Siva Sathya, Suganthirababu Prathap, Prakash V Surya, Titus J, Vignesh S, Priyadharshini K, Dhanusia S, Santhanalakshmi S, Vanitha J, Das Kishoremoy, Fazulah Mohammed Arifullah Mohamed
Department of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.
Int J Ther Massage Bodywork. 2025 Jun 12;18(2):28-39. doi: 10.3822/ijtmb.v18i2.1203. eCollection 2025 Jun.
Tendinopathies are common musculoskeletal disorders characterized by pain and functional impairment, often requiring therapeutic interventions for effective management. This systematic review and meta-analysis aimed to evaluate the effectiveness of deep transverse frictional massage (DTFM) combined with conventional therapy for the treatment of tendinopathies.
A study search of electronic databases including MEDLINE, Google Scholar, and PubMed databases, was conducted for randomized controlled trials, pilot study, and comparative study design comparing the combined application of DTFM with conventional physiotherapy (e.g., exercise, stretching, or modalities) to conventional therapy alone for the treatment of tendinopathies. Inclusion criteria were studies that reported clinical outcomes such as pain reduction and disability. Data extraction was performed independently by reviewers. A meta-analysis was conducted using random-effects models to estimate the pooled effect size, and heterogeneity was assessed using the I statistic. The risk of bias was assessed using the Cochrane risk-of-bias approach.
A total of 13 studies met the inclusion criteria. The combined treatment group (DTFM + conventional therapy) showed significant improvements in pain reduction (standardized mean difference (SMD) = -0.92, 95% confidence interval (CI): -1.70 to -0.14, p < 0.05) and disability in the shoulder (SMD = -15.05, 95% CI: -15.60 to -14.50, p < 0.05) and elbow (SMD = -2.67, 95% CI: -3.38 to -1.96, p < 0.05) compared to conventional therapy alone. No significant adverse effects were reported.
The findings suggest that DTFM, when combined with conventional therapy, offers significant benefits over conventional therapy alone in the management of tendinopathies, particularly in reducing pain and improving function. The exact physiological mechanisms through which DTFM works in combination with conventional therapies remain unclear. Research into how DTFM influences tissue healing, collagen remodeling, or pain reduction pathways could provide more insights into its effectiveness and guide its integration into treatment protocols.
肌腱病是常见的肌肉骨骼疾病，其特征为疼痛和功能障碍，通常需要进行治疗干预以实现有效管理。本系统评价和荟萃分析旨在评估深部横向摩擦按摩（DTFM）联合传统疗法治疗肌腱病的有效性。
对包括MEDLINE、谷歌学术和PubMed数据库在内的电子数据库进行研究检索，查找随机对照试验、试点研究和比较研究设计，比较DTFM与传统物理治疗（如运动、拉伸或理疗方式）联合应用与单纯传统疗法治疗肌腱病的效果。纳入标准为报告疼痛减轻和功能障碍等临床结局的研究。由评审人员独立进行数据提取。使用随机效应模型进行荟萃分析以估计合并效应量，并使用I统计量评估异质性。采用Cochrane偏倚风险方法评估偏倚风险。
共有13项研究符合纳入标准。与单纯传统疗法相比，联合治疗组（DTFM + 传统疗法）在减轻疼痛（标准化均数差（SMD）= -0.92，95%置信区间（CI）：-1.70至-0.14，p < 0.05）以及肩部功能障碍（SMD = -15.05，95% CI：-15.60至-14.50，p < 0.05）和肘部功能障碍（SMD = -
2.67，95% CI：-3.38至-1.96，p < 0.05）方面有显著改善。未报告明显不良反应。
研究结果表明，DTFM与传统疗法联合应用在肌腱病管理方面比单纯传统疗法具有显著优势，尤其是在减轻疼痛和改善功能方面。DTFM与传统疗法联合作用的确切生理机制尚不清楚。对DTFM如何影响组织愈合、胶原蛋白重塑或疼痛减轻途径的研究可能会为其有效性提供更多见解，并指导其纳入治疗方案。
