治疗性运动对头前倾并发颈痛患者颈部功能和生活质量影响的Meta分析

doi:10.3969/j.issn.1006-9771.2023.02.010

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (2): 214-222.doi: 10.3969/j.issn.1006-9771.2023.02.010

治疗性运动对头前倾并发颈痛患者颈部功能和生活质量影响的Meta分析

孙喜妹, 刘华(), 柴良伟, 李凯洋, 马景

首都体育学院，北京市 100191

收稿日期:2022-05-11 修回日期:2022-08-24 出版日期:2023-02-25 发布日期:2023-03-16
通讯作者: 刘华 E-mail:liuhua@cupes.edu.cn
作者简介:孙喜妹(1997-)，女，汉族，山西临汾市人，硕士研究生，主要研究方向：运动损伤的预防与康复。
基金资助:
北京高校优质本科课程(145122005/004);北京高等教育"本科教学改革创新项目"(145122002/007)

Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis

SUN Ximei, LIU Hua(), CHAI Liangwei, LI Kaiyang, MA Jing

Capital University of Physical Education and Sports, Beijing 100191, China

Received:2022-05-11 Revised:2022-08-24 Published:2023-02-25 Online:2023-03-16
Contact: LIU Hua E-mail:liuhua@cupes.edu.cn
Supported by:
Supported by Quality Undergraduate Programme in Beijing Universities No(145122005/004);Beijing Higher Education "Undergraduate Teaching Reform Innovation Project" No(145122002/007)

摘要/Abstract

摘要：

目的系统分析治疗性运动对头前倾并发颈痛患者颈部功能和生活质量的效果。方法计算机检索PubMed、Web of Science、Embase、Medline、Science Direct、EBSCO、Springlink、中国知网、维普、万方数据库。文献类型为不同类型治疗性运动对头前倾并发颈痛患者颈部功能和生活质量的随机对照试验，检索时间为建库至2022年4月。由2名研究人员独立对文献进行筛选，研究人员采用Cochrane风险评估量表与物理治疗证据数据库量表进行文献质量评价，运用Revman 5.4软件进行Meta分析。结果最终纳入11篇文献，共416例患者。1a级证据证明肩胛骨稳定性训练能有效改善头前倾并发颈痛患者头前倾角度(MD = 3.62, 95%CI 2.41~4.83, P < 0.001)，减轻颈部疼痛(MD = 1.32, 95%CI 0.18~2.46, P = 0.02)。1b级证据证明肩胛骨稳定性训练可减轻功能残疾(MD = -0.92, 95%CI -1.11~-0.74, P < 0.001)；1b级证据证明颈深屈肌训练能改善头前倾角度(MD = -0.83, 95%CI -1.56~-0.10, P = 0.03)，减轻颈部疼痛(MD = 0.93, 95%CI 0.54~1.32, P < 0.001)，改善功能残疾(MD = 2.17, 95%CI 1.39~2.95, P < 0.001)。结论肩胛骨稳定性训练颈深屈肌训练均能有效改善头前倾，减轻疼痛，改善颈部功能。

关键词: 头前倾, 颈痛, 运动, 生活质量, 颈部功能, Meta分析

Abstract:

Objective To systematically analyze the effect of therapeutic exercise on neck function and quality of life in patients with neck pain and forward head posture. Methods Randomized controlled trials about the effects of exercise training on forward head posture and neck pain were searched from PubMed, Web of science, Embase, Medline, Science Direct, EBSCO, Springlink, CNKI, VIP, and Wanfang Data from database establishment to April, 2022. The literature was screened by two researchers independently. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software was used for meta-analysis. Results A total of 416 patients from eleven literatures were included. Level 1a evidence indicated scapula stability training could effectively improve cranial vertebral angle (MD = 3.62, 95%CI 2.41 to 4.83, P < 0.001), and relieve pain (MD = 1.32, 95%CI 0.18 to 2.46, P = 0.02). Level 1b evidence indicated scapula stability training could reduce functional disability (MD = -0.92, 95%CI -1.11 to -0.74, P < 0.001). Level 1b evidence indicated deep cervical flexor training could improve cranial vertebral angle (MD = -0.83, 95%CI -1.56 to -0.10, P = 0.03), relieve pain (MD = 0.93, 95%CI 0.54 to 1.32, P < 0.001), and improve neck functional disability (MD = 2.17, 95%CI 1.39 to 2.95, P < 0.001). Conclusion Scapula stability training and deep cervical flexor training can effectively improve cranial vertebral angle, relieve neck pain, and improve neck function.

Key words: forward head posture, neck pain, exercise, quality of life, neck function, meta-analysis

中图分类号:

R681.5

孙喜妹, 刘华, 柴良伟, 李凯洋, 马景. 治疗性运动对头前倾并发颈痛患者颈部功能和生活质量影响的Meta分析[J]. 《中国康复理论与实践》, 2023, 29(2): 214-222.

SUN Ximei, LIU Hua, CHAI Liangwei, LI Kaiyang, MA Jing. Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 214-222.

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参考文献 44

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纳入文献	n		运动干预		干预时间	结局指标
纳入文献	对照组	试验组	对照组	试验组	干预时间	CVA	VAS	NDI	生活质量
Gupta等^[21](2013)	15	15	姿势矫正	颈深屈肌训练	4周	√	√	√
Lee等^[22](2016)	14	14	拉伸练习	普拉提运动	10周	√	√	√
Im等^[23](2016)	7	8	放松练习	肩胛骨稳定性训练	4周	√	√	√	√
Chung等^[24](2018)	19	22	自我姿势矫正	颈深屈肌训练	8周		√	√
Fathollahnejad等^[25](2019)	20	40	姿势矫正	肩胛骨稳定性训练	6周	√	√	√
Letafatkar等^[26](2020)	24	24	姿势矫正	本体感觉，力量耐力练习	8周	√	√	√	√
Mehri等^[27](2020)	16	16	自我锻炼	肩颈肌肉强化训练	8周	√	√
Sikka等^[28](2020)	15	15	姿势教育	颈深屈肌训练	4周	√	√	√
Abadiyan等^[29](2021)	20	40	日常姿势矫正	拉伸紧张肌肉，训练薄弱肌肉	8周	√	√	√	√
Kang等^[30](2021)	16	16	颈椎伸展练习	肩胛骨稳定性训练	6周	√	√	√
Dareh-Deh等^[31](2022)	20	20	姿势矫正	肩胛骨稳定性训练	8周	√	√

研究	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率 ≤ 15%	意向性分析	组间统计比较	变异性测量	总分
Gupta等^[21](2013)	√	√		√				√		√	√	5
Lee等^[22](2016)	√	√		√	√		√	√	√	√	√	8
Im等^[23](2016)	√	√		√				√		√	√	5
Chung等^[24](2018)	√	√	√	√				√			√	5
Fathollahnejad等^[25](2019)	√	√	√		√	√	√	√		√	√	8
Letafatkar等^[26](2020)	√	√	√	√	√	√	√	√	√	√		9
Mehri等^[27](2020)	√	√		√	√		√	√	√	√	√	8
Sikka等^[28](2020)	√	√	√	√	√	√	√	√		√		8
Abadiyan等^[29](2021)	√	√	√	√	√		√	√		√	√	8
Kang等^[30](2021)	√	√	√	√				√		√		5
Dareh-Deh等^[31](2022)	√	√	√		√	√	√	√		√	√	8

治疗性运动对头前倾并发颈痛患者颈部功能和生活质量影响的Meta分析

Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis

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