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肌筋膜松解术治疗慢性机械性颈痛患者的疼痛和功能障碍:随机对照试验的系统评价和荟萃分析

Myofascial release for the treatment of pain and dysfunction in patients with chronic mechanical neck pain: Systematic review and meta-analysis of randomised controlled trials.

作者信息

Guo Yaorui, Lv Xiuying, Zhou Yu, Li Zhijun, She Huiping, Bai Li, Bao Jing

机构信息

Department of Rehabilitation, The First People's Hospital of Yinchuan, Yinchuan, China.

Department of Pediatric Rehabilitation, 74747General Hospital of Ningxia Medical University, Yinchuan, China.

出版信息

Clin Rehabil. 2023 Apr;37(4):478-493. doi: 10.1177/02692155221136108. Epub 2022 Oct 27.

DOI:10.1177/02692155221136108
PMID:36305079
Abstract

OBJECTIVE

To explore the effects of myofascial release (MFR) on pain and dysfunction in individuals with chronic mechanical neck pain (MNP).

DATA SOURCES

PubMed, Embase, Medline, Wiley Online Library, Web of Science, CNKI, VIP, WanFang Data, and the Cochrane Library were searched until 12 September 2022.

REVIEW METHODS

This study was registered in PROSPERO (CRD42022302485). Methodological quality was assessed using Cochrane risk of bias assessment, and the quality of the evidence followed the GRADE recommendation. The outcomes pain, cervical mobility (Flexion, Extension, Rotation, lateral flexion), trapezius and suboccipital pressure pain thresholds (PPT), neck disability index (NDI), and adverse effects were extracted.

RESULTS

After screening of 346 studies, 13 studies and 601 participants met the inclusion criteria. All studies were of moderate methodological quality. Compared with the control group, the participants in the MFR group showed significantly greater improvements trapezius PPT SMD 0.41 (95% CI 0.11-0.72), suboccipital PPT SMD 0.47 (95% CI 0.21-0.72), respectively. The differences were not significant to support the MFR treatment on pain, flexion, extension, rotation, lateral flexion angle, and NDI. None of the studies reported any adverse events.

CONCLUSION

This systematic review suggests that MFR is an effective treatment for the improvement of PPT of trapezius and suboccipital muscle in patients with chronic MNP. However, there is low to moderate evidence and may change over time.

摘要

目的

探讨肌筋膜放松(MFR)对慢性机械性颈痛(MNP)患者疼痛和功能障碍的影响。

数据来源

检索了PubMed、Embase、Medline、Wiley Online Library、Web of Science、中国知网(CNKI)、维普资讯(VIP)、万方数据和Cochrane图书馆,检索截至2022年9月12日。

综述方法

本研究在国际前瞻性注册系统(PROSPERO,注册号:CRD42022302485)登记。采用Cochrane偏倚风险评估方法评估方法学质量,证据质量遵循GRADE推荐标准。提取疼痛、颈椎活动度(前屈、后伸、旋转、侧屈)、斜方肌和枕下肌压痛阈(PPT)、颈部功能障碍指数(NDI)以及不良反应等结局指标。

结果

在筛选的346项研究中,13项研究及601名参与者符合纳入标准。所有研究的方法学质量均为中等。与对照组相比,MFR组参与者的斜方肌PPT[标准化均数差(SMD)为0.41,95%可信区间(CI)为0.11 - 0.72]和枕下肌PPT(SMD为0.47,95%CI为0.21 - 0.72)改善更为显著。在疼痛、前屈、后伸、旋转、侧屈角度及NDI方面,差异无统计学意义,不足以支持MFR治疗。所有研究均未报告任何不良事件。

结论

本系统综述表明,MFR是改善慢性MNP患者斜方肌和枕下肌PPT的有效治疗方法。然而,证据质量低至中等,且可能随时间变化。

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