全身振动训练对骨质疏松患者治疗效果的Meta分析

The effects of whole body vibration exposure on treatment outcomes in osteoporotic patients:a meta analysis

目的系统评价全身振动训练对骨质疏松患者的治疗效果。方法计算机检索Pub Med、EMbase、The Cochrane Library(2017年1期)、CBM、Wan Fang Data和CNKI数据库,收集关于全身振动训练对骨质疏松患者效果的随机对照试验,检索时限均从建库至2017年1月31日。2名研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入文献8篇,657例患者。Meta分析结果显示,与对照组相比,全身振动训练对骨质疏松患者的腰椎骨密度[MD=0.00,95%CI(-0.01~0.01),P=0.92]、桡骨松质骨体积骨密度[MD=-0.87,95%CI(-2.93~1.20),P=0.41]、胫骨松质骨体积骨密度[MD=0.34,95%CI(-0.69~1.38),P=0.52]没有影响;但可以减轻患者的疼痛[MD=-0.67,95%CI(-1.12^-0.22),P=0.003]、降低跌倒发生率[MD=0.50,95%CI(0.29~0.86),P=0.01]。结论全身振动训练并不能改善骨质疏松患者的腰椎骨密度、胫骨和桡骨松质骨体积骨密度,但可以减轻疼痛,而预防跌倒的效果及其安全性还有待进一步的证实。

Objective To assess the effects of whole body vibration （WBV） exposure on treatment outcomes in osteoporotic patients systematically. Methods Electronic databases including PubMed, EMbase, the Cochrane Library （Issue 1, 2017）, CBM, WanFang Data and CNKI were searched to collect randomized controlled trials （RCTs） on effects of WBV exposure in treating osteoporotic patients from inception of databases to January 31, 2017. Two researchers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results Totally 8 RCTs involving 657 patients were included. The meta-analysis results suggested that there were no significant differences when comparing the WBV and control groups, for lumbar areal spine bone mineral density （aBMD） （MD=0.00, 95%CI-0.01 to 0.01, P=0.92）, radius trabecular volumetric bone mineral density （Tb.vBMD） （MD=-0.87, 95%CI -2.93 to 1.20, P=0.41） or tibia Tb.vBMD （MD=0.34, 95%CI -0.69 to 1.38, P=0.52）. However, in the WBV group the pain was improved （MD=-0.67, 95%CI -1.12 to ？0.22, P=0.003） and the rate of falling was decreased （MD=0.50, 95%CI 0.29 to 0.86, P=0.01）. Conclusion No significant effect was found associated with WBV, either for lumbar spine aBMD, or for radius and tibia Tb.vBMD. However, the pain was improved in the WBV group. Further studies are needed to confirm its effect on risk of falling and its safety.