全身振动训练对前交叉韧带重建后影响的Meta分析

Effects of whole-body vibration training on anterior cruciate ligament reconstruction:a meta-analysis

目的:全身振动训练近年来被广泛运用于前交叉韧带重建后康复当中,然而其疗效仍存在争议。文章采用Meta分析方法,系统评价全身振动训练对前交叉韧带重建后的影响,以期为全身振动训练的临床应用提供循证医学证据。方法:计算机检索PubM ed、Embase、The Cochrane Library、Web of Science、EBSCO、中国知网、万方和维普数据库的相关文献,收集全身振动训练对前交叉韧带重建后患者影响的随机对照试验,检索时限均为各数据库建库至2022-07-16。结局指标包括股四头肌峰值力矩、腘绳肌峰值力矩、膝关节角度重现误差、Biodex偏移指数及Lysholm膝关节功能评分共5个连续性变量,采用Cochrane风险偏倚评估工具和Jadad量表对纳入的文献进行质量评价,应用RevMan 5.3软件对结局指标进行Meta分析。结果:(1)共纳入10项随机对照试验,包括372例前交叉韧带重建后患者,纳入文献整体质量较高。(2)Meta分析结果显示:与对照组相比,全身振动训练可以显著提升股四头肌峰值力矩(SMD=0.75,95%CI:0.20-1.30,P=0.008)和腘绳肌峰值力矩(SMD=0.90,95%CI:0.03-1.77,P=0.04),降低膝关节角度重现误差(SMD=-0.60,95%CI:-1.04至-0.17,P=0.007)和Biodex偏移指数(SMD=-0.93,95%CI:-1.46至-0.41,P=0.0005),改善Lysholm膝关节功能评分(MD=4.69,95%CI:0.79-8.60,P=0.02)。结论:全身振动训练可能有助于提升前交叉韧带重建后患者股四头肌及腘绳肌肌肉力量,改善本体感觉和平衡功能,提高膝关节功能。

OBJECTIVE:Whole-body vibration training has been widely used in the postoperative rehabilitation after anterior cruciate ligament reconstruction.However,its efficacy remains controversial.In this study,meta-analysis was conducted to systematically evaluate the effect of whole-body vibration training on anterior cruciate ligament reconstruction,in order to provide evidence-based medicine evidence for the clinical use of whole-body vibration training.METHODS:Randomized controlled trials about effects of whole-body vibration training on anterior cruciate ligament reconstruction were electronically searched from PubMed,Embase,The Cochrane Library,Web of Science,EBSCO,CNKI,WanFang,and VIP databases,from inception to July 16,2022.The outcome measures included five continuous variables:quadriceps peak torque,hamstring peak torque,knee angle recurrence error,Biodex migration index,and Lysholm knee score.The Cochrane Risk Bias Assessment Tool and Jadad Scale were used to evaluate the quality of the included literature,and RevMan 5.3software was used for meta-analysis.RESULTS:(1)Ten randomized controlled trials involving 372 patients with anterior cruciate ligament reconstruction were finally included.The overall quality of the included literature was high.(2)The results of meta-analysis:Compared with the control group,whole-body vibration training significantly improved quadriceps peak torque(SMD=0.75,95%CI:0.20 to 1.30,P=0.008)and hamstring peak torque(SMD=0.90,95%CI:0.03 to 1.77,P=0.04),reduced knee angle recurrence error(SMD=-0.60,95%CI:-1.04 to-0.17,P=0.007)and Biodex migration index(SMD=-0.93,95%CI:-1.46 to-0.41,P=0.0005),and improved Lysholm knee score(MD=4.69,95%CI:0.79 to 8.60,P=0.02).CONCLUSION:Whole-body vibration training may help to improve quadriceps peak torque and hamstring peak torque,proprioception and balance function,and knee joint function scale score in patients after anterior cruciate ligament reconstruction.