足底感觉治疗对慢性踝关节不稳患者姿势控制的影响：系统评价和荟萃分析。
Effects of plantar-sensory treatments on postural control in chronic ankle instability: A systematic review and meta-analysis.
机构信息
Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China.
出版信息
PLoS One. 2023 Jun 27;18(6):e0287689. doi: 10.1371/journal.pone.0287689. eCollection 2023.
OBJECTIVE
This study aimed to examine the effects of plantar-sensory treatments on postural control in individuals with chronic ankle instability (CAI).
METHODS
This study was registered in PROSPERO (registration number CRD42022329985) on May 14, 2022. An extensive search was performed in Pubmed, Embase, Cochrane, Web of Science, and Scopus to identify the potential studies on plantar-sensory treatments affecting postural control before May 2022. The methodological quality of involved studies was assessed using the scale of Physiotherapy Evidence Database (PEDro). The Cochrane Tool and the Risk of Bias in Non-randomized Studies of Interventions assessment tool were used to evaluate the risk of bias in randomised controlled trials (RCTs) and non-RCTs respectively. RevMan 5.4 was utilised to calculate the standardised mean difference (SMD), with 95% confidence interval (CI).
RESULTS
Eight RCTs with a mean PEDro rating of 6 and four non-RCTs with a mean PEDro rating of 4.75 were included in the quantitative analysis. The types of plantar-sensory treatments included plantar massage, whole-body vibration and textured surface-stimulation treatment. A significant effect of static balance with eyes open (SMD = -0.54; 95% CI: -0.81 to -0.27; p < 0.001) was found and subgroup analysis showed that plantar massage (SMD = -0.49; 95% CI: -0.84 to -0.14; p = 0.006) and whole-body vibration (SMD = -0.66; 95% CI: -1.12 to -0.19; p = 0.005) had positive effects. In the subgroup analysis of anterior dynamic balance, whole-body vibration revealed a significant increase (SMD = 0.60; 95% CI: 0.06-1.14; p = 0.03). The pooled results or subgroup analysis including eyes-closed static balance and other directions of dynamic balance indicated no significant difference (p > 0.05).
CONCLUSIONS
This meta-analysis indicated that plantar-sensory treatments could improve postural control in CAI, especially the treatments of plantar massage and long-term whole-body vibration.
目的
本研究旨在探讨足底感觉治疗对慢性踝关节不稳（CAI）患者姿势控制的影响。
方法
本研究于 2022 年 5 月 14 日在 PROSPERO（注册号 CRD42022329985）上注册。我们对 Pubmed、Embase、Cochrane、Web of Science 和 Scopus 进行了广泛检索，以确定 2022 年 5 月之前有关足底感觉治疗影响姿势控制的潜在研究。使用 Physiotherapy Evidence Database（PEDro）量表评估纳入研究的方法学质量。使用 Cochrane 工具和非随机干预研究的偏倚风险评估工具分别评估随机对照试验（RCT）和非 RCT 的偏倚风险。使用 RevMan 5.4 计算标准化均数差（SMD），置信区间（CI）为 95%。
结果
纳入了 8 项 PEDro 平均评分为 6 的 RCT 和 4 项 PEDro 平均评分为 4.75 的非 RCT 进行定量分析。足底感觉治疗的类型包括足底按摩、全身振动和纹理表面刺激治疗。发现睁眼静态平衡有显著影响（SMD=-0.54；95%CI：-0.81 至-0.27；p<0.001），亚组分析显示足底按摩（SMD=-0.49；95%CI：-0.84 至-0.14；p=0.006）和全身振动（SMD=-0.66；95%CI：-1.12 至-0.19；p=0.005）有积极影响。在前庭动态平衡的亚组分析中，全身振动显示出显著增加（SMD=0.60；95%CI：0.06-1.14；p=0.03）。包括闭眼静态平衡和其他方向动态平衡的汇总结果或亚组分析表明无显著差异（p>0.05）。
结论
这项荟萃分析表明，足底感觉治疗可以改善 CAI 患者的姿势控制，特别是足底按摩和长期全身振动治疗。
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