Pablo Muñoz Lazcano, Daniel Rojano Ortega, Isidro Fernández López
{"title":"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。","authors":"Pablo Muñoz Lazcano, Daniel Rojano Ortega, Isidro Fernández López","doi":"10.1097/PHM.0000000000002460","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>To claim cme credits: </strong>Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.</p><p><strong>Cme objectives: </strong>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.</p><p><strong>Level: </strong>Advanced.</p><p><strong>Accreditation: </strong>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.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"971-978"},"PeriodicalIF":2.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of a Guided Neck-Specific Exercise Therapy on Recovery After a Whiplash: A Systematic Review and Meta-analysis.\",\"authors\":\"Pablo Muñoz Lazcano, Daniel Rojano Ortega, Isidro Fernández López\",\"doi\":\"10.1097/PHM.0000000000002460\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>To claim cme credits: </strong>Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.</p><p><strong>Cme objectives: </strong>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.</p><p><strong>Level: </strong>Advanced.</p><p><strong>Accreditation: </strong>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) ™. 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Effects of a Guided Neck-Specific Exercise Therapy on Recovery After a Whiplash: A Systematic Review and Meta-analysis.
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.
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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