Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Sweden.
Department of Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals' Theme, Karolinska University Hospital, Stockholm, Sweden.
BMC Musculoskelet Disord. 2023 Oct 12;24(1):806. doi: 10.1186/s12891-023-06930-9.
To date, no consensus exists as to whether one exercise type is more effective than another in chronic neck pain. This systematic review and meta-analysis of systematic reviews aimed to summarize the literature on the effect of various exercise types used in chronic neck pain and to assess the certainty of the evidence.
We searched the databases Ovid MEDLINE, Embase, Cochrane Library, SportDiscus, and Web of Science (Core Collection) for systematic reviews and meta-analyses on adults between 18 and 70 years with chronic neck pain lasting ≥ 12 weeks which investigated the effects of exercises on pain and disability. The included reviews were grouped into motor control exercise (MCE), Pilates exercises, resistance training, traditional Chinese exercise (TCE), and yoga. Study quality was assessed with AMSTAR-2 and the level of certainty for the effects of the exercise through GRADE. A narrative analysis of the results was performed and in addition, meta-analyses when feasible.
Our database search resulted in 1,794 systematic reviews. We included 25 systematic reviews and meta-analyses including 17,321 participants (overlap not accounted for). The quality of the included reviews ranged from critically low to low (n = 13) to moderate to high (n = 12). We found low to high certainty of evidence that MCE, Pilates exercises, resistance training, TCE, and yoga have short-term positive effects on pain and that all exercise types except resistance training, show positive effects on disability compared to non-exercise controls. We found low to moderate certainty of evidence for conflicting results on pain and disability when the exercise types were compared to other exercise interventions in the short-term as well as in intermediate/long-term apart for yoga, as no long-term results were available.
Overall, our findings show low to high certainty of evidence for positive effects on pain and disability of the various exercise types used in chronic neck pain compared to non-exercise interventions, at least in the short-term. Based on our results, no optimal exercise intervention for patients with chronic neck pain can be recommended, since no large differences between the exercise types were shown here. Because the quality of the included systematic reviews varied greatly, future systematic reviews need to increase their methodological quality.
Prospero CRD42022336014.
迄今为止，对于哪种运动类型在慢性颈痛中更有效，尚无共识。本系统评价和系统评价的荟萃分析旨在总结关于各种运动类型用于慢性颈痛的文献，并评估证据的确定性。
我们在 Ovid MEDLINE、Embase、Cochrane 图书馆、SportDiscus 和 Web of Science（核心合集）数据库中搜索了关于 18 至 70 岁成年人慢性颈痛持续时间≥12 周的系统评价和荟萃分析，这些系统评价和荟萃分析调查了运动对疼痛和残疾的影响。纳入的综述分为运动控制训练（MCE）、普拉提练习、阻力训练、传统中医练习（TCE）和瑜伽。使用 AMSTAR-2 评估研究质量，并使用 GRADE 评估运动效果的确定性级别。对结果进行叙述性分析，并在可行的情况下进行荟萃分析。
我们的数据库搜索产生了 1794 篇系统评价。我们纳入了 25 篇系统评价和荟萃分析，共纳入 17321 名参与者（未考虑重叠）。纳入的综述质量从批判性低到低（n=13）到中等到高（n=12）不等。我们发现 MCE、普拉提练习、阻力训练、TCE 和瑜伽在短期对疼痛有积极影响的证据质量为低到高，除了阻力训练之外，所有运动类型与非运动对照组相比，对残疾都有积极影响。我们发现，当在短期和中期/长期内将运动类型与其他运动干预进行比较时，除了瑜伽外，对于疼痛和残疾的结果存在低到中等确定性的证据，因为没有长期结果。
总的来说，与非运动干预相比，我们的发现表明，在慢性颈痛中使用各种运动类型至少在短期对疼痛和残疾有低到高确定性的证据。基于我们的结果，不能推荐慢性颈痛患者的最佳运动干预措施，因为这里没有显示出运动类型之间的显著差异。由于纳入的系统评价质量差异很大，未来的系统评价需要提高其方法学质量。
Prospero CRD42022336014。
