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Tác động của liệu pháp photobiomodulation đỏ và gần hồng ngoại mức thấp đến cơn đau và chức năng trong bệnh tendinopathy: đánh giá hệ thống và phân tích tổng hợp các thử nghiệm kiểm soát ngẫu nhiên
Tóm tắt
Bệnh tendinopathy là một tình trạng lâm sàng phổ biến có thể ảnh hưởng đáng kể đến chức năng thể chất và chất lượng cuộc sống của một người. Mặc dù liệu pháp tập luyện là phương pháp chính trong quản lý bệnh tendinopathy, nhưng vẫn còn nhiều liệu pháp hỗ trợ tiềm năng chưa được nghiên cứu đầy đủ, trong đó có photobiomodulation (PBM). PBM sử dụng các bước sóng ánh sáng khác nhau để tạo ra một hiệu ứng sinh học. Trong khi PBM thường được sử dụng trong quản lý bệnh tendinopathy, bằng chứng chất lượng cao hỗ trợ sự hữu ích của nó vẫn còn thiếu. Một cuộc tìm kiếm hệ thống trên các cơ sở dữ liệu Pubmed, CINAHL, SCOPUS, Cochrane Database, Web of Science và SPORTSDICUS đã được thực hiện để tìm các bài báo đủ điều kiện vào tháng 8 năm 2020. Các thử nghiệm kiểm soát ngẫu nhiên (RCT) sử dụng PBM đỏ hoặc gần hồng ngoại để điều trị các rối loạn tendinopathy và so sánh với nhóm giả dược hoặc 'can thiệp khác' đã được đưa vào. Dữ liệu về cơn đau và chức năng đã được trích xuất từ các nghiên cứu được chọn. Dữ liệu được tổng hợp bằng cách sử dụng mô hình hiệu ứng ngẫu nhiên. Phân tích tổng hợp được thực hiện bằng cách sử dụng các chỉ số chênh lệch trung bình (MD) và chênh lệch trung bình chuẩn hóa (SMD). Tổng cộng có 17 thử nghiệm được đưa vào (n = 835). Khi so sánh chỉ với các can thiệp khác, PBM đã làm giảm cơn đau tương tự (MD -0.09; 95% CI − 0.79 đến 0.61) và cải thiện chức năng ít hơn (SMD -0.52; 95% CI − 0.81 đến − 0.23). Khi so sánh PBM cộng với tập luyện với điều trị giả dược cộng với tập luyện, PBM cho thấy sự giảm cơn đau lớn hơn (MD 1.06; 95% CI 0.57 đến 1.55) và cải thiện chức năng (MD 5.65; 95% CI 0.25 đến 11.04). Khi so sánh PBM cộng với tập luyện với các can thiệp khác cộng với tập luyện, không có sự khác biệt nào về mức độ đau (MD 0.31; 95% CI − 0.07 đến 0.70). Hầu hết các nghiên cứu được đánh giá là có nguy cơ thiên lệch thấp. Các chỉ số kết quả được phân loại là chứng cứ rất thấp đến trung bình theo công cụ Grading of Recommendation, Development and Evaluation (GRADE). Có bằng chứng chất lượng rất thấp đến trung bình cho thấy rằng PBM có tác dụng như một liệu pháp độc lập và/hoặc bổ sung cho các rối loạn tendinopathy. Số đăng ký PROPERO:
CRD42020202508
.
Từ khóa
Tài liệu tham khảo
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