Hamed Hamed Dina, Struyf Filip, Pruimboom Leo, Navarro-Ledesma Santiago
Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Melilla, Spain.
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences, University of Antwerp, Melilla, Spain.
Front Physiol. 2023 Sep 4;14:1221807. doi: 10.3389/fphys.2023.1221807. eCollection 2023.
The objective of this systematic review was to analyze the existing scientific evidence on the influence of dietary strategies, exercise, and sleep disorders on the symptomatology of patients with chronic shoulder pain, as well as to assess the methodological quality of the literature collected. The selection criteria were as follows: we included randomized controlled clinical trials written in English that investigated the effects of such interventions in patients with chronic shoulder pain and excluded studies where pre-operative rehabilitation or rehabilitation combined with corticosteroid injections was performed. We searched six databases Pubmed, Cochrane Library, Web of Science, CINAHL, Sportdiscus and Scopus, using the keywords "shoulder pain," "fasting," "physical therapy modalities," "rehabilitation," "exercise," "circadian clocks," and "chronic pain" to select randomized controlled clinical trials conducted in humans and written in English. The last search was conducted on 24/01/2023. (PROSPERO:CRD42023379925). We used the tool proposed by the Cochrane Handbook to assess the risk of bias in the included studies of the 17 studies included, nine had a high risk of bias, two studies had an unclear risk of bias, and the remaining six studies had a low risk of bias. A total of 17 articles were selected, including 10 studies that showed a positive influences of exercise on chronic shoulder pain and five studies that showed a negative influence of sleep disorders on this patient profile. The remaining two articles analyzed the influence of nutritional strategies and metabolic problems in patients with chronic shoulder pain. The total sample size of the 17 included articles amounted to 9,991 individuals. Studies confirm that exercise generates a hypoalgesic effect that improves chronic shoulder pain, functionality, and quality of life. Although dietary strategies and sleep disorders are known to influence chronic shoulder pain, there is a lack of studies that conduct interventions on these problems to assess how chronic shoulder pain varies.
本系统评价的目的是分析饮食策略、运动和睡眠障碍对慢性肩痛患者症状的影响的现有科学证据，并评估所收集文献的方法学质量。选择标准如下：我们纳入了以英文撰写的随机对照临床试验，这些试验研究了此类干预措施对慢性肩痛患者的影响，并排除了进行术前康复或康复联合皮质类固醇注射的研究。我们检索了六个数据库，即PubMed、Cochrane图书馆、科学网、护理学与健康领域数据库（CINAHL）、体育与运动科学数据库（Sportdiscus）和Scopus，使用关键词“肩痛”“禁食”“物理治疗方式”“康复”“运动”“生物钟”和“慢性疼痛”来选择在人类中进行的、以英文撰写的随机对照临床试验。最后一次检索于2023年1月24日进行。（国际系统评价注册平台：CRD42023379925）。我们使用Cochrane手册提出的工具来评估纳入研究中的偏倚风险。在纳入的17项研究中，9项有高偏倚风险，2项研究的偏倚风险不明确，其余6项研究有低偏倚风险。总共选择了17篇文章，其中10项研究表明运动对慢性肩痛有积极影响，5项研究表明睡眠障碍对该患者群体有负面影响。其余两篇文章分析了营养策略和代谢问题对慢性肩痛患者的影响。17篇纳入文章的总样本量为9991人。研究证实，运动产生一种镇痛作用，可改善慢性肩痛、功能和生活质量。虽然已知饮食策略和睡眠障碍会影响慢性肩痛，但缺乏针对这些问题进行干预以评估慢性肩痛如何变化的研究。
