OBJECTIVE: This study aimed to perform a systematic review to summarize evidence if exercise therapy may be considered an effective treatment in conservative management for patients with hand and wrist tendinopathy.
METHODS: This was a systematic review.
METHODS: A literature search in MEDLINE, Cochrane Library, PEDro, and Embase was conducted from their inception until April 10, 2022. Two independent reviewers included the studies administering exercise therapy in patients with hand and/or wrist tendinopathy in the review and extrapolated the data. Methodological quality was assessed using the framework developed by Murad et al for case reports and case series and the PEDro score for clinical trials.
RESULTS: Seven case reports, 3 case series, and 2 randomized controlled studies were included and methodologically evaluated, obtaining a low score for all the analyzed studies. The total number of included patients in the analyzed studies was 106, of which 54 were female, 13 were male, and 39 were not specified. The type of exercise was widespread and often not really well described: it varies from eccentric forearm training to mobilization with movement, passing through strengthening exercises, grip proprioception training, and self-management exercises according to the McKenzie method. The dosage was often not precise, making it difficult to reproduce the therapeutic proposals. Exercise therapy was always administered together with different treatments; therefore, its efficacy alone is difficult to distinguish, although in some cases, the patients improved pain and functionality.
CONCLUSIONS: Evidence on the efficacy of exercise therapy in patients with hand and wrist tendinopathies is limited. Future research is strongly recommended to determine the appropriate dosage of the exercise therapy to determine clinical changes in these patients.
目的:本研究旨在进行系统评价,总结运动疗法是否可被视为腕部肌腱病患者保守治疗的有效治疗方法的证据。
方法:这是一个系统综述。
方法:在MEDLINE,科克伦图书馆,PEDro,Embase从成立之初一直持续到2022年4月10日。两名独立的审阅者将在手和/或腕部肌腱病变患者中进行运动疗法的研究纳入审查中,并推断了数据。使用Murad等人开发的病例报告和病例系列框架以及临床试验的PEDro评分评估方法学质量。
结果:7例病例报告,3个案例系列,纳入2项随机对照研究,并进行方法学评价,获得所有分析研究的低分。被分析的研究中纳入的患者总数为106,其中54为女性,13是男性,39个没有具体说明。运动的类型很普遍,通常没有很好的描述:从偏心的前臂训练到运动动员,通过加强练习,抓地力本体感觉训练,根据麦肯齐方法进行自我管理练习。剂量通常不精确,这使得很难重现治疗建议。运动疗法总是与不同的治疗方法一起进行;因此,单凭它的功效很难区分,虽然在某些情况下,患者疼痛和功能改善。
结论:关于手和腕部肌腱病变患者运动疗法疗效的证据有限。强烈建议将来进行研究,以确定运动疗法的适当剂量,以确定这些患者的临床变化。