Diao Yingxiu, Pan Jiaxin, Xie Yuhua, Liao Manxia, Wu Dongyu, Liu Hao, Liao Linrong
Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Guangdong; School of Rehabilitation Medicine, Gannan Medical University, Jiangxi.
School of Rehabilitation Medicine, Gannan Medical University, Jiangxi; School of Rehabilitation Medicine, Weifang Medical University, Shandong.
Arch Phys Med Rehabil. 2023 Sep;104(9):1526-1538. doi: 10.1016/j.apmr.2023.03.016. Epub 2023 Apr 26.
The purpose of this meta-analysis was to investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on pain intensity, functional mobility, and kinesiophobia in individuals with low back pain (LBP).
The PubMed, Physiotherapy Evidence Database, Embase, Cochrane Library, and Web of Science databases were systematically searched from inception until November 25, 2022.
Eligible randomized controlled trials contained information on the population (LBP), intervention (rPMS), and outcomes (pain intensity, functional mobility, and kinesiophobia). Participants in the rPMS intervention group were compared with those in sham or other control groups. Two independent researchers searched for, screened, and qualified the articles.
Two independent researchers extracted key information from each eligible study. The authors' names, year of publication, setting, total sample size, rPMS parameters, baseline/mean difference (MD), and 95% confidence interval (CI) were extracted using a standardized form, and the methodological quality was assessed using the Physiotherapy Evidence Database score and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system.
Of 733 studies identified, 6 randomized controlled trials (n = 139) were included for meta-analysis. Compared with sham rPMS or other therapy, rPMS showed significant efficacy in reducing pain intensity (visual analog scale: MD, -1.89; 95% CI, -3.32 to -0.47; P<.05; very low-quality evidence). Significant efficacy was also found in terms of functional disability (Oswestry Disability Index: MD, -8.39; 95% CI, -13.65 to -3.12; P<.001; low-quality evidence). However, there was no statistically significant between-group difference on the Tampa scale of kinesiophobia (MD, -1.81; 95% CI, -7.60 to 3.98; P>.05; very low-quality evidence).
This meta-analysis found very low- to low-quality evidence that rPMS can be used to reduce pain intensity and improve functional disability in individuals with LBP. However, no significant effect of rPMS on kinesiophobia was found.
本荟萃分析旨在研究重复经外周磁刺激(rPMS)对腰痛(LBP)患者疼痛强度、功能活动度和运动恐惧的影响。
对PubMed、物理治疗证据数据库、Embase、Cochrane图书馆和Web of Science数据库进行系统检索,检索时间从建库至2022年11月25日。
符合条件的随机对照试验需包含有关研究对象(LBP患者)、干预措施(rPMS)和结局指标(疼痛强度、功能活动度和运动恐惧)的信息。将rPMS干预组的参与者与假刺激组或其他对照组的参与者进行比较。两名独立研究人员对文章进行检索、筛选和资格审定。
两名独立研究人员从每项符合条件的研究中提取关键信息。使用标准化表格提取作者姓名、发表年份、研究背景、总样本量、rPMS参数、基线/平均差值(MD)和95%置信区间(CI),并使用物理治疗证据数据库评分和GRADE(推荐分级、评估、制定与评价)系统评估方法学质量。
在检索到的733项研究中,纳入6项随机对照试验(n = 139)进行荟萃分析。与假刺激rPMS或其他治疗相比,rPMS在降低疼痛强度方面显示出显著疗效(视觉模拟量表:MD,-1.89;95%CI,-3.32至-0.47;P<0.05;极低质量证据)。在功能障碍方面也发现了显著疗效(Oswestry功能障碍指数:MD,-8.39;95%CI,-13.65至-3.12;P<0.001;低质量证据)。然而,在坦帕运动恐惧量表上,组间差异无统计学意义(MD,-1.81;95%CI,-7.60至3.98;P>0.05;极低质量证据)。
本荟萃分析发现,有极低至低质量的证据表明rPMS可用于降低LBP患者的疼痛强度并改善功能障碍。然而,未发现rPMS对运动恐惧有显著影响。