛水平并提高其功能状态。
按照 2020 年 PRISMA 声明进行系统评价和荟萃分析。在五个数据库中搜索随机对照试验（RCT），通过标准化表格进行评估，并使用“13 项 Cochrane 偏倚风险（RoB）工具”进行评估。治疗后计算效应大小（ES），并通过 GRADE 标准评估证据质量。
综述纳入了 5 篇文章，其中没有一篇被完全判定为低 RoB。其中 4 篇被纳入荟萃分析。与无干预/假治疗相比，整骨干预在疼痛水平（ES=-1.57[-2.50，-0.65]；P=0.0008）和功能状态（ES=-1.71[-3.12，-0.31]；P=0.02）方面具有统计学显著差异。所有评估结果的证据质量均为“极低”。其他结果以定性综合呈现。
整骨干预可能对改善成人非特异性颈痛的疼痛水平和功能状态有效。然而，这些发现受到极低证据质量的影响。因此，需要进一步开展高质量的 RCT，以提高证据质量并推广结果。
