It Hurts to Move! Assessing and Treating Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review With Meta-analysis.
It Hurts to Move! Assessing and Treating Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review With Meta-analysis.
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动起来就痛！
DOI：
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发表时间：
2022
影响因子：
6.1
通讯作者：
D. Beckwée
中科院分区：
文献类型：
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作者：
Lynn Leemans;Andrea Polli;J. Nijs;Timothy Wideman;Hester L den Bandt;D. Beckwée
目的
评估肌肉骨骼康复干预对运动诱发疼痛的影响，并探讨用于评估肌肉骨骼疼痛成人运动诱发疼痛的方法/方案。
设计
荟萃分析的系统综述。
文献检索
检索了3个电子数据库（PubMed、Web of Science和Scopus）。
研究选择标准
随机对照试验调查肌肉骨骼康复干预运动诱发疼痛的成人肌肉骨骼疼痛。
资料综合
对来自至少2项试验的具有同质数据的结局进行荟萃分析。运动诱发疼痛的平均变化是主要的结局指标。证据的可靠性使用建议评估、发展和评价分级（GRADE）框架进行评估。
结果
纳入了38项试验，评估了60种不同的干预措施。有中等确定性证据表明，运动疗法与未治疗相比，对肌肉骨骼疼痛的成人运动诱发疼痛有有益作用（SMD=-0.65; 95%CI-0.83，-0.47; p<0.001）。经皮神经电刺激与未治疗相比的有益效果的确定性证据较低（SMD=-0.46; 95%CI-0.71，-0.21; p=0.0004）。与假经皮神经电刺激相比，经皮神经电刺激没有获益（SMD=-0.28; 95%CI：-0.60，0.05; p=0.09;中等确定性证据）。
结论
有中等确定性证据表明，与未治疗相比，运动疗法可有效减少肌肉骨骼疼痛患者的运动诱发疼痛。在临床实践中，运动疗法应作为运动诱发疼痛的首选治疗方法。J Orthop Sports Phys Ther，Epub 2022年2月5日。doi：10.2519/jospt.2022.10527。
OBJECTIVE
To estimate the effects of musculoskeletal rehabilitation interventions on movement-evoked pain and to explore the methods/protocols used to evaluate movement-evoked pain in adults with musculoskeletal pain.
DESIGN
Systematic review with meta-analysis.
LITERATURE SEARCH
Three electronic databases (PubMed, Web of Science, and Scopus) were searched.
STUDY SELECTION CRITERIA
Randomized controlled trials investigating musculoskeletal rehabilitation interventions on movement-evoked pain in adults with musculoskeletal pain were included.
DATA SYNTHESIS
Meta-analysis was conducted for outcomes with homogeneous data from at least 2 trials. The mean change in movement-evoked pain was the primary outcome measure. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
RESULTS
Thirty-eight trials were included, and 60 different interventions were assessed. There was moderate-certainty evidence of a beneficial effect of exercise therapy compared to no treatment (SMD=-0.65; 95%CI -0.83,-0.47; p<0.001) on movement-evoked pain in adults with musculoskeletal pain. There was low-certainty evidence of a beneficial effect of transcutaneous electrical nerve stimulation compared to no treatment (SMD=-0.46; 95%CI -0.71,-0.21; p=0.0004). There was no benefit of transcutaneous electrical nerve stimulation when compared to sham transcutaneous electrical nerve stimulation (SMD=-0.28; 95%CI: -0.60,0.05; p=0.09; moderate-certainty evidence).
CONCLUSIONS
There was moderate-certainty evidence that exercise therapy is effective for reducing movement-evoked pain in patients with musculoskeletal pain compared to no treatment. Consider exercise therapy as the first-choice treatment for movement-evoked pain in clinical practice. J Orthop Sports Phys Ther, Epub 5 Feb 2022. doi:10.2519/jospt.2022.10527.