Elsig Simone, Allet Lara, Bastiaenen Caroline Henrice Germaine, de Bie Rob, Hilfiker Roger
School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Rathausstrasse 25, 3954, Valais, Leukerbad, Switzerland.
Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI - Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, Maastricht, the Netherlands.
Arch Physiother. 2023 Aug 15;13(1):15. doi: 10.1186/s40945-023-00170-9.
Neck pain is one of the leading causes of years lived with disability, and approximately half of people with neck pain experience recurrent episodes. Deficits in the sensorimotor system can persist even after pain relief, which may contribute to the chronic course of neck pain in some patients. Evaluation of sensorimotor capacities in patients with neck pain is therefore important. No consensus exists on how sensorimotor capacities of the neck should be assessed in physiotherapy. The aims of this systematic review are: (a) to provide an overview of tests used in physiotherapy for assessment of sensorimotor capacities in patients with neck pain; and (b) to provide information about reliability and measurement error of these tests, to enable physiotherapists to select appropriate tests.
Medline, CINAHL, Embase and PsycINFO databases were searched for studies reporting data on the reliability and/or measurement error of sensorimotor tests in patients with neck pain. The results for reliability and measurement error were compared against the criteria for good measurement properties. The quality of evidence was assessed according to the modified GRADE method proposed by the COSMIN group.
A total of 206 tests for assessment of sensorimotor capacities of the neck were identified and categorized into 18 groups of tests. The included tests did not cover all aspects of the sensorimotor system; tests for the sensory and motor components were identified, but not for the central integration component. Furthermore, no data were found on reliability or measurement error for some tests that are used in practice, such as movement control tests, which apply to the motor component. Approximately half of the tests showed good reliability, and 12 were rated as having good (+) reliability. However, tests that evaluated complex movements, which are more difficult to standardize, were less reliable. Measurement error could not be evaluated because the minimal clinically important change was not available for all tests.
Overall, the quality of evidence is not yet high enough to enable clear recommendations about which tests to use to assess the sensorimotor capacities of the neck.
颈部疼痛是导致残疾生存年数的主要原因之一，约半数颈部疼痛患者会经历反复发作。即使疼痛缓解后，感觉运动系统的缺陷仍可能持续存在，这可能导致部分患者颈部疼痛呈慢性病程。因此，评估颈部疼痛患者的感觉运动能力很重要。在物理治疗中，对于如何评估颈部的感觉运动能力尚无共识。本系统评价的目的是：(a) 概述物理治疗中用于评估颈部疼痛患者感觉运动能力的测试；(b) 提供这些测试的可靠性和测量误差信息，以使物理治疗师能够选择合适的测试。
检索Medline、CINAHL、Embase和PsycINFO数据库，查找报告颈部疼痛患者感觉运动测试可靠性和/或测量误差数据的研究。将可靠性和测量误差的结果与良好测量特性的标准进行比较。根据COSMIN小组提出的改良GRADE方法评估证据质量。
共识别出206项评估颈部感觉运动能力的测试，并将其分为18组测试。纳入的测试未涵盖感觉运动系统的所有方面；识别出了感觉和运动成分的测试，但未涉及中枢整合成分的测试。此外，对于一些实际应用的测试，如适用于运动成分的运动控制测试，未找到关于可靠性或测量误差的数据。约半数测试显示出良好的可靠性，12项被评为具有良好（+）可靠性。然而，评估更难标准化的复杂运动的测试可靠性较低。由于并非所有测试都有最小临床重要变化，因此无法评估测量误差。
总体而言，证据质量尚不足以就使用哪些测试来评估颈部感觉运动能力给出明确建议。
