在多发性硬化症中治疗性的非药理学干预措施的有效性:系统性审查
Bhasker Amatya1,2,3,4, Fary Khan1,2,3,4, Krystal Song1,2,4
1Department of Rehabilitation Medicine, Royal Melbourne Hospital, Melbourne, Australia.
Annals of rehabilitation medicine
|November 5, 2024
概括
非药物疗法,如体力活动和跨磁刺激,对管理多发性硬化症性有中低确定性证据. 其他干预措施缺乏足够的证据,突出显示需要更强大的试验.
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 基于证据的实践.
背景情况:
- 是多发性硬化症 (MS) 的常见且经常使人衰弱的症状.
- 不药物干预越来越多地被探索用于管理MS相关的性.
- 这些干预措施的现有证据需要进行系统的评估.
研究的目的:
- 系统地审查多发性硬化症 (pwMS) 患者的性非药物干预措施的有效性.
- 评估各种非药物管理策略的证据质量.
主要方法:
- 在主要的健康科学数据库 (MEDLINE,Embase,CENTRAL,CINHAL) 进行了全面的文献搜索,截至2024年4月.
- 包含的随机对照试验 (RCT) 被独立选择并由两位作者对方法质量进行评估.
- 由于研究异质性,没有进行元分析.
主要成果:
- 32项涉及1481名参与者的RCT评估了包括体力活动,跨磁刺激 (TMS) 和针在内的干预措施.
- 所有纳入的研究都具有较低的方法质量,表明存在高偏差风险.
- 中等到低确定性证据支持身体活动和TMS (iTBS/rTMS) 治疗;其他干预措施的确定性证据非常低.
结论:
- 虽然体力活动和TMS显示出一些希望,但对于许多治疗MS性的非药物干预措施缺乏确的证据.
- 目前的证据基础受到现有试验的方法质量和异质性的限制.
- 未来的研究应该专注于强大的,大规模的RCT,随访时间更长,以确定最终的疗效.
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