活动中麦立根松动术（MWM）对踝关节扭伤患者治疗效果的影响：一项系统评价与Meta分析
The effectiveness of mulligan mobilization with movement (MWM) on outcomes of patients with ankle sprain: a systematic review and meta-analysis.
作者信息
ElMeligie Mohamed M, Abdeen Heba A, Atef Hady, Marques-Sule Elena, Karkosha Rania N
机构信息
Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt.
Department of Basic Sciences, Faculty of Physical Therapy, Al Hayah University, Cairo, Egypt.
出版信息
BMC Sports Sci Med Rehabil. 2025 Apr 29;17(1):105. doi: 10.1186/s13102-025-01121-6.
BACKGROUND
Ankle sprains are common injuries that cause pain, swelling, and reduced range of motion (ROM), adversely affecting physical activity. In this study, we aim to review the effectiveness of mobilization with movement (MWM) in improving outcomes for patients with ankle sprains.
METHODS
We conducted a search of PubMed, Cochrane Library, PEDro, Web of Science, and Scopus up to October 2023 for English trials comparing Mulligan MWM with other treatments. The Cochrane Risk of Bias tool (ROB 2) was used for quality assessment, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Heterogeneity was evaluated using Cochrane's Q and I statistics.
RESULTS
A total of 10 trials involving 419 patients (209 in the MWM group and 210 controls) were included. The overall risk of bias was low. MWM significantly reduced pain (MD = - 0.92; 95% CI:[- 1.37, - 0.46]; P < 0.0001) and improved ankle ROM (SMD = 1.65; 95% CI:[0.17, 3.14]; P = 0.03). MWM also demonstrated superior performance in the Star Excursion Balance Test (SEBT) (MD = 3.15; 95% CI:[1.44, 4.86]; P = 0.0003) and Y Balance Test (MD = 4.69; 95% CI:[1.67, 7.70]; P = 0.02). However, no significant differences were found in pain pressure threshold (SMD = - 0.10; 95% CI:[- 0.59, 0.39]; P = 0.7), stiffness perception (MD = 0.10; 95% CI:[- 0.64, 0.85]; P = 0.79), or peroneus longus latency time (MD = - 12.85; 95% CI:[- 22.08, - 3.63]; P = 0.006). The quality evaluation showed that the majority of RCTs revealed some concerns, except of two studies that established a low risk of bias. The GRADE assessment classified the overall evidence as low or very low, due to imprecision, risk of bias, and inconsistency.
CONCLUSIONS
MWM significantly reduced pain and improved ROM and WBLT scores in patients with ankle sprains. The MWM group also showed enhanced balance in the posterolateral SEBT compared to controls.
背景
踝关节扭伤是常见损伤，会导致疼痛、肿胀和活动范围（ROM）减小，对身体活动产生不利影响。在本研究中，我们旨在回顾动态关节松动术（MWM）对改善踝关节扭伤患者预后的有效性。
方法
我们检索了截至2023年10月的PubMed、Cochrane图书馆、PEDro、科学网和Scopus，查找比较Mulligan MWM与其他治疗方法的英文试验。使用Cochrane偏倚风险工具（ROB 2）进行质量评估，并计算95%置信区间（CI）的平均差异（MD）。使用Cochrane的Q和I统计量评估异质性。
结果
共纳入10项试验，涉及419例患者（MWM组209例，对照组210例）。总体偏倚风险较低。MWM显著减轻疼痛（MD = -0.92；95% CI：[-1.37，-0.46]；P < 0.0001），并改善踝关节ROM（标准化均数差[SMD] = 1.65；95% CI：[0.17，3.14]；P = 0.03）。MWM在星形偏移平衡测试（SEBT）中也表现出更好的效果（MD = 3.15；95% CI：[1.44，4.86]；P = 0.0003）和Y平衡测试（MD = 4.69；95% CI：[1.67，7.70]；P = 0.02）。然而，在疼痛压力阈值（SMD = -0.10；95% CI：[-0.59，0.39]；P = 0.7）、僵硬感（MD = 0.10；95% CI：[-0.64，0.85]；P = 0.79）或腓骨长肌潜伏期（MD = -12.85；95% CI：[-22.08，-3.63]；P = 0.006）方面未发现显著差异。质量评估表明，除两项偏倚风险较低的研究外，大多数随机对照试验存在一些问题。由于不精确性、偏倚风险和不一致性，GRADE评估将总体证据分类为低或极低。
结论
MWM显著减轻踝关节扭伤患者的疼痛，改善ROM和WBLT评分。与对照组相比，MWM组在SEBT后外侧方向的平衡能力也有所增强。
Zotero 插件