振动训练对多发性硬化症患者运动和非运动症状的影响：一项系统评价和荟萃分析。
Effects of vibration training on motor and non-motor symptoms for patients with multiple sclerosis: A systematic review and meta-analysis.
作者信息
Zhang Yang, Xu Peng, Deng Yu, Duan Wenxiu, Cui Juncai, Ni Chaomin, Wu Ming
机构信息
Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
出版信息
Front Aging Neurosci. 2022 Aug 5;14:960328. doi: 10.3389/fnagi.2022.960328. eCollection 2022.
BACKGROUND
Vibration therapy is one of the rehabilitation programs that may be effective in treating both motor and non-motor symptoms in Multiple Sclerosis patients. We conducted a comprehensive systematic review and meta-analysis to assess the effects of vibration therapy on motor and non-motor symptoms (functional mobility, balance, walking endurance, gait speed, fatigue, and quality of life) of this population.
METHODS
A systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Physiotherapy Evidence Database, Scopus, Google Search Engine, and the China National Knowledge Infrastructure (CNKI). Two reviewers independently assessed the study quality.
RESULTS
Fourteen studies with 393 participants were finally included in the meta-analysis. The pooled results showed that vibration therapy had a significant advantage over the control intervention in improving balance function [mean difference (MD) = 2.04, 95% confidence interval (CI): 0.24-3.84, = 0.03], and walking endurance (SMD = 0.34, 95% CI: 0.07-0.61, = 0.01). Meanwhile, the degree of disability subgroup analysis revealed that the Expanded Disability Status Scale (EDSS) score (3.5-6) significantly improved functional mobility (MD: -1.18, 95% CI: -2.09 to 0.28, = 0.01) and balance function (MD: 3.04, 95% CI: 0.49-5.59, = 0.02) compared with the control group, and the EDSS (0-3.5) were more beneficial in walking endurance. The duration subgroup analysis indicated a significant difference in the effect of the duration (<4 weeks) on enhancing walking endurance (SMD: 0.46, 95% CI: 0.04-0.87, = 0.03). However, no significant improvement was found in functional mobility, gait speed, fatigue, and quality of life.
CONCLUSION
Vibration therapy may improve balance function and walking endurance, and the degree of disability and duration of intervention may affect outcomes. The evidence for the effects of vibration therapy on functional mobility, gait speed, fatigue, and quality of life remains unclear. More trials with rigorous study designs and a larger sample size are necessary to provide this evidence.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022326852.
背景
振动疗法是一种康复方案，可能对治疗多发性硬化症患者的运动和非运动症状有效。我们进行了一项全面的系统评价和荟萃分析，以评估振动疗法对该人群运动和非运动症状（功能活动能力、平衡、步行耐力、步态速度、疲劳和生活质量）的影响。
方法
对PubMed、Embase、Cochrane图书馆、Web of Science、物理治疗证据数据库、Scopus、谷歌搜索引擎和中国知网（CNKI）进行系统检索。两名评价者独立评估研究质量。
结果
最终有14项研究、393名参与者纳入荟萃分析。汇总结果显示，在改善平衡功能方面，振动疗法比对照干预具有显著优势[平均差（MD）=2.04，95%置信区间（CI）：0.24 - 3.84，P = 0.03]，以及步行耐力方面（标准化均数差（SMD）=0.34，95%CI：0.07 - 0.61，P = 0.01）。同时，残疾程度亚组分析显示，与对照组相比，扩展残疾状态量表（EDSS）评分（3.5 - 6）显著改善了功能活动能力（MD：-1.18，95%CI：-2.09至0.28，P = 0.01）和平衡功能（MD：3.04，95%CI：0.49 - 5.59，P = 0.02），而EDSS（0 - 3.5）在步行耐力方面更有益。疗程亚组分析表明，疗程（<4周）对增强步行耐力的效果存在显著差异（SMD：0.46，95%CI：0.04 - 0.87，P = 0.03）。然而，在功能活动能力、步态速度、疲劳和生活质量方面未发现显著改善。
结论
振动疗法可能改善平衡功能和步行耐力，残疾程度和干预疗程可能影响结果。振动疗法对功能活动能力、步态速度、疲劳和生活质量影响的证据仍不明确。需要更多设计严谨、样本量更大的试验来提供此证据。
系统评价注册
PROSPERO，https://www.crd.york.ac.uk/prospero/#recordDetails，标识符：CRD42022326852 。
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