Institute of Sports Medicine, Peking University Third Hospital, China.
Nursing Department, Peking University Third Hospital, China.
Asian Nurs Res (Korean Soc Nurs Sci). 2023 May;17(2):53-60. doi: 10.1016/j.anr.2023.03.001. Epub 2023 Mar 16.
Ankle pump exercises (APE) have been widely used in clinical practice. However, best practices for APE have not been established. Recognize the most effective frequency of APE for improving lower extremity hemodynamics and establish recommendations in clinical practice.
Therefore, a systematic review and network meta-analysis (NMA) was performed according to PRISMA-NMA. Six English databases (Pubmed, Medline, CINAHL, Embase, the Cochrane library and ProQuest) and four Chinese databases (CNKI, Wanfang, VIP and Sinomed) were searched. Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of different frequencies of APE on lower limb hemodynamics published before July 2022 were included. The reference list was also searched. Seven studies (one RCTs and six quasi-experimental studies) were included in the systematic review and five studies (one RCTs and four quasi-experimental studies) were included in the NMA. The risk of bias was assessed using the Cochrane and Joanna Briggs Institute tools. The NMA was performed using the R software (version 4.2.1) and OpenBUGS (version 3.2.3).
The results of the NMA showed that a frequency of every 3-4 s the most effective in improving lower extremity hemodynamics (P =.85), followed by every 1-2 s (P = .81), every 5-6 s (P=.32) and less than every 10 s (P =.02). Subgroup analysis failed to find a difference between healthy participants and those with unilateral total hip arthroplasty or fracture (MD = -0.23, 95% CI-5.92 to 4.61).
Consequencely, for adult patients, with or without lower extremity disease, a frequency of every 3-4 s can be recommended as the optimal frequency of APE in clinical care practice.
CRD42022349365. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365.
踝关节泵运动（APE）在临床实践中被广泛应用。然而，APE 的最佳实践尚未确定。本研究旨在确定改善下肢血液动力学的最佳 APE 频率，并在临床实践中提出建议。
因此，根据 PRISMA-NMA 进行了系统评价和网络荟萃分析（NMA）。检索了 6 个英文数据库（PubMed、Medline、CINAHL、Embase、Cochrane 图书馆和 ProQuest）和 4 个中文数据库（CNKI、万方、VIP 和中国生物医学文献数据库），检索时间截至 2022 年 7 月前发表的关于不同频率 APE 对下肢血液动力学影响的随机对照试验（RCT）和准实验研究。还检索了参考文献列表。系统评价纳入了 7 项研究（1 项 RCT 和 6 项准实验研究），NMA 纳入了 5 项研究（1 项 RCT 和 4 项准实验研究）。使用 Cochrane 和 Joanna Briggs 研究所工具评估偏倚风险。使用 R 软件（版本 4.2.1）和 OpenBUGS（版本 3.2.3）进行 NMA。
NMA 的结果显示，每 3-4 秒的频率在改善下肢血液动力学方面最为有效（P=.85），其次是每 1-2 秒（P=.81）、每 5-6 秒（P=.32）和每 10 秒以下（P=.02）。亚组分析未发现健康参与者与单侧全髋关节置换或骨折参与者之间存在差异（MD=-0.23，95%CI-5.92 至 4.61）。
因此，对于成人患者，无论是否患有下肢疾病，每 3-4 秒的频率可作为临床护理实践中 APE 的最佳频率推荐。
CRD42022349365。https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365。
