- 期刊
比較徒手治療與運動治療介入對薦髂關節失能之效果：系統性回顧與統合分析
Comparison of The Effect of Manual Therapy and Exercise Therapy for Patients With Sacroiliac Joint Dysfunction: A Systematic Reviews and Meta-Analysis
摘要
背景與目的：薦髂關節失能是常見的下背痛原因之一。本研究探討徒手治療作為主要或附加治療相較於運動治療，是否能有效改善髂關節失能患者之疼痛、功能和生活品質。方法：搜索PubMed、Medline、CINAHL、PEDro、Cochrane、EBMASE及Google scholar資料庫於2002∼2022年發表之文獻，使用PEDro量表及牛津實證醫學中心2011年版評估文獻的品質與證據等級，並以Comprehensive Meta-analysis V.2（Biostat Inc, Englewood, NJ, USA）進行統合分析，統計顯著水平定為0.05。結果：7篇研究納入分析。結果顯示與運動治療相比，徒手治療於短期疼痛改善效果不顯著（p=0.200），但於長期疼痛改善（p=0.019）則有顯著效果，且有顯著的長期功能改善效果（p=0.001）。徒手治療結合運動治療與單獨運動治療相比，在長期疼痛改善（p=0.001）及功能改善（p<0.001）達到顯著差異，但在短期疼痛改善（p=0.199）則沒有達到顯著差異；在生活品質方面，則不論短期（p=0.234）或長期（p=0.787）皆未達到顯著差異。結論：徒手治療能夠改善薦髂關節失能患者的疼痛和功能；且相較於單純運動治療，加入徒手治療能更加的改善薦髂關節失能患者的疼痛與功能。本統合分析結果提供臨床實證，支持徒手治療介入的療效。
並列摘要
Background and Purpose: Sacroiliac joint dysfunction (SID) is a common source of chronic low back pain. Past research showed both exercise and manual therapy effectively improved SID symptoms. This study compared the effect of manual therapy (main effect or additional effect) and exercise therapy on pain, function, and quality of life in patients with SID. Methods: Databases including PubMed, Medline, CINAHL, PEDro, Cochrane, EBMASE, and Google scholar were searched for randomized controlled trials examining treatment effects of manual and exercise therapy for patients with SID published between 2002 and 2022. The quality of studies was evaluated using the PEDro scale and the evidence level was determined using the 2011 Cochrane collaboration review group standards for Evidence-Based Medicine. Meta-analyses were performed using the Comprehensive Meta-analysis V.29 (Biostat Inc, Englewood, NJ, USA), with the significance level of 0.05. Results: Seven randomized controlled trials were included. The analysis showed that manual therapies were significantly better than exercises on long-term pain reduction (p < 0.001) and functional improvement (p = 0.001); but not for short-term pain (p = 0.200). Compared with exercise alone, combining manual and exercises intervention was more beneficial for long-term pain (p = 0.001) and function (p < 0.001); but not for short-term pain (p = 0.199) or quality of life (short-term p = 0.234, long-term p = 0.787). Conclusion: Manual therapy would improve pain and function for patient with SID. Combining manual therapy and therapeutic exercises was superior to exercise alone for pain and function. Our findings provided clinical evidence to support the effectiveness of manual therapy for patient with SID.