Al Hanna Reem, Cofré Lizama Luis Eduardo, Amatya Bhasker, Galea Mary P, Khan Fary
Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, Australia.
Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, Australia.
Disabil Rehabil. 2024 Dec;46(26):6266-6287. doi: 10.1080/09638288.2024.2327482. Epub 2024 Mar 15.
To systematically evaluate evidence from published systematic reviews for the effectiveness of rehabilitation interventions in adults with burn injury.
A comprehensive literature review conducted using medical and health science electronic databases up to 31 July 2022. Two independent reviewers selected studies, extracted data, and assessed methodological study quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2), and the certainty of evidence for reported outcomes using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool.
Twenty-one systematic reviews evaluated five categories of interventions: physical, psychological, technology-aided modalities, educational and occupational programs, complementary and alternative medicine. Outcomes included fitness level, hand function, oedema, pain, pruritus, psychological state, quality of life, range of motion, return to work, strength, scar characteristics, level of impairment and burn knowledge. The methodological quality was rated as "critically low" for all reviews. Quality of evidence for the effectiveness of evaluated interventions ranged from "moderate to very low."
Beneficial effects of inhaled aromatherapy and extracorporeal shockwave therapy on pain reduction; inhaled or massage aromatherapy, music therapy on anxiety were reported. Safety of interventions was not evaluated, due to the lack of adverse event reporting in primary studies and the included reviews.
系统评价已发表的系统评价中关于烧伤成年患者康复干预效果的证据。
截至2022年7月31日，使用医学和健康科学电子数据库进行全面的文献综述。两名独立评审员选择研究、提取数据，并使用系统评价评估测量工具（AMSTAR-2）评估研究方法质量，使用推荐分级、评估、制定与评价（GRADE）工具评估报告结果的证据确定性。
21项系统评价评估了五类干预措施：物理、心理、技术辅助方式、教育和职业项目、补充和替代医学。结果包括体能水平、手部功能、水肿、疼痛、瘙痒、心理状态、生活质量、关节活动范围、重返工作岗位、力量、瘢痕特征、损伤程度和烧伤知识。所有综述的方法学质量均被评为“极低”。所评估干预措施有效性的证据质量从“中等至极低”不等。
有报道称吸入式芳香疗法和体外冲击波疗法对减轻疼痛有有益效果；吸入式或按摩式芳香疗法、音乐疗法对焦虑有效果。由于原始研究和纳入综述中缺乏不良事件报告，未对干预措施的安全性进行评估。
