背景:慢性下腰痛(CLBP)是老年人最常见的肌肉骨骼疾病之一。这对老年人的健康有严重影响。然而,CLBP治疗非常具有挑战性,需要更有效的治疗方法。肌筋膜释放可能是治疗慢性肌肉骨骼疼痛的有效疗法。临床上广泛用于治疗CLBP,但其临床疗效仍存在争议。目的:系统评价肌筋膜松解术治疗CLBP的有效性。方法:我们选择了PubMed,科克伦图书馆,EMBASE数据库,和WebofScience数据库文章发表到2021年4月5日。包括CLBP肌筋膜释放的随机对照试验(RCT)。结果测量包括疼痛,物理功能,生活质量,平衡功能,疼痛压力阈值,躯干移动性,和心理健康。对于每个结果,计算标准化平均差(SMD)或平均差(MD)和95%置信区间(CI)。结果:根据纳入和排除标准纳入了8个RCT(n=375)。荟萃分析显示,肌筋膜松解术对CLBP的总体疗效是显著的,包括两个方面:疼痛[SMD=-0.37,95%CI(-0.67,-0.08),I2=46%,P=0.01]和身体功能[SMD=-0.43,95%CI(-0.75,-0.12),I2=44%,P=0.007]。然而,肌筋膜释放并未显著改善患者的生活质量[SMD=0.13,95%CI(-0.38,0.64),I2=53%,P=0.62],平衡函数[SMD=0.58,95%CI(-0.49,1.64),I2=82%,P=0.29],疼痛压力阈值[SMD=0.03,95%CI(-0.75,0.69),I2=73%,P=0.93],树干移动性[SMD=1.02,95%CI(-0.09,2.13),I2=92%,P=0.07]和心理健康[SMD=-0.06,95%CI(-0.83,0.71),I2=73%,P=0.88]。结论:在这项研究中,我们系统回顾并量化了肌筋膜释放治疗CLBP的疗效.Meta分析结果显示,肌筋膜松解术能显著改善CLBP患者的疼痛和躯体功能,但对平衡功能无明显影响。疼痛压力阈值,躯干移动性,心理健康,和生活质量。然而,由于质量低,收录文献少,未来应纳入越来越严格设计的RCT来验证这些结论。
Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal diseases in the elderly, which has a severe impact on the health of the elderly. However, CLBP treatment is very challenging, and more effective treatment methods are needed. Myofascial release may be an effective therapy for the management of chronic musculoskeletal pain. It is widely used clinically to treat CLBP, but its clinical efficacy is still controversial. Objective: This study aims to systematically evaluate the effectiveness of myofascial release for patients with CLBP. Methods: We selected PubMed, Cochrane Library, EMBASE database, and Web of Science database articles published until April 5, 2021. Randomized controlled trials (RCTs) of myofascial release for CLBP were included. Outcome measures included pain, physical function, quality of life, balance function, pain pressure-threshold, trunk mobility, and mental health. For each outcome, Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CIs) were calculated. Results: Eight RCTs (n = 375) were included based on inclusion and exclusion criteria. The meta-analysis showed that the overall efficacy of myofascial release for CLBP was significant, including two aspects: pain [SMD = -0.37, 95% CI (-0.67, -0.08), I 2 = 46%, P = 0.01] and physical function [SMD = -0.43, 95% CI (-0.75, -0.12), I 2 = 44%, P = 0.007]. However, myofascial release did not significantly improve quality of life [SMD = 0.13, 95% CI (-0.38, 0.64), I 2 = 53%, P = 0.62], balance function [SMD = 0.58, 95% CI (-0.49, 1.64), I 2 = 82%, P = 0.29], pain pressure-threshold [SMD = 0.03,95% CI (-0.75, 0.69), I 2 = 73%, P = 0.93], trunk mobility [SMD = 1.02, 95% CI (-0.09, 2.13), I 2 = 92%, P = 0.07] and mental health [SMD = -0.06, 95% CI (-0.83, 0.71), I 2 = 73%, P = 0.88]. Conclusions: In this study, we systematically reviewed and quantified the efficacy of myofascial release in treating CLBP. The meta-analysis results showed that myofascial release significantly improved pain and physical function in patients with CLBP but had no significant effects on balance function, pain pressure-threshold, trunk mobility, mental health, and quality of life. However, due to the low quality and a small number of included literature, more and more rigorously designed RCTs should be included in the future to verify these conclusions.