■慢性踝关节不稳(CAI)是运动员常见的损伤。已将不同形式的物理疗法应用于CAI人群,以评估其对脊柱兴奋性的影响。
■本系统综述和荟萃分析的目的是研究各种物理治疗干预措施对CAI患者脊柱兴奋性改变的有效性。
■四个数据库(EMBASE,MEDLINE,科克伦中部,和Scopus)从成立之初到2022年11月进行了搜索。
■共获得并筛选了253项研究;确定了11项关于物理治疗干预对CAI患者脊柱兴奋性改变的影响的研究用于荟萃分析。
■系统评价和荟萃分析。
■3a级。
■提取并总结了总共11项研究,这些研究包括通过腓骨长肌和比目鱼肌的最大肌肉反应(H/M比)归一化的最大霍夫曼反射。使用PEDro量表评估研究的质量。
■提取的研究的平均PEDro评分为4.7±1.4,表明其中大多数具有良好的质量。物理疗法干预措施包括冷冻疗法,录音,动员,本体感受训练,和干针刺。总体效果显示,CAI患者的腓骨长肌(P=0.44,I2=0%)和比目鱼肌(P=0.56,I2=22%)的H/M比值未通过物理治疗改变。
■荟萃分析表明,物理治疗干预措施,如冷冻疗法,录音,动员,本体感受训练,干针刺不会改变CAI患者的脊髓兴奋性。鉴于只有一项研究报告了干针刺导致的脊髓兴奋性的无效变化,更多的研究对于建立和验证其功效至关重要。
■CRD42022372998。
UNASSIGNED: Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability.
UNASSIGNED: The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI.
UNASSIGNED: Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022.
UNASSIGNED: A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis.
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: Level 3a.
UNASSIGNED: A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale.
UNASSIGNED: The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus (P = 0.44, I2 = 0%) and soleus (P = 0.56,I2 = 22%) muscles were not changed by physical therapy in patients with CAI.
UNASSIGNED: The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy.
UNASSIGNED: CRD42022372998.