摘要
目的评价早期锻炼对关节镜下肩袖修补术后康复影响相关系统评价的方法学质量及结论的可靠程度。方法计算机检索中国知网、万方、Cochrane Library、Embase、PubMed数据库,搜集肩袖修补术后早期锻炼相关的系统评价,检索时限均为建库至2020年10月31日。由2名评价员独立筛选文献、提取资料后,使用AMSTAR 2量表和GRADE系统分别对纳入研究的方法学及证据质量等级进行评价。结果共纳入8篇系统评价,AMSTAR 2量表评价结果显示,3篇系统评价的方法学质量为低,5篇系统评价的方法学质量为极低。应用GRADE工具对51个结局指标进行证据质量评价,结果显示,52.94%(27/51)为中等证据,21.57%(11/51)为低级证据,25.49%(13/51)为极低级证据,无证据质量显示为高级。结论目前证据显示,早期锻炼可促进关节镜下肩袖修补患者术后早期的关节活动度康复,同时也会一定程度地增加肩袖肌腱再撕裂的风险;在长期效果方面,早期锻炼与延迟锻炼方案相比并未见显著差异。但相关系统评价的方法学质量和证据等级的可靠程度均较低,有待开展更多高质量的原始研究进一步证实结论。
Objective To evaluate the methodological quality and reliability of the conclusions of systematic reviews on the effectiveness of early exercise on rehabilitation after arthroscopic rotator cuff repair.Methods Systematic reviews related to early exercise after rotator cuff repair were retrieved by computer from China National Knowledge Infrastructure(CNKI),WanFang,Cochrane Library,Embase and PubMed.The retrieval time limit was from the establishment of the database to October 31,2020.Two reviewers independently screened the articles,extracted data,and used A Measurement Tool to Assess Systematic Reviews(AMSTAR)2 and the Grades of Recommendation,Assessment,Development,and Evaluation(GRADE)to evaluate the methodology and quality of evidence of the included studies,respectively.Results A total of 8 systematic reviews were included.The evaluation results of the AMSTAR 2 showed that 3 articles were of low methodological quality,and 5 articles were of very low methodological quality.The GRADE was used to evaluate the quality of evidence for 51 outcome indicators,and the results showed that 52.94%(27/51)were moderate evidence,21.57%(11/51)were low-level evidence,25.49%(13/51)were very low-level evidence,and no evidence quality was shown as high.Conclusions Current evidence shows that early exercise can promote early recovery of joint range of motion in patients with arthroscopic rotator cuff repair,while also increasing the risk of rotator cuff tendon re-tear to a certain extent.In terms of long-term effects,no significant difference is seen between early exercise and delayed exercise.However,the methodological quality and the reliability of the evidence level of the systematic reviews are low,and high-quality original studies are needed to be further confirmed.
作者
尹朱丹
钟琦
包倪荣
刘云
Yin Zhudan;Zhong Qi;Bao Nirong;Liu Yun(Neurosurgery Intensive Care Unit,the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China;Department of Orthopedics,Nanjing Drum Tower Hospital,Nanjing 210008,China;Department of Orthopedics,General Hospital of Eastern Theater Command of the Chinese People's Liberation Army,Nanjing 210002,China;Health Technology Cadre Training Center,General Hospital of Eastern Theater Command of the Chinese People's Liberation Army,Nanjing 210002,China)
出处
《中华现代护理杂志》
2022年第7期886-892,共7页
Chinese Journal of Modern Nursing
关键词
康复
肩袖修补术
早期锻炼
系统评价再评价
Rehabilitation
Rotator cuff repair
Early exercise
Overview of systematic review
