不同干预措施对腰痛患者恐动症干预效果的网状Meta分析

A Network Meta-analysis of the Effect of Different Interventions in Kinesiophobia Patients with Low Back Pain

目的:采用网状Meta分析的方法评价不同干预措施对腰痛患者恐动症干预效果。方法:计算机检索The Cochrane Library、PubMed、WOS、Embase、CNKI、CBM、VIP、WanFang Data数据库中与腰痛患者恐动症干预措施相关的随机对照试验,检索时限从建库至2022年1月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件进行网状Meta分析。结果:纳入16项研究,1137例患者。网状Meta分析结果显示,认知行为疗法、虚拟现实训练与常规治疗相比,差异均有统计学意义。SUCRA概率排序结果显示,由高到低依次为虚拟现实训练>认知行为疗法>疼痛神经科学教育>多学科协作疗法>手法治疗>物理治疗>普拉提>分级活动>常规治疗>视频锻炼。结论:本研究证据表明,虚拟现实训练干预腰痛患者恐动症效果最优,其次是认知行为疗法。受纳入研究数量和质量限制,上述结论还需开展更多高质量的RCT来对本研究结果进一步验证。

Objective:To evaluate the effect of different interventions in kinesiophobia patients with low back pain by using network meta-analysis.Method:Randomized controlled trials related to kinesiophobia intervention in patients with low back pain were searched in The Cochrane Library,PubMed,WOS,Embase,CNKI,CBM,VIP and WanFang Data databases.The retrieval period is from database construction to January 2022.Two researchers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies.Stata 16.0 software was used for mesh Meta-analysis.Result:A total of 16 studies involving 1137 patients were included.Results of network Meta-analysis showed that cognitive behavioral therapy,virtual reality training,and multidisciplinary collaborative therapy were statistically significant compared with conventional treatment.The ranking results of SUCRA probability showed that the order from high to low was virtual reality training>cognitive behavioral therapy>pain neuroscience education>multidisciplinary collaborative therapy>manual therapy>physical therapy>Pilates>graded activity>routine therapy>video exercise.Conclusion:The evidence of this study indicates that virtual reality training has the best effect on motility in patients with low back pain,followed by cognitive behavioral therapy.Due to the limitations of the number and quality of the included studies,the above conclusions need to be further verified by more high-quality RCTS.