非手术治疗慢性踝关节不稳者足踝功能和动态平衡能力的网状Meta分析  

Network meta-analysis of non-surgical treatments for foot and ankle ability and dynamic balance in patients with chronic ankle instability

作　　者：张新新 高克 谢世栋 陀浩雯 经飞跃 刘卫国[1] Zhang Xinxin;Gao Ke;Xie Shidong;Tuo Haowen;Jing Feiyue;Liu Weiguo(School of Physical Education and Health,Guangxi Normal University,Guilin 541004,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西师范大学体育与健康学院,广西壮族自治区桂林市541004

出　　处：《中国组织工程研究》2025年第9期1931-1944,共14页Chinese Journal of Tissue Engineering Research

基　　金：广西哲学社会科学研究课题“广西优势项目爆发力测量与训练方法研究”(23BTY004),项目负责人:刘卫国;广西研究生教育创新计划项目“消防救援任务生物力学共性特征与个性化策略研究”(XYCBZ2024014),项目负责人:张新新。

摘　　要：目的:尽管多种非手术疗法改善慢性踝关节不稳患者足踝功能和动态平衡能力的效果已得到证实,但由于治疗方法的不断更新,目前最佳的慢性踝关节不稳非手术疗法尚不明确。文章通过网状Meta分析的方法,探讨不同非手术疗法对慢性踝关节不稳患者足踝功能和动态平衡能力的疗效,以期寻找最佳治疗措施。方法:以“CAI,Exercise,Randomized controlled trial”等为检索词,通过计算机网络对PubMed,Embase,Cochrane图书馆和Web of Science数据库进行文献检索,收集各数据库建库至2024年3月关于非手术疗法治疗慢性踝关节不稳患者足踝功能或动态平衡能力的随机对照试验。运用EndNote软件进行文献管理,采用RevMan 5.4软件和Cochrane风险偏倚评估工具对纳入文献进行风险偏倚评价。使用Stata 14.0软件的network命令对足踝能力评估日常活动子量评分、足踝能力评估体育活动子量表评分、前侧星形偏移平衡测试评分、后内侧星形偏移平衡测试评分、后外侧星形偏移平衡测试评分和坎伯兰踝关节不稳问卷评分结局指标进行传统Meta分析和网状Meta分析。根据GRADE证据等级及推荐强度分级标准对结局指标进行证据强度等级评价。结果:在符合纳入标准的22项随机对照试验中,1项研究被评为低风险,8项研究被评为中风险,13项研究被评为高度风险,共计纳入952例患者,25种治疗措施。①网状Meta分析结果显示,与对照组相比,等速力量训练、平衡训练、平衡+频闪眼镜训练、力量训练、关节活动度训练、CrossFit训练、CrossFit+自我动员训练、震动板训练、美国国家运动医学学会矫正锻炼计划、触发点干针法和神经肌肉训练在改善慢性踝关节不稳患者足踝功能和动态平衡能力方面具有不同程度的显著提升效果(P<0.05)。②累积概率排序结果显示,坎伯兰踝关节不稳问卷评分排名最靠前的3种治疗措施为:关节�OBJECTIVE:The optimal non-surgical therapy for chronic ankle instability remains unclear due to the continuous introduction of novel treatment methods despite the availability of several non-surgical options for improving foot and ankle function and dynamic balance in chronic ankle instability patients.This study aims to investigate the most effective non-surgical therapy options to improve foot and ankle function and dynamic balance for patients with chronic ankle instability using a network meta-analysis.METHODS:Using“CAI,exercise,and randomized controlled trial”as search terms,a literature search of PubMed,Embase,Cochrane Library,and Web of Science databases was conducted through a computer network to collect information from the databases from their inception to March 2024 on non-surgical therapies for the treatment of chronic ankle instability randomized controlled trials on foot and ankle function or dynamic balance in patients.EndNote software was utilized for literature management.RevMan 5.4 software and Cochrane Risk of Bias Assessment Tool were used to evaluate the risk of bias of the included literature.Paired meta-analysis and network meta-analysis of the outcomes such as the Foot and Ankle Ability Measure in daily living subscale score,Foot and Ankle Ability Measure in sports activities subscale score,Star Excursion Balance Test-Anterior score,Star Excursion Balance Test-Posteromedial score,Star Excursion Balance Test-Posterolateral score and Cumberland ankle instability tool score were performed using the network commands of Stata 14.0 software.The strength of evidence rating of the outcome metrics was evaluated according to the GRADE Level of Evidence and Strength of Recommendation Grading Criteria.RESULTS:Of the 22 randomized controlled trials that met the inclusion criteria,1 study was rated as low risk,8 studies were rated as medium risk,and 13 studies were rated as high risk,enrolling a total of 952 patients and 25 treatments.(1)Network meta-analysis showed that compared with the control gr

关 键 词：慢性踝关节不稳 足踝功能 足踝能力评估 动态平衡 星形偏移平衡测试 非手术疗法 CAI 网状Meta分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R319