Effects of a Guided Neck-Specific Exercise Therapy on Recovery After a Whiplash: A Systematic Review and Meta-analysis.

IF 2.2 4区 医学 Q1 REHABILITATION American Journal of Physical Medicine & Rehabilitation Pub Date : 2024-11-01 Epub Date: 2024-02-29 DOI:10.1097/PHM.0000000000002460
Pablo Muñoz Lazcano, Daniel Rojano Ortega, Isidro Fernández López
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引用次数: 0

Abstract

Objective: To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise therapy, compared to a different or an unguided neck-specific exercise therapy.

Design: A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Meta-analyses were performed with Review Manager software. The standardized mean difference with a 95% confidence interval was used to measure the effect sizes and only short-term time points were considered.

Results: Not all studies reported a significant decrease of pain and disability in the neck-specific exercise group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (standardized mean difference: -0.25; 95% confidence interval: [-0.38, -0.12]; P = 0.0002) and neck-disability index (standardized mean difference: -0.35; 95% confidence interval: [-0.54, -0.15]; P = 0.0005) in the neck-specific exercise group.

Conclusions: In addition to the benefits that a guided neck-specific exercise therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided neck-specific exercise therapy. Positive results are observed primarily with intervention periods of more than 6 wks and at least two sessions per week.

To claim cme credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.

Cme objectives: Upon completion of this article, the reader should be able to: (1) Determine the impact that whiplash-associated disorders have on a patient's life; (2) Identify and recognize the greater benefits of a supervised exercise therapy on recovery after a whiplash injury; and (3) Differentiate between the different exercise protocols conducted (types of exercises and duration) and incorporate therapy appropriately as part of an effective treatment plan.

Level: Advanced.

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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颈部指导性运动疗法对鞭打后恢复的影响:系统回顾和荟萃分析。
目的分析有指导的颈部特异性锻炼(NSE)疗法与不同的或无指导的NSE疗法相比,对鞭打后疼痛和残疾恢复的影响:设计:从开始到 2023 年 5 月 31 日,在三个电子数据库中进行了文献检索:PubMed、ScienceDirect 和 Web of Science。共纳入 11 项随机对照试验。使用Review Manager软件进行了元分析。采用标准化平均差(SMD)和95%置信区间(CI)来衡量效应大小,并且只考虑短期时间点:结果:并非所有研究都表明,与对照组相比,NSE 组的疼痛和残疾程度明显减轻。然而,荟萃分析表明,NSE 组的颈部疼痛(SMD:-0.25;95% CI:[-0.38,-0.12];P = 0.0002)和颈部残疾指数(SMD:-0.35;95% CI:[-0.54,-0.15];P = 0.0005)明显减少:结论:指导性 NSE疗法除了对动机和计划的坚持有好处外,还比不同的或无指导的 NSE疗法对疼痛和残疾有更大的益处。主要在干预时间超过六周且每周至少进行两次治疗的情况下才能观察到积极效果。
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来源期刊
CiteScore
4.60
自引率
6.70%
发文量
423
审稿时长
1 months
期刊介绍: American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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