The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management OPTIMa CollaborationReportar como inadecuado




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Chiropractic and Manual Therapies

, 23:30

First Online: 27 October 2015Received: 18 August 2015Accepted: 14 October 2015

Abstract

BackgroundMusculoskeletal disorders MSDs of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity.

MethodsRandomized controlled trials RCTs, cohort studies, and case–control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI.

ResultsWe screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults.

ConclusionsThe current evidence on the effectiveness of manual therapy for MSDs of the upper and lower extremities is limited. The available evidence supports the use of manual therapy for non-specific shoulder pain and ankle sprains, but not for subacromial impingement syndrome in adults. Future research is needed to determine the effectiveness of manual therapy and guide clinical practice.

Systematic review registration numberCRD42014009899

KeywordsManual therapy Musculoskeletal disorders Upper and lower extremities Treatment Rehabilitation Recovery Outcome Systematic review AbbreviationsADLActivities of daily living

CCGPPThe Council for Chiropractic Guidelines and Practice Parameters

CDCThe Centers for Diseases Control and Prevention

CIConfidence interval

FAAMThe Foot and Ankle Ability Measure

LEFSThe Lower Extremity Functional Scale

KKappa statistic

MCIDThe minimal clinically important difference

MeSHMedical Subject Headings

NRSThe Numeric Rating Scale

PRESSThe Peer Review of Electronic Search Strategies

PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analyses

PROSPEROThe International Prospective Register of Systematic Reviews

QuickDASHThe Quick Disabilities of the Arm, Hand, and Shoulder

RCTRandomized controlled trial

RRRelative risk

SDQThe Shoulder Disability Questionnaire

SIGNThe Scottish Intercollegiate Guidelines Network

WSIBThe Workplace Safety and Insurance Board

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Autor: Danielle Southerst - Hainan Yu - Kristi Randhawa - Pierre Côté - Kevin D’Angelo - Heather M. Shearer - Jessica J. Won

Fuente: https://link.springer.com/







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