脊柱活动和操作对心血管反应影响的系统回顾和荟萃分析。

Pub Date : 2020-12-01 Epub Date: 2020-08-06 DOI:10.1142/S1013702520500122

Charu Gera, Manoj Malik, Jaspreet Kaur, Minaxi Saini

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Mean changes in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Quality of the included studies was assessed by PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias.Results: Results of meta-analysis showed that there was statistically significant decrease in SBP ( <math><mstyle><mtext>MD</mtext></mstyle> <mo>=-</mo> <mn>4</mn> <mo>.</mo> <mn>56</mn></math> , 95% <math><mstyle><mtext>CI</mtext></mstyle> <mo>=-</mo> <mn>9</mn> <mo>.</mo> <mn>20</mn></math> , 0.08; <math><mi>p</mi> <mo>≤</mo> <mn>0</mn> <mo>.</mo> <mn>05</mn></math> ) with moderate heterogeneity ( <math><mstyle><mtext>I</mtext></mstyle> <mn>2</mn> <mo>=</mo> <mn>75</mn> <mi>%</mi></math> , <math><mi>p</mi> <mo><</mo> <mn>0</mn> <mo>.</mo> <mn>0002</mn></math> ) in experimental group as compared to control group. There was statistically non-significant decrease in DBP ( <math><mstyle><mtext>MD</mtext></mstyle> <mo>=-</mo> <mn>1</mn> <mo>.</mo> <mn>96</mn></math> , 95% <math><mstyle><mtext>CI</mtext></mstyle> <mo>=-</mo> <mn>4</mn> <mo>.</mo> <mn>60</mn></math> , 0.69; <math><mi>p</mi> <mo>=</mo> <mn>0</mn> <mo>.</mo> <mn>15</mn></math> ) with high heterogeneity ( <math><mstyle><mtext>I</mtext></mstyle> <mn>2</mn> <mo>=</mo> <mn>91</mn> <mi>%</mi></math> , <math><mi>p</mi> <mo><</mo> <mn>0</mn> <mo>.</mo> <mn>00001</mn></math> ), Change HR was statistically non-significant ( <math><mstyle><mtext>MD</mtext></mstyle> <mo>=-</mo> <mn>0</mn> <mo>.</mo> <mn>24</mn></math> , 95% <math><mstyle><mtext>CI</mtext></mstyle> <mo>=-</mo> <mn>3</mn> <mo>.</mo> <mn>59</mn></math> , 3.11; <math><mi>p</mi> <mo>=</mo> <mn>0</mn> <mo>.</mo> <mn>89</mn></math> ) with moderate heterogeneity ( <math><mstyle><mtext>I</mtext></mstyle> <mn>2</mn> <mo>=</mo> <mn>60</mn> <mi>%</mi></math> , <math><mi>p</mi> <mo>=</mo> <mn>0</mn> <mo>.</mo> <mn>01</mn></math> ). Exclusion of short duration studies in sensitivity analysis revealed a statistically significant change in DBP ( <math><mstyle><mtext>MD</mtext></mstyle> <mo>=-</mo> <mn>0</mn> <mo>.</mo> <mn>94</mn></math> , 95% <math><mstyle><mtext>CI</mtext></mstyle> <mo>=-</mo> <mn>1</mn> <mo>.</mo> <mn>85</mn></math> , <math><mo>-</mo> <mn>0</mn> <mo>.</mo> <mn>03</mn></math> ; <math><mi>p</mi> <mo>=</mo> <mn>0</mn> <mo>.</mo> <mn>04</mn></math> ). However, the result was statistically non-significant for HR after sensitivity analysis.Conclusion: Spinal manipulations and mobilizations may result in significant decrease of systolic as well as diastolic Blood Pressure.","PeriodicalId":0,"journal":{"name":"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1142/S1013702520500122","citationCount":"4","resultStr":"{\"title\":\"A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.\",\"authors\":\"Charu Gera, Manoj Malik, Jaspreet Kaur, Minaxi Saini\",\"doi\":\"10.1142/S1013702520500122\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Spinal pain or misalignment is a very common disorder affecting a significant number of populations resulting in substantial disability and economic burden. 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Risk of bias was assessed by Cochrane collaboration tool of risk of bias.Results: Results of meta-analysis showed that there was statistically significant decrease in SBP ( <math><mstyle><mtext>MD</mtext></mstyle> <mo>=-</mo> <mn>4</mn> <mo>.</mo> <mn>56</mn></math> , 95% <math><mstyle><mtext>CI</mtext></mstyle> <mo>=-</mo> <mn>9</mn> <mo>.</mo> <mn>20</mn></math> , 0.08; <math><mi>p</mi> <mo>≤</mo> <mn>0</mn> <mo>.</mo> <mn>05</mn></math> ) with moderate heterogeneity ( <math><mstyle><mtext>I</mtext></mstyle> <mn>2</mn> <mo>=</mo> <mn>75</mn> <mi>%</mi></math> , <math><mi>p</mi> <mo><</mo> <mn>0</mn> <mo>.</mo> <mn>0002</mn></math> ) in experimental group as compared to control group. 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引用次数: 4

摘要

背景:脊柱疼痛或错位是一种非常常见的疾病，影响了大量人群，导致大量残疾和经济负担。各种手工治疗技术，如脊柱操作和动员，可用于治疗和管理疼痛和运动功能障碍，如脊柱排列不当和相关并发症。这些手工治疗技术可以影响心血管参数。目的:本系统综述和荟萃分析的目的是评估脊柱操作和活动对心血管参数的影响。方法:我们进行了系统回顾和荟萃分析，以评估脊柱活动和操作对心血管反应的影响。收缩压(SBP)、舒张压(DBP)和心率(HR)的平均变化是主要的结局指标。采用RevMan 5.3软件进行meta分析。采用PEDro评定量表评估纳入研究的质量。偏倚风险评估采用Cochrane偏倚风险协作工具。结果:meta分析结果显示，两组患者收缩压降低有统计学意义(MD =- 4)。56, 95% ci =- 9。20,0.08;P≤0。0.05)，异质性中等(I 2 = 75%， p 0。0002)，与对照组比较。DBP降低无统计学意义(MD =- 1)。96, 95% ci =- 4。60, 0.69;P = 0。15)具有高异质性(I 2 = 91%， p 0。00001)， HR变化无统计学意义(MD =- 0)。24, 95% ci =- 3。59,3.11;P = 0。89)具有中等异质性(i2 = 60%， p = 0)。01)。在敏感性分析中排除短时间研究显示DBP有统计学意义的变化(MD =- 0)。94, 95% ci =- 1。85， - 0。03;P = 0。04)。然而，经敏感性分析，HR的结果无统计学意义。结论:脊柱操作和活动可显著降低收缩压和舒张压。

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A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.

Background: Spinal pain or misalignment is a very common disorder affecting a significant number of populations resulting in substantial disability and economic burden. Various manual therapeutic techniques such as spinal manipulations and mobilizations can be used to treat and manage pain and movement dysfunctions such as spinal mal-alignments and associated complications. These manual therapeutic techniques can affect the cardiovascular parameters.

Objective: The objective of this systematic review and meta-analysis is to assess the effect of spinal manipulation and mobilization on cardiovascular parameters.

Methods: We conducted a systematic review and meta-analysis to assess the effects of spinal mobilization and manipulation on cardiovascular responses. Mean changes in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Quality of the included studies was assessed by PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias.

Results: Results of meta-analysis showed that there was statistically significant decrease in SBP ( $MD =- 4.56$ , 95% $CI =- 9.20$ , 0.08; $p \leq 0.05$ ) with moderate heterogeneity ( $I 2 = 75 %$ , $p < 0.0002$ ) in experimental group as compared to control group. There was statistically non-significant decrease in DBP ( $MD =- 1.96$ , 95% $CI =- 4.60$ , 0.69; $p = 0.15$ ) with high heterogeneity ( $I 2 = 91 %$ , $p < 0.00001$ ), Change HR was statistically non-significant ( $MD =- 0.24$ , 95% $CI =- 3.59$ , 3.11; $p = 0.89$ ) with moderate heterogeneity ( $I 2 = 60 %$ , $p = 0.01$ ). Exclusion of short duration studies in sensitivity analysis revealed a statistically significant change in DBP ( $MD =- 0.94$ , 95% $CI =- 1.85$ , $- 0.03$ ; $p = 0.04$ ). However, the result was statistically non-significant for HR after sensitivity analysis.

Conclusion: Spinal manipulations and mobilizations may result in significant decrease of systolic as well as diastolic Blood Pressure.

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