Doctor of Science in Physical Therapy, Bellin College, Green Bay, WI, USA.
Doctor of Physical Therapy Program, College of Rehabilitative Sciences, the University of St. Augustine for Health Sciences, Austin, TX, USA.
J Man Manip Ther. 2023 Jun;31(3):153-161. doi: 10.1080/10669817.2022.2113295. Epub 2022 Sep 1.
Neck pain is a leading cause of disability, and manual therapy (MT) is a common intervention used across disciplines and settings to treat it. While there is consistent support for MT in managing neck pain, questions remain about the feasibility of incorporating MT from research into clinical practice. The purpose of this scoping review was to assess the adequacy of MT intervention descriptions and the variability in clinician and setting for MT delivery in trials for neck pain.
Medline (via PubMed), CINAHL, PEDRo, and the Cochrane Central Registry for Controlled Trials were searched for clinical trials published from January 2010 to November 2021. A 11-item tool modified from the Consensus on Exercise Reporting Template was used to assess appropriateness of intervention reporting. Clinicians, subclassifications of neck pain, and clinical settings were also extracted.
113 trials were included. A low percentage of studies provided the recommended level of detail in the description of how MT was delivered (4.4%), while 39.0% included no description at all. Just over half of trials included clinician's qualifications (58.4%), dose of MT (59.3%), and occurrence of adverse events (55.8%). The proportion of trials with clinicians delivering MT were physical therapists (77.9%), chiropractors (10.6%), and osteopaths (2.7%).
DISCUSSION/CONCLUSION: These results reveal incomplete reporting of essential treatment parameters, and a lack of clinician diversity. To foster reproducibility, researchers should report detailed descriptions of MT interventions. Future research should incorporate a variety of MT practitioners to improve generalizability.
颈部疼痛是导致残疾的主要原因之一,手法治疗(MT)是一种常见的干预措施,被广泛应用于各种学科和环境,用于治疗颈部疼痛。尽管 MT 在管理颈部疼痛方面得到了一致的支持,但在将 MT 从研究纳入临床实践的可行性方面仍存在疑问。本研究旨在评估颈部疼痛试验中 MT 干预描述的充分性以及 MT 实施者和环境的变异性。
通过 Medline(通过 PubMed)、CINAHL、PEDRo 和 Cochrane 对照试验中心注册库,检索 2010 年 1 月至 2021 年 11 月发表的临床试验。使用从共识运动报告模板修改而来的 11 项工具来评估干预措施报告的适当性。还提取了实施者、颈部疼痛亚类和临床环境。
共纳入 113 项试验。只有少数研究(4.4%)提供了 MT 实施方式的详细描述,而 39.0%的研究则完全没有描述。超过一半的试验包括实施者的资格(58.4%)、MT 的剂量(59.3%)和不良事件的发生(55.8%)。实施 MT 的实施者大多是物理治疗师(77.9%)、脊椎按摩师(10.6%)和整骨师(2.7%)。
讨论/结论:这些结果表明,重要的治疗参数报告不完整,且实施者缺乏多样性。为了提高可重复性,研究人员应报告 MT 干预措施的详细描述。未来的研究应纳入各种 MT 从业者,以提高其普遍性。