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首页> 外文期刊>The journal of orthopaedic and sports physical therapy >The Effect of Therapeutic Exercise and Mobilization on Patients With Shoulder Dysfuction: A Systematic Review With Meta-analysis.
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The Effect of Therapeutic Exercise and Mobilization on Patients With Shoulder Dysfuction: A Systematic Review With Meta-analysis.

机译：治疗性运动和动员对肩功能不全患者的影响：荟萃分析的系统评价。

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STUDY DESIGN: Systematic review with meta-analysis. OBJECTIVE: To pool and summarize the published research evidence examining if the combination of therapeutic exercise and joint mobilization is more beneficial than therapeutic exercise alone in patients with shoulder dysfunction. BACKGROUND: Therapeutic exercise is an effective intervention for patients with shoulder dysfunction, which is often supplemented by joint mobilization techniques. Numerous studies have examined the effects of the combination of therapeutic exercise and joint mobilization on patients with shoulder dysfunction. METHODS: Six databases were searched for randomized controlled trials. All the randomized controlled trials published in English that have studied the effectiveness of therapeutic exercise and joint mobilization on adults with either clinically or radiographically confirmed shoulder dysfunction resulting in pain, restriction of range of motion (ROM), and/or limitation in function, were included in this review. Effect size was calculated in the form of standardized mean difference and 95% confidence interval (CI) for each variable, then combined to represent weighted standardized mean differences (WSMDs) and 95% CIs. RESULTS: Seven studies that met the inclusion criteria were identified, with a total of 290 participants. The WSMDs and CIs, which combined the results of all the studies for a particular variable, revealed equivocal results for all variables. The resulting WSMD (95% CI) for each of the variables was 0.2 (-0.68, 1.08) for pain, 0.15 (-0.67, 0.97) for abduction ROM, -0.04 (-0.65, 0.57) for flexion ROM, 0.01(-0.79, 0.81) for internal and external rotation ROM, and 0.09 (-0.46, 0.64) for function and disability. Even after elimination of sources of heterogeneity, the new WSMDs and CIs continued to overlap zero, giving equivocal results. CONCLUSION: The current evidence is inconclusive with respect to the beneficial effects of the combination of therapeutic exercise and joint mobilization versus therapeutic exercise alone for reducing pain, increasing ROM and function, and limiting disability in patients with shoulder dysfunction. LEVEL OF EVIDENCE: Therapy, level 1a-. J Orthop Sports Phys Ther 2011;41(10):734-748, Epub 4 September 2011. doi:10.2519/jospt.2011.3440.
机译：研究设计：荟萃分析的系统评价。目的：汇总并总结已发表的研究证据，以研究治疗性运动与联合关节运动相结合是否比肩部功能障碍患者更有益于治疗性运动。背景：治疗性运动是对肩部功能障碍患者的有效干预，通常以关节动员技术为补充。许多研究已经检查了治疗运动和关节活动相结合对肩功能不全患者的影响。方法：从六个数据库中搜索随机对照试验。所有以英语发表的随机对照试验均研究了治疗性运动和关节活动对成年人的临床或影像学证实的肩部功能障碍导致疼痛，活动范围（ROM）受限和/或功能受限的有效性。包括在此评论中。针对每个变量，以标准化平均差和95％置信区间（CI）的形式计算效果大小，然后合并以代表加权的标准化平均差（WSMD）和95％CI。结果：确定了七项符合纳入标准的研究，共有290名参与者。 WSMD和CI结合了针对特定变量的所有研究结果，揭示了所有变量的模棱两可的结果。对于每个变量，所得WSMD（95％CI）对于疼痛而言分别为0.2（-0.68，1.08），对于外展ROM为0.15（-0.67，0.97），对于屈曲ROM为-0.04（-0.65，0.57），0.01（-内部和外部ROM分别为0.79、0.81）和功能和残障度为0.09（-0.46、0.64）。即使消除了异质性源之后，新的WSMD和CI仍然重叠为零，结果模棱两可。结论：目前的证据对于治疗性运动和关节活动相结合与单独治疗性运动对减轻疼痛，增加ROM和功能以及限制肩功能不全患者的残疾的有益作用尚无定论。证据级别：治疗，级别1a-。 J Orthop Sports Phys Ther 2011; 41（10）：734-748，Epub，2011年9月4日。doi：10.2519 / jospt.2011.3440。

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