An overview of systematic reviews examining the quantitative sensory testing-derived hypoalgesic effects of manual therapy for musculoskeletal pain.

IF 1.6 Q2 REHABILITATION Journal of Manual & Manipulative Therapy Pub Date : 2024-02-01 Epub Date: 2024-01-16 DOI:10.1080/10669817.2023.2267954
Logan J Rodgers, Joel E Bialosky, Sophie A Minick, Rogelio A Coronado
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Abstract

Background: Changes in quantitative sensory testing (QST) after manual therapy can provide insight into pain relief mechanisms. Prior systematic reviews have evaluated manual-therapy-induced QST change. This overview of systematic reviews aims to consolidate this body of literature and critically review evidence on the hypoalgesic effects of manual therapy in clinical populations.

Methods: A comprehensive search was conducted on PubMed, CINAHL, PsycInfo, and Embase. Peer-reviewed systematic reviews with or without meta-analysis were eligible if the reviews examined the effect of manual therapy compared to non-manual therapy interventions on QST outcomes in clinical populations. Methodological quality was assessed with the AMSTAR 2 tool. Meta-analysis results and qualitative (non-meta-analysis) interpretations were summarized by type of manual therapy. Overlap of studies was examined with the corrected covered area (CCA) index.

Results: Thirty systematic reviews, including 11 meta-analyses, met inclusion. There was a slight overlap in studies (CCA of 1.72% for all reviews and 1.69% for meta-analyses). Methodological quality was predominantly low to critically low. Eight (27%) reviews examined studies with a range of manual therapy types, 13 (43%) reviews focused on joint-biased manual therapy, 7 (23%) reviews focused on muscle-biased manual therapy, and 2 (7%) reviews focused on nerve-biased manual therapy. Twenty-nine (97%) reviews reported on pressure pain threshold (PPT). Meta-analytic results demonstrated conflicting evidence that manual therapy results in greater hypoalgesic effects compared to other interventions or controls.

Conclusion: Our overview of QST effects, which has relevance to mechanisms underlying hypoalgesia, shows conflicting evidence from mostly low to critically low systematic reviews.

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对肌肉骨骼疼痛手动治疗的定量感觉测试衍生的痛觉减退效应进行系统综述。
背景:手法治疗后定量感觉测试(QST)的变化可以深入了解疼痛缓解机制。先前的系统综述已经评估了手动治疗引起的QST变化。这篇系统综述旨在巩固这一文献,并批判性地回顾临床人群中手动治疗的痛觉减退作用的证据。方法:在PubMed、CINAHL、PsycInfo和Embase上进行综合检索。如果审查检查了手动治疗与非手动治疗干预对临床人群QST结果的影响,则有或没有荟萃分析的同行评审系统审查是合格的。使用AMSTAR 2工具评估方法学质量。按手法治疗类型总结荟萃分析结果和定性(非荟萃分析)解释。采用校正覆盖面积(CCA)指数检查研究重叠情况。结果:30篇系统综述,包括11篇荟萃分析,符合入选标准。研究中略有重叠(所有综述的CCA为1.72%,荟萃分析的CCA则为1.69%)。方法学质量主要从低到极低。8篇(27%)综述审查了一系列手法治疗类型的研究,13篇(43%)综述关注关节偏向手法治疗,7篇(23%)综述关注肌肉偏向手法治疗和2篇(7%)综述关注神经偏向手法治疗。29篇(97%)评论报道了压痛阈值(PPT)。荟萃分析结果表明,与其他干预或对照相比,手动治疗会产生更大的痛觉减退效果,这一证据相互矛盾。结论:我们对QST效应的概述与痛觉减退的潜在机制有关,从大多数低到极低的系统综述显示了相互矛盾的证据。
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来源期刊
CiteScore
2.50
自引率
20.00%
发文量
55
期刊介绍: The Journal of Manual & Manipulative Therapy is an international peer-reviewed journal dedicated to the publication of original research, case reports, and reviews of the literature that contribute to the advancement of knowledge in the field of manual therapy, clinical research, therapeutic practice, and academic training. In addition, each issue features an editorial written by the editor or a guest editor, media reviews, thesis reviews, and abstracts of current literature. Areas of interest include: •Thrust and non-thrust manipulation •Neurodynamic assessment and treatment •Diagnostic accuracy and classification •Manual therapy-related interventions •Clinical decision-making processes •Understanding clinimetrics for the clinician
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