背景:宫颈肌张力障碍是一种运动障碍,通常以持续或间歇性肌肉收缩的模式和扭曲运动为特征。最近,新的临床试验正在出现,强调物理治疗(PT)对疾病结局的潜在益处。因此,本综述的目的是更新PT对宫颈肌张力障碍疾病结局的有效性,并随后进行荟萃分析.
方法:纳入了以英文发表的对患有孤立性宫颈肌张力障碍的成年患者进行物理治疗的介入研究。在PubMed(MEDLINE)中搜索了相关文章,WebofScience,还有Scopus.Cochrane和JoannaBriggs研究所的偏见风险清单用于质量报告。使用ReviewManager5.3统计软件进行荟萃分析,并提供疼痛的汇总平均差异。
结果:本综述纳入14篇文献,荟萃分析纳入2篇文献。荟萃分析显示,当用作肉毒杆菌毒素(BoNT)注射的额外治疗时,PT干预对疼痛减轻量表具有显着影响(-5.00,95%CI-6.26,-3.74)。此外,研究结果表明PT疾病严重程度可能有积极作用,残疾,和生活质量。
结论:除BoNT外,还建议进行物理治疗以减轻疼痛。研究结果表明疾病严重程度降低,残疾,以及生活质量的提高。PT干预的类型和持续时间的多样性不允许明确推荐特定类型的PT。
BACKGROUND: Cervical dystonia is a movement disorder typically characterized by a patterned and twisting movement of sustained or intermittent muscle contractions. Recently, new clinical trials are emerging, highlighting the potential benefit of physiotherapy (PT) on disease outcomes. Thus, the objective of this
review is to update the effectiveness of PT on cervical dystonia disease outcomes and subsequently perform a meta-analysis.
METHODS: Interventional studies published in English with adult patients with isolated cervical dystonia following a physiotherapy program were included. Relevant articles were searched in PubMed (MEDLINE), Web of Science, and Scopus. Cochrane and Joanna Briggs Institute risk of bias checklists were used for quality reporting. Meta-analysis was done using
Review Manager 5.3 statistical software and a pooled mean difference for pain was presented.
RESULTS: Fourteen articles were included in the
review and two articles were included in the meta-analysis. The meta-analysis revealed that PT intervention had a significant effect on pain reduction scale (-5.00, 95% CI -6.26, -3.74) when used as an additional therapy with botulinum toxin (BoNT) injection. Additionally, findings indicate a possible positive effect of PT disease severity, disability, and quality of life.
CONCLUSIONS: Physiotherapy in addition to BoNT is recommended to decrease pain. The findings suggest a reduction of disease severity, disability, and improvement in quality of life. The variety in the type and duration of PT interventions did not allow a clear recommendation of a specific type of PT.