慢性腰痛(CLBP)是全球残疾多年的主要原因。经皮电疗法已被广泛用于治疗CLBP,但是,除部分经皮神经电刺激(TENS)外,它们对疼痛的影响,残疾,生活质量,和社会心理结果尚未进行系统审查。这项系统评价和荟萃分析的目的是阐明经皮电疗法对CLBP患者患者报告的结局指标(PROMs)的总体影响。
■搜索了四个数据库和两个研究注册表,以寻找利用经皮电疗法作为CLBP主要干预措施的研究,与主动或被动控制进行比较。两名评审员独立提取研究数据并评估偏倚风险。研究按干预措施与干预措施进行分组。比较,和随访时间。在适当的情况下进行荟萃分析。
■总共对89篇全文进行了资格评估;纳入了14项研究,在荟萃分析中有6个(所有TENS或混合TENS)。疼痛:荟萃分析显示TENS与TENS之间没有显着差异主动控制,TENSvs.被动控制,或混合TENSvs.干预后的主动控制,也不是混合的TENSvs.干预后1个月积极控制。干扰电流(IFC)比主动控制更有效(2项研究),虽然肌电刺激(EMS)通常优于被动,但不活跃,对照(6项研究)。
■荟萃分析显示TENS与TENS之间没有显着差异干预后的主动控制,混合TENSvs.干预后的主动控制,或混合TENSvs.干预后1个月积极控制。IFC比主动控制更有效(2项研究),而EMS结果好坏参半(6项研究)。我们无法对生活质量或社会心理结果进行荟萃分析。
■有适度的证据表明,TENS在改善疼痛和残疾方面与所有对照相似。有限的证据表明,IFC在改善疼痛和残疾方面优于主动控制。有限的证据表明,EMS在改善疼痛方面优于被动但不是主动控制。与所有改善残疾的控制相似。
■https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=452851,标识符(CRD42023452851)。
UNASSIGNED: Chronic low back pain (CLBP) is the leading cause of years lived with disability worldwide. Transcutaneous electrotherapies have been widely used to treat CLBP but, with the partial exception of transcutaneous electrical nerve stimulation (
TENS), their effect on pain, disability, quality-of-life, and psychosocial outcomes have not been systematically reviewed. The purpose of this systematic review and meta-analysis was to clarify the overall effect of transcutaneous electrotherapies on patient-reported outcome measures (PROMs) in CLBP patients.
UNASSIGNED: Four databases and two study registries were searched for studies that utilized transcutaneous electrotherapies as a primary intervention for CLBP, compared against active or passive controls. Two reviewers independently extracted study data and assessed risk of bias. Studies were grouped by intervention vs. comparison, and by time of follow-up. Meta-analyses were conducted where appropriate.
UNASSIGNED: A total of 89 full-text were assessed for eligibility; 14 studies were included, with 6 in the meta-analyses (all TENS or mixed
TENS). Pain: meta-analyses revealed no significant difference for
TENS vs. active control,
TENS vs. passive control, or mixed
TENS vs. active control at post-intervention, nor for mixed
TENS vs. active control at 1-month post-intervention. Interferential current (IFC) was more effective than active control (2 studies), while electromyostimulation (EMS) was generally superior to passive, but not active, controls (6 studies).
UNASSIGNED: Meta-analyses revealed no significant difference for TENS vs. active control at post-intervention, mixed
TENS vs. active control at post-intervention, or mixed
TENS vs. active control at 1-month post-intervention. IFC was more effective than active control (2 studies), while the EMS results were mixed (6 studies). We were unable to perform meta-analyses for quality-of-life or psychosocial outcomes.
UNASSIGNED: There is moderate evidence that TENS is similar to all controls for improving pain and disability. There is limited evidence that IFC is superior to active controls for improving pain and disability. There is limited evidence that EMS is superior to passive but not active controls for improving pain, and similar to all controls for improving disability.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=452851, Identifier (CRD42023452851).