Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.
Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.
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DOI：
10.1097/pr9.0000000000000834
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发表时间：
2020-09
期刊：
影响因子：
4.8
通讯作者：
Schmid AB
中科院分区：
文献类型：
--
作者：
Jesson T;Runge N;Schmid AB
补充数字内容在文本中可用。物理治疗的有效性和安全性在周围神经病变的人的管理进行了探讨。根据有希望的数据提出了可能的前进道路。周围神经性疼痛的药物治疗只有适度的效果，并经常受到严重不良反应的限制。替代治疗方法，包括物理治疗管理，因此获得了周围神经病变的人的管理的兴趣。本叙述性综述总结了目前关于物理治疗减轻神经根疼痛和化疗诱导的周围神经病变（2种常见的周围神经病变）患者疼痛和残疾的有效性和安全性的文献。对于化疗引起的周围神经病变，目前基于8项随机对照试验的证据表明，运动可能会减轻已确诊神经病变患者的症状，但缺乏证据表明其对尚未出现症状的患者具有预防作用。对于神经根性疼痛，21项试验中的大多数研究了旨在改善运动控制或降低神经机械敏感性的干预措施。结果是模棱两可的，有一些迹象表明，神经组织管理可能显示出一些好处，在减少疼痛。物理治疗的不良事件似乎很罕见;然而，这些不良事件在所有研究中的报告并不一致。虽然这是令人鼓舞的是，物理治疗周围神经性疼痛的证据基础正在稳步增长，现有的研究质量参差不齐，目前阻止了坚定的治疗建议。根据有希望的初步数据，建议的潜在方向，以推动该领域的前进。
Supplemental Digital Content is Available in the Text. The efficacy and safety of physiotherapy in the management of people with peripheral neuropathies is explored. Potential ways forward based on promising data are suggested. Pharmacological treatment for peripheral neuropathic pain has only modest effects and is often limited by serious adverse responses. Alternative treatment approaches including physiotherapy management have thus gained interest in the management of people with peripheral neuropathies. This narrative review summarises the current literature on the efficacy and safety of physiotherapy to reduce pain and disability in people with radicular pain and chemotherapy-induced peripheral neuropathy, 2 common peripheral neuropathies. For chemotherapy-induced peripheral neuropathy, the current evidence based on 8 randomised controlled trials suggests that exercise may reduce symptoms in patients with established neuropathy, but there is a lack of evidence for its preventative effect in patients who do not yet have symptoms. For radicular pain, most of the 21 trials investigated interventions targeted at improving motor control or reducing neural mechanosensitivity. The results were equivocal, with some indication that neural tissue management may show some benefits in reducing pain. Adverse events to physiotherapy seemed rare; however, these were not consistently reported across all studies. Although it is encouraging to see that the evidence base for physiotherapy in the treatment of peripheral neuropathic pain is growing steadily, the mixed quality of available studies currently prevents firm treatment recommendations. Based on promising preliminary data, suggestions are made on potential directions to move the field forward.