水疗对青少年异常性关节炎的影响:系统性审查和元分析
Gleb Verit1, Danish Anwar, Matthew Greenberg
1Department of Physical Therapy, Long Island University, Brooklyn, New York (Drs Verit, Anwar, Greenberg, Cisek, Hinrichs, Mensah, and Kirker).
概括
水疗 (HT) 与标准护理相比,在患有青少年异常性关节炎 (JIA) 的儿童中显著减少疼痛和改善心肺呼吸能力 (VO2max). 然而,功能性结果显示没有显著差异.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 康复医学 康复医学 康复医学
- 临床试验 临床试验
背景情况:
- 青少年异常性关节炎 (JIA) 是一种慢性自身免疫性疾病,影响儿童,导致关节疼痛和功能限制.
- 水疗 (HT),在水中进行运动干预,正在作为JIA的潜在治疗方式进行探索.
- 关于HT对儿科JIA患者疼痛和功能的特定益处的证据需要进行系统评估.
研究的目的:
- 系统地评估水疗 (HT) 干预治疗疼痛和功能能力的有效性,在被诊断为青少年异常性关节炎 (JIA) 的儿童中.
主要方法:
- 随机临床试验 (RCT) 的系统审查和元分析,将HT与JIA儿童的控制干预措施进行比较.
- 偏差风险评估使用柯克兰偏差风险2和证据质量评估与推评估,开发和评估 (GRADE) 的评级.
主要成果:
- 分析表明,减少疼痛和心肺呼吸能力 (VO2最大值) 的统计显著改善,有利于水疗 (HT) 与标准护理相比.
- 对于功能性测量 (儿童健康评估问卷 - CHAQ),峰值膝盖延伸器扭矩或6分钟步行测试,没有观察到HT和标准护理之间的显著差异.
- 支持这些发现的证据的整体质量从非常低到中等.
结论:
- 水疗在与标准护理相比,在患有青少年异常性关节炎 (JIA) 的儿童中,显示出降低疼痛和提高心肺呼吸能力 (VO2max) 的有益作用.
- 目前的证据表明,水疗可能不会显著改善这一群体的功能结果.
- 需要进一步进行高质量的研究来证实这些发现,并探索JIA管理的最佳HT协议.
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