平衡训练对慢性踝关节不稳患者自我报告功能及动态平衡稳定性疗效的系统综述及Meta分析

Balance Training for Chronic Ankle Instability on Self-reported Function and Dynamic Balance Stability: Systematic Review and Meta Analysis

目的研究平衡训练对慢性踝关节不稳患者自我报告的功能和动态平衡能力的治疗进展,确定平衡训练对慢性踝关节不稳患者临床应用的意义。方法在数据PubMed、Web of Science、the Cochrane Library和中国知网中检索关于平衡训练治疗慢性踝关节不稳患者的随机对照试验(RCT),检索从2008年1月—2019年11月。系统综述平衡训练对慢性踝关节不稳患者自我报告的功能和动态平衡稳定性的治疗进展。由两位研究员独立进行文献筛选,信息提取及纳入文献的质量评估,提取文献相关数据,采用Review Manager5.3软件对观察指标进行Meta分析,并做系统综述。结果①最终纳入12个RCT,总计393例患者。②Meta分析显示,平衡训练提高CAIT(WMD=4.15,95%CI(3.54,4.75),P<0.001)及SEBT-M评分(WMD=8.02,95%CI(5.12,10.93),P<0.001)。结论平衡训练可以有效改善慢性踝关节不稳患者的自我报告的不稳定性,降低自感严重程度,同时能够提高慢性踝关节不稳患者在动态内侧向偏移时的平衡稳定性,值得在临床中推广使用。但是具体的针对慢性踝关节不稳患者的平衡训练运动处方(如平衡训练的方式、强度、频率和干预时间)至今未能统一规范,可作为之后研究的重点方向。由于本次Meta分析存在纳入研究的数量较少、大多数研究样本量较小、受试者基线水平一致性不确定、纳入研究的方法学质量高低不一等问题,仍需要高质量的研究来对结论进行补充和肯定。

Objective To investigate the effects of balance training on self-reported function and dynamic balance stability in patients with chronic ankle instability and identify the significance of clinical application.Methods Databases of PubMed,Web of Science,the Cochrane Library,EMBASE,China Biology Medicine and CNKI were searched for randomized controlled trials(RCT)of balance training in patients with chronic ankle instability from January 2008 to November 2019.Two researchers screened the literature,extracted the information and evaluated the included literature methodological quality independently,did the systematic review and Meta-analysis by the Review Manager5.3 software.Results①12 RCTS were finally included with a total of 393 patients.②Metaanalysis showed that balance training improved CAIT(WMD=4.15,95%CI(3.54,4.75),P<0.001)and SEBT-M score(WMD=8.02,95%CI(5.12,10.93),P<0.001).Conclusion Balance training can effectively improve the self-reported instability,dynamic stability during medial direction of the Star Excursion Balance Test,reduce the self-reported severity of patients with chronic ankle instability.It is worthy of being popularized in clinical practice.However,specific balance training prescription for patients with chronic ankle instability(balance training type,intensity,intervention,frequency and time)has not been standardized so far,which can be focus in the future research.Due to the lack of included studies in this Meta-analysis,the consistency of baseline,the small sample size,and the uneven methodological quality,this study still needs a randomized controlled trial with a large sample size and high methodological quality for further verification.