背景:脊柱手法(SM)是推荐的有效治疗肌肉骨骼疾病的方法。生物力学(动力学)参数(例如,预载荷/峰值力,力施加率和推力持续时间)可以在SM期间测量,量化干预。了解这些力-时间特征是确定负责SM临床有效性的可能活性成分的第一步。很少有研究量化SM力-时间特征,并且具有明显的异质性,对发现的解释是困难的。这项研究的目的是综合描述手动SM的力-时间特性的文献。
方法:此范围界定文献综述是根据范围界定综述的首选报告项目(PRISMA-ScR)声明进行报告的。从成立到2022年10月搜索数据库:MEDLINE(Ovid),Embase,CINAHL,ICL,PEDro和Cochrane图书馆。以下搜索词及其衍生物适用于每个平台:脊柱,脊柱,操纵,动员或动员,肌肉骨骼,脊椎按摩疗法,骨病,物理治疗,naprapathy,力,运动技能,生物力学,剂量,剂量反应,教育,性能,精神运动,回来,脖子,脊柱,胸廓,腰椎,骨盆,颈椎和骶骨。提取数据并描述性报告以下领域:一般研究特征,交付/接收SM的个人的数量和特征,区域处理,使用的设备和SM的力-时间特性。
结果:在确定的7,607条记录中,66(0.9%)符合资格标准,并被纳入分析。其中,SM被输送到颈椎12(18.2%),40例(60.6%)的胸椎和19例(28.8%)的腰骨盆脊柱。在6项(9.1%)研究中,未说明脊柱区域。对于应用于所有脊柱区域的SM,力-时间特征为:预紧力(范围:0-671N);峰值力(17-1213N);施力速率(202-8700N/s);达到峰值推力的时间(12-938ms);和推力持续时间(36-2876ms)。
结论:报道的SM的动力-时间特性存在相当大的可变性。这种可变性中的一些可能是由于SM递送(例如不同的临床医生)和用于量化力-时间特性的测量设备的差异。然而,改进某些关键领域的报告可以促进将来对部队时间特征数据进行更复杂的综合。这样的合成可以提供关于SM的临床有效性的剂量反应估计的基础。
Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of force application and thrust duration) can be measured during SM, quantifying the intervention. Understanding these force-time characteristics is the first step towards identifying possible active ingredient/s responsible for the clinical effectiveness of SM. Few studies have quantified SM force-time characteristics and with considerable heterogeneity evident, interpretation of findings is difficult. The aim of this study was to synthesise the literature describing force-time characteristics of manual SM.
This scoping literature
review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. Databases were searched from inception to October 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro and Cochrane Library. The following search terms and their derivatives were adapted for each platform: spine, spinal, manipulation, mobilization or mobilisation, musculoskeletal, chiropractic, osteopathy, physiotherapy, naprapathy, force, motor skill, biomechanics, dosage, dose-response, education, performance, psychomotor, back, neck, spine, thoracic, lumbar, pelvic, cervical and sacral. Data were extracted and reported descriptively for the following domains: general study characteristics, number of and characteristics of individuals who delivered/received SM, region treated, equipment used and force-time characteristics of SM.
Of 7,607 records identified, 66 (0.9%) fulfilled the eligibility criteria and were included in the analysis. Of these, SM was delivered to the cervical spine in 12 (18.2%), the thoracic spine in 40 (60.6%) and the lumbopelvic spine in 19 (28.8%) studies. In 6 (9.1%) studies, the spinal region was not specified. For SM applied to all spinal regions, force-time characteristics were: preload force (range: 0-671N); peak force (17-1213N); rate of force application (202-8700N/s); time to peak thrust force (12-938ms); and thrust duration (36-2876ms).
Considerable variability in the reported kinetic force-time characteristics of SM exists. Some of this variability is likely due to differences in SM delivery (e.g. different clinicians) and the measurement equipment used to quantify force-time characteristics. However, improved reporting in certain key areas could facilitate more sophisticated syntheses of force-time characteristics data in the future. Such syntheses could provide the foundation upon which dose-response estimates regarding the clinical effectiveness of SM are made.