Alaca Nuray, Acar Ali Ömer, Öztürk Sergen
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Acibadem Mehmet Ali Aydınlar, Kerem Aydinlar Kampusu, Icerenkoy Mah. Kayisdagi Cad. No: 32, Atasehir, 34752, Istanbul, Turkey.
Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Marmara, İstanbul, Turkey.
Sci Rep. 2025 Jan 2;15(1):205. doi: 10.1038/s41598-024-84016-9.
This systematic review and meta-analysis aims to assess the effects of movement representation techniques (MRT) on pain, range of motion, functional outcomes, and pain-related fear in patients with non-specific shoulder pain (NSSP). A literature search conducted in PubMed, PEDro, EBSCO, Scopus, Cochrane Library, ScienceDirect, and gray literature on April 31, 2023. We selected seven randomized controlled trials based on the PICOS framework. Incomplete data or non-NSSP excluded. Study quality was assessed using the PEDro scale (mean score = 6.43), and certainty of evidence was evaluated with the GRADE approach. MRT demonstrated a large effect size for pain reduction (high heterogeneity, I2 = 85.2%, Hedges'g = 1.324, 95% CI = 0.388-2.260, P = 0.006), functional improvement (moderate heterogeneity, I2 = 70.82%, Hedges'g = 1.263, 95% CI = 0.622-1.904, P < 0.001), and reduction of pain-related fear (moderate heterogeneity, I2 = 70.86%, Hedges'g = 0.968, 95% CI = 0.221-1.716, P < 0.001). MRT also showed significant benefits for range of motion, particularly in flexion (low heterogeneity, I2 = 26.38%, Hedges'g = 0.683), abduction (low heterogeneity, I2 = 33.27%, Hedges'g = 0.756), and external rotation (low heterogeneity, I2 = 48.33%, Hedges'g = 0.542) (P < 0.001 for all), while no significant effect was found for internal rotation (P > 0.05). No publication bias was detected. While limited evidence and methodological concerns necessitate further research, MRT appears to positively impact pain, range of motion, functional outcomes, and pain-related fear in NSSP patients.
本系统评价和荟萃分析旨在评估运动表象技术（MRT）对非特异性肩痛（NSSP）患者的疼痛、关节活动范围、功能结局以及与疼痛相关的恐惧的影响。于2023年4月31日在PubMed、PEDro、EBSCO、Scopus、Cochrane图书馆、ScienceDirect以及灰色文献中进行了文献检索。我们根据PICOS框架选择了七项随机对照试验。排除数据不完整或非NSSP的研究。使用PEDro量表评估研究质量（平均得分=6.43），并采用GRADE方法评估证据的确定性。MRT在减轻疼痛方面显示出较大的效应量（异质性高，I2=85.2%，Hedges'g=1.324，95%CI=0.388-2.260，P=0.006），在功能改善方面（异质性中等，I2=70.82%，Hedges'g=1.263，95%CI=0.622-1.904，P<0.001），以及在减轻与疼痛相关的恐惧方面（异质性中等，I2=70.86%，Hedges'g=0.968，95%CI=0.221-1.716，P<0.001）。MRT在关节活动范围方面也显示出显著益处，尤其是在屈曲（异质性低，I2=26.38%）、外展（异质性低，I2=33.27%）和外旋（异质性中等，I2=48.33%）方面（所有P<0.001），而在内旋方面未发现显著影响（P>0.05）。未检测到发表偏倚。虽然有限的证据和方法学问题需要进一步研究，但MRT似乎对NSSP患者的疼痛、关节活动范围、功能结局以及与疼痛相关的恐惧有积极影响。
