退化性膝關節炎運動治療合併徒手治療之加乘效果：系統性回顧與統合分析

背景與目的：運動治療為退化性膝關節炎具證據力之治療選項，若個案運動出現疼痛多建議合併徒手治療以提升治療效益。但此建議目前仍缺乏實證支持。本研究利用系統性回顧與統合分析，探討退化性膝關節炎運動合併徒手治療之加乘效益。方法：蒐集2016年5月前相關資料庫之退化性膝關節炎研究；比較運動合併徒手治療與運動治療和僅作運動治療在功能提升與疼痛減緩之成效。結果：共收錄9篇文章。統合分析顯示運動額外徒手治療對功能改善於短期（成效值：-0.517）及長期（成效值：-0.287）皆具加乘效益；對疼痛減緩則具長期加乘效益（成效值為：-0.528）。結論：運動合併徒手治療比運動治療於退化性膝關節炎之功能提升與疼痛減緩具有額外加乘效果，也可維持6個月以上的療效。

關鍵字

退化性膝關節炎；運動治療；徒手治療；系統性回顧；統合分析

並列摘要

Background and Purpose: Exercise therapy is the first-line management for patients with knee osteoarthritis. Recently published systematic reviews and clinical practice guidelines suggested that exercise therapy should be combined with manual therapy for improving intervention efficacy in cases of pain. However, no consensus has been reached due to lacking up-to-date evidence support in the literature. Therefore, the purpose of this systematic review and meta-analysis was to investigate the effects of manual therapy in addition to exercise therapy for patients with knee osteoarthritis. Methods: We searched related databases and identified studies on knee osteoarthritis before May 2016, in comparing exercise plus manual therapy to exercise therapy alone on functional enhancement and pain reduction. Results: A total of nine studies were included. The analysis showed that exercise plus manual therapy resulted in superior functional improvement both in the short-term (pooled effect size = -0.517) and long-term (pooled effect size= -0.287) as compared to exercise alone. Also, the analysis favored the combination of exercise and manual therapy in the long-term pain reduction effect (pooled effect size = -0.528). Conclusions: When compared to only exercise therapy, exercise plus manual therapy showed significantly better improvement in functional performance and pain reduction, especially in the long-term effect.

並列關鍵字

Knee osteoarthritis ； Exercise therapy ； Manual therapy ； Systematic review ； Meta-analysis

國際替代計量

退化性膝關節炎運動治療合併徒手治療之加乘效果：系統性回顧與統合分析

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