Abstract：
This systematic review and meta-analysis aimed to identify, critically appraise, and synthesize current evidence regarding the effects of spinal mobilization on physical function in patients with stroke. Three databases, PubMed, Embase, and Scopus, were searched from inception to March 15, 2024. Randomized controlled trials comparing the effects of spinal mobilization to conventional therapy were eligible for inclusion. Methodological quality was assessed using the Physiotherapy Evidence Database scale. Meta-analyses were performed to determine the effects of spinal mobilization. Nine randomized controlled trials were included, with a total of 294 patients with stroke. All included studies were evaluated as good or above for quality assessment. No adverse events related to spinal mobilization were reported. Compared to conventional therapy, spinal mobilization demonstrated significantly improved forward head posture (SMD: 1.00, 95% CI: 0.53 to 1.46, p < 0.001); there were no between-group differences on forced vital capacity (SMD: 0.44, 95% CI: -0.01 to 0.88, p = 0.06), forced expiratory volume (SMD: 0.33, 95% CI: -0.12 to 0.77, p = 0.15), balance (SMD: 0.36, 95% CI: -0.04 to 0.77, p = 0.08), gait speed (SMD: 0.48, 95% CI: -0.44 to 1.40, p = 0.31), and trunk function (SMD: 0.79, 95% CI: -0.17 to 1.75, p = 0.11). Cervical mobilization significantly improved forward head posture; however, no significant differences were found in other outcomes. Clinicians may consider spinal mobilization as an adjunctive intervention in stroke rehabilitation to address posture-related impairments to expand treatment strategy and optimize quality of care.
摘要：
本系统综述和荟萃分析旨在确定，批判性评价，并综合目前有关脊柱动员对中风患者身体功能影响的证据。三个数据库,PubMed,Embase,还有Scopus,从成立之初到2024年3月15日进行了搜索。比较脊柱动员与常规治疗效果的随机对照试验符合纳入条件。使用物理治疗证据数据库量表评估方法质量。进行荟萃分析以确定脊柱动员的效果。包括9项随机对照试验，共有294名中风患者。所有纳入的研究均被评估为良好或高于质量评估。未报告与脊髓动员相关的不良事件。与常规治疗相比,脊柱动员显示前头姿势显着改善（SMD：1.00，95％CI：0.53至1.46，p<0.001）；强迫肺活量没有组间差异（SMD：0.44，95％CI：-0.01至0.88，p=0.06），用力呼气量（SMD：0.33，95%CI：-0.12至0.77，p=0.15），平衡(SMD：0.36，95%CI：-0.04至0.77，p=0.08)，步态速度（SMD：0.48，95%CI：-0.44至1.40，p=0.31），和躯干功能（SMD：0.79，95%CI：-0.17至1.75，p=0.11）。颈椎动员显着改善了前头部姿势；然而，其他结局无显著差异.临床医生可能会考虑将脊柱动员作为中风康复的辅助干预措施，以解决与姿势相关的障碍，从而扩大治疗策略并优化护理质量。
