持杖行走训练对老年周围血管病变病人干预效果的Meta分析

Meta-analysis of intervention effect of walking-with-poles on elderly patients with peripheral arterial disease

[目的]评价持杖行走训练对老年周围血管病变病人的训练效果。[方法]计算机检索Cochrane Library、Joanna Briggs Institute Library、PubMed、Web of Science、EMbace、中国生物医学文献服务系统(SinoMed)、中国知网(CNKI)、万方数据资源系统中关于持杖行走训练对周围血管病变病人训练效果的随机对照试验,检索时限为各数据库建库至2017年2月28日。由2名研究者按照纳入和排除标准筛选文献、提取资料、评价质量,然后采用RevMan 5.3软件进行Meta分析或进行描述性分析。[结果]共纳入6项随机对照试验,378例病人。Meta分析结果提示,持杖行走训练组较对照组能够有效降低病人行走疼痛[MD=-0.54,95%CI(-0.89,-0.20),P=0.002];增加病人的摄氧量[SMD=0.76,95%CI(0.35,1.16),P<0.000 3];增加病人的行走距离[MD=0.48,95%CI(0.29,0.66),P<0.000 01]。[结论]持杖行走训练对PAD病人训练效果较好,且在增加步行距离方面与平板步行训练具有相同的效果,但更适合推荐给老年PAD病人。

Objective：To evaluate the effect of walking-with-poles on elderly patients with peripheral arterial dis- ease. Method： Database including Cochrane Library, Joanna Briggs Institute Library, PubMed, Web of Science, EMbaee, SinoMed,CNKI,WanFang Data were electronically searched from inception to February 28th, 2017 to collect randomized controlled trials（RTCs） about training effect of walking-with-poles on elderly patients with peripheral arterial disease. According to inclusion and exclusion criteria, two reviewers independently screened literatures,extracted data and evaluated the quality. RevMan 5. 3 software was used for Meta-analysis or de- scriptive analysis. Result：A total of 6 RTCs involving 378 patients were included. The result of Meta-analysis showed ： compare with the control group, the walking-with-poles group could effectively reduce the patient walk- ing pain[MD： - 0.54,95 % CI （ -0. 89, - 0.20）, P = 0. 002] ; increase oxygen uptake of the patients[SMD= 0.76, 95%CI（0. 35,1.16） ,P〈0. 000 3] ;increase walking distance of the patients[MD=0. 48,95%CI（0. 29,0. 66） ,P〈 0. 000 01]. Conclusions： Walking-with-poles training had better effect for PAD patients,and had same effect in increasing walking distance with Treadmill training, but it was more suitable for elderly patients with PAD.