全身振动训练对慢性踝关节不稳姿势稳定性影响的Meta分析

Effects of whole body vibration training on postural stability in chronic ankle instability:a meta-analysis

目的对全身振动训练干预慢性踝关节不稳(CAI)患者姿势稳定性的效果进行Meta分析。方法检索PubMed、Cochrane Library、Web of Science、物理治疗证据数据库(PEDro)、中国知网和万方数据库中全身振动训练干预CAI患者姿势稳定性相关的随机对照试验(RCT),时间范围自建库至2022年11月。同时追溯纳入研究的参考文献,补充相关文献。由两名研究人员独立检索、筛选,并提取相关数据。采用PEDro量表进行质量评价,采用Cochrane手册独立评估偏倚风险。采用Review Manager 5.3进行Meta分析,采用Stata 15.0进行Egger检验来判断发表偏倚。结果最终纳入RCT 12篇,共440例受试者。与其他运动或者无干预相比,全身振动训练能够改善压力中心偏移面积(MD=-0.70,95%CI-0.97~-0.43,P<0.001)和星形偏移平衡测试的前向(MD=6.16,95%CI 3.88~8.44,P<0.001)、后内向(MD=6.22,95%CI 3.68~8.76,P<0.001)、后外向(MD=6.68,95%CI 4.28~9.08,P<0.001)、前内向(MD=8.78,95%CI 6.71~10.85,P<0.001)、内向(MD=4.16,95%CI 1.46~6.86,P=0.002)、后向(MD=6.69,95%CI 3.81~9.58,P<0.001)、外向(MD=12.37,95%CI 8.09~16.65,P<0.001)和前外向(MD=5.29,95%CI 1.44~9.13,P=0.007)距离。但两组间总体稳定指数(MD=0.02,95%CI-0.05~0.09,P=0.643)和跳跃试验(MD=6.24,95%CI-8.80~21.28,P=0.416)比较无显著性差异。结论全身振动训练能够提高CAI患者星形偏移平衡测试各个方向的可达距离,而对于压力中心偏移面积的改善需更多研究来确定。

Objective To investigate the effects of whole body vibration training on postural stability in patients with chronic ankle instability(CAI)using meta-analysis.Methods Randomized controlled trials about whole body vibration training on patients with CAI in relation to postural stability were retrieved from PubMed,Cochrane Library,Web of Science,Physiotherapy Evidence Database(PEDro)scale,CNKI and WanFang data from inception to November,2022.Reference lists of included studies were also traced to supplement the relevant literature.Two researchers independently searched the literature,and extracted relevant data.The PEDro scale was used to assess the quality,and the Cochrane Handbook was used to assess the risk of bias.The meta-analysis was conducted using Review Manager 5.3.And Stata 15.0 was used to conduct the Egger's test to assess publication bias.Results Twelve randomized controlled trials involving 440 individuals were included.Compared with the other exercises or no exercise,whole body vibration training could improve the center of pressure-area(MD=-0.70,95%CI-0.97 to-0.43,P<0.001)and the Star Excursion Balance Test in the direction of anterior(MD=6.16,95%CI 3.88 to 8.44,P<0.001),posteromedial(MD=6.22,95%CI 3.68 to 8.76,P<0.001),posterolateral(MD=6.68,95%CI 4.28 to 9.08,P<0.001),anteromedial(MD=8.78,95%CI 6.71 to 10.85,P<0.001),medial(MD=4.16,95%CI 1.46 to 6.86,P=0.002),posterior(MD=6.69,95%CI 3.81 to 9.58,P<0.001),lateral(MD=12.37,95%CI 8.09 to 16.65,P<0.001)and anterolateral(MD=5.29,95%CI 1.44 to 9.13,P=0.007).However,there was no significant difference in the overall stability index(MD=0.02,95%CI-0.05 to 0.09,P=0.643)and hop-test(MD=6.24,95%CI-8.80 to 21.28,P=0.416)between whole body vibration training and other exercises or no exercise.Conclusion Whole body vibration training can improve the range of all directions of the Star Excursion Balance Test in individuals with CAI.However,more studies are needed to determine the improvement of center of pressure-area.