中国康复理论与实践2024，Vol.30Issue(7)：778-788,11.DOI:10.3969/j.issn.1006-9771.2024.07.005
ICF框架下运动疗法对慢性非特异性颈痛效果的Meta分析
Effect of exercise therapy on chronic nonspecific neck pain:a meta-analysis based on ICF
摘要
Abstract
Objective To systematically evaluate the effect of exercise therapy on body structure,function,and activity and partici-pation in patients with chronic nonspecific neck pain(CNSNP)based on the International Classification of Func-tioning,Disability and Health(ICF)framework. Methods A PICO framework was constructed,and randomized controlled trials(RCTs)on the intervention of different types of exercise therapy for patients with CNSNP were retrieved from databases of CBM,Wanfang data,VIP,CNKI,Cochrane Library,Embase,PubMed and Web of Science,from the establishment to March,2024.The quality of the literature was evaluated with Cochrane Risk of Bias Tool and Physiotherapy Evidence Database(PEDro)scale,and the evidence quality of the outcome indicators was evaluated using GRADE.Data were syn-thesized and analyzed using RevMan 5.3,and the risk of bias was evaluated using Stata 18.0. Results A total of eleven RCTs involving 668 subjects were included.The scores of PEDro scale were five to eight.The types of interventions included muscle strength training,stability training,proprioception training,Yoga and Pi-lates.The control groups received placebo,physical factor therapy and health education.Exercise therapy could increase the craniovertebral angle(SMD=0.84,95%CI 0.42 to 1.26,P<0.001),reduce the Visual Analogue Scale score(SMD=-2.05,95%CI-2.58 to-1.52,P<0.001),increase the pressure pain threshold(MD=112.27,95%CI 75.03 to 149.50,P<0.001),increase the range of motion of cervical forward(SMD=1.24,95%CI 0.34 to 2.15,P=0.007)and lateral(SMD=1.52,95%CI 0.40 to 2.65,P=0.008)flexion,and improve the endurance of the deep cervical flexors(SMD=1.02,95%CI 0.10 to 1.94,P=0.03)and position sense of the cervical spine(SMD=-1.00,95%CI-1.47 to-0.53,P<0.001);however,it was not significant in improving the range of motion of backward flexion(SMD=0.85,95%CI-1.04 to 2.75,P=0.38)and rotation(SMD=1.65,95%CI-0.35 to 3.65,P=0.11).Exercise therapy could also reduce the Neck Disability Index score(MD=-11.88,95%CI-16.09 to-7.68,P<0.001),and it was no significant in the Short-Form-36 score(MD=19.04,95%CI-3.00 to 41.08,P=0.09). Conclusion Exercise therapy can improve head posture,pain,motion of forward flexion and lateral flexion,endurance of the cervical flexors and joint position sense,and the overall function in patients with CNSNP.However,fur-ther researches are needed to verify the effects on cervical backward flexion and rotation,and quality of life.关键词
慢性非特异性颈痛/运动/国际功能、残疾和健康分类/Meta分析Key words
chronic nonspecific neck pain/exercise/International Classification of Functioning,Disability and Health/meta-analysis分类
医药卫生引用本文复制引用
温艳飞,杨露,班玥,张郝琪,王丽,刘华..ICF框架下运动疗法对慢性非特异性颈痛效果的Meta分析[J].中国康复理论与实践,2024,30(7):778-788,11.基金项目
1.北京高校"优质本科课程"项目(No.145122005/004) （No.145122005/004）
2.北京高等教育"本科教学改革创新项目"(No.145122002/007) （No.145122002/007）
3.内涵发展-科研-科技强校支持计划项目(No.155223021) （No.155223021）
4.内涵发展-运动科学与健康学院"一融双高"双创项目(No.515124001) （No.515124001）
5.内涵发展-《肌肉骨骼康复学》(No.515124004) Quality Undergraduate Program in Beijing Universities(No.145122005/004),Beijing Higher Education Undergraduate Teaching Reform and Innovation Project(No.145122002/007),Inner Connotation Development-Research-Science and Technology Stronger Schools Supporting Program(No.155223021),Inner Connotation Development-School of Kinesiology and Health Dual Creation Project(No.515124001),and Inner Connotation Development-Musculoskeletal Rehabilitation(No.515124004) （No.515124004）
