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大多数针对儿童和青少年肌肉骨骼疼痛的物理干预措施在临床实践中无法再现:一项随机临床试验的元研究。

Most physical interventions for musculoskeletal pain in children and adolescents cannot be reproduced in clinical practice: a meta-research study of randomized clinical trials.

机构信息

Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.

Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

出版信息

BMC Musculoskelet Disord. 2024 Sep 2;25(1):698. doi: 10.1186/s12891-024-07668-8.

Abstract

INTRODUCTION

Conservative treatments such as physical therapies are usually the most indicated for the management of musculoskeletal pain; therefore, a detailed description of interventions enables the reproducibility of interventions in clinical practice and future research. The objective of this study is to evaluate the description of physical interventions for musculoskeletal pain in children and adolescents.

METHODS

We considered randomized controlled trials that included children and adolescents between 4 and 19 years old with acute or chronic/persistent musculoskeletal pain. We included physical therapies related to all types of physical modalities aimed at reducing the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. We performed electronic searches in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to April 2024. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs) of the TIDieR checklist items described in each study. We also calculated the total TIDieR score for each study and presented these data as mean and standard deviation.

RESULTS

We included 17 randomized controlled trials. The description measured through the TIDieR checklist scored an average of 11 (5.2) points out of 24. The item of the TIDieR that was most described was item 1 (brief name) and most absent was item 10 (modifications).

CONCLUSION

The descriptions of physical interventions for the treatment of musculoskeletal pain in children and adolescents are partially described, indicating the need for strategies to improve the quality of description to enable true clinical reproducibility.

摘要

简介

对于肌肉骨骼疼痛的管理,通常最适合采用保守治疗,如物理疗法;因此,详细描述干预措施可使干预措施在临床实践和未来研究中具有可重复性。本研究的目的是评估儿童和青少年肌肉骨骼疼痛的物理干预措施的描述情况。

方法

我们纳入了纳入年龄在 4 至 19 岁之间、患有急性或慢性/持续性肌肉骨骼疼痛的儿童和青少年的随机对照试验。我们纳入了与所有类型的物理模式相关的物理疗法,旨在减轻患有肌肉骨骼疼痛的儿童和青少年的疼痛或残疾程度。干预措施的描述使用干预措施描述和复制工具(TIDieR)清单进行评估。我们在以下数据库中进行了电子检索:CENTRAL、MEDLINE、EMBASE、CINAHL、PsyINFO 和 PEDro,检索截至 2024 年 4 月。使用 TIDieR 清单中描述的每个研究的项目的频率、百分比和 95%置信区间(CI)呈现干预措施的描述。我们还计算了每个研究的 TIDieR 总分,并以平均值和标准差呈现这些数据。

结果

我们纳入了 17 项随机对照试验。通过 TIDieR 清单测量的描述平均得分为 24 分中的 11 分(5.2 分)。TIDieR 清单中描述最多的项目是第 1 项(简短名称),描述最少的项目是第 10 项(修改)。

结论

儿童和青少年肌肉骨骼疼痛治疗的物理干预措施的描述部分描述,表明需要采取策略来提高描述质量,以实现真正的临床可重复性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27af/11370070/291a9dce92f7/12891_2024_7668_Fig1_HTML.jpg

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