血流限制训练促进骨骼肌康复的系统评价再评价

An Overview of Systematic Reviews on Blood Flow Restriction Training Improving Skeletal Muscle Rehabilitation

目的:BFR训练对骨骼肌康复的SR和Meta分析进行再评价,旨在为BFR训练对骨骼肌康复进一步提供方法学质量和证据质量的参考。方法:检索数据库Web of Science、PubMed、Cochrane Library、PROSPERO、中国知网(CNKI)、万方和维普等,检索时间从建库至2022年4月,纳入符合标准的相关SR研究。两位作者采用盲法分别根据AMSTAR 2量表对纳入研究进行方法学质量评价,根据PRISMA声明对纳入研究进行学术规范评价,根据GRADE证据分级系统对纳入研究进行证据质量分级,其中争议处交由第三人决定。结果:本文根据检索策略共检索到94篇文献,并最终纳入9篇SR研究。AMSTAR 2量表评价结果显示:6篇研究为极低质量,1篇为低质量,2篇为中质量;PRISMA声明评价得分在11.5~23.5之间;GRADE证据质量分级系统评价结果显示:有7项结局指标为极低级,11项为低级,7项为中级,3项为高级,证据降级的主要原因为局限性、不一致、不精确和发表偏倚等。结论:BFR训练对骨骼肌康复的真实性尚未得到准确判断,研究仅说明BFR训练干预可能对骨骼肌的影响效果存在一定优势性。基于当前证据,建议后期的研究中需科学制定纳入、排除标准,报道内容要全面,寻找BFR训练对于其他运动的优势和特定人群的优势,中、英文SR分别需注重效应模型的选择和偏倚风险的分析。

The SR and Meta-analysis of the effect of BFR training on skeletal muscle rehabilitation were re-evaluated so that the effect of BFR training on skeletal muscle rehabilitation can be further informed by the methodological quality of evidence-based medicine and the quality of evidence. Methods: Databases were searched including Web of Science, PubMed, Cochrane Library, PROSPERO, China Knowledge Network(CNKI), Wanfang, and Vipul, and the search period was from the establishment of the database to April 2022, and relevant SR studies that met the criteria were included. The two authors used a blind method to evaluate the methodological quality of the included studies according to the AMSTAR 2 scale, to evaluate the included studies according to the PRISMA statement, and to classify the included studies according to the GRADE evidence classification system. The third person decides. Results: A total of 94 articles were retrieved according to the search strategy, and 9 SR were included in the final list. The results of the AMSTAR 2 assessment scale showed that 6 studies were of very low quality, 1 was of low quality, and 2 were of medium quality;the evaluation scores of PRISMA statement ranged from 11.5 to 23.5;the evaluation results of GRADE evidence quality grading system showed that 7 outcome indicators were of very low quality, 11 were of low quality, and 7 were of medium quality. items were low, 7 were intermediate, and 3 were high;the main reasons for evidence downgrading were limitations, inconsistency, imprecision, and publication bias. Conclusion: The true nature of the effect of BFR training on skeletal muscle improvement has not been accurately judged, and the study only indicates that there may be some advantageous effect of BFR training intervention on skeletal muscle. Based on the current evidence, it is recommended that later studies need to focus on scientific development of inclusion and exclusion criteria, complete reporting of content, finding the advantages of BFR training for other exercises and for specific populations, and the need to focus on the selection of effect models and the analysis of risk of bias in Chinese and English SR, respectively.