不同锻炼方式改善乳腺癌术后患者肩关节功能的网状Meta分析  

Effect of different exercise modalities to improve shoulder function in postoperative breast cancer patients:a network Meta-analysis

作　　者：冯颖 魏洪悦 王维宁[2] Feng Ying;Wei Hongyue;Wang Weining(Graduate School,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;不详)

机构地区：[1]天津中医药大学研究生院,天津301617 [2]天津中医药大学第一附属医院

出　　处：《护理学杂志》2024年第19期81-85,共5页Journal of Nursing Science

摘　　要：目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。Objective To evaluate the effect of different rehabilitation exercises on shoulder joint function after breast cancer surgery.Methods Randomized controlled trials on the improvement of shoulder joint function by exercise in patients with breast cancer after operation were retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Embase,Cochrane Library and Web of Science databases.The retrieval time was from the establishment of the database to January 2024.The quality assessment and data analysis of the literature were performed using the Stata17.0 software.Results A total of 13 studies were included,involving 9 exercise methods and 994 patients.The results of the network Meta-analysis showed that the effects of hydrotherapy and progressive rehabilitation exercise were better than those of routine nursing in improving shoulder flexion function(both P<0.05),and the effect of hydrotherapy was the best.In terms of improving shoulder extension function,the effects of progressive rehabilitation exercise,proprioceptive neuromuscular facilitation and tuina were better than those of routine nursing(all P<0.05),and the effect of progressive rehabilitation exercise was the best.In terms of improving shoulder external rotation function,the effect of progressive rehabilitation exercise was better than that of routine nursing(P<0.05).In terms of improving the internal rotation function of the shoulder,there was no statistical difference between the two exercise methods involved.In terms of pain relief,the intervention effect of resistance training was better than that of routine nursing(P<0.05).Conclusion Hydrotherapy can better improve shoulder flexion function.Progressive rehabilitation exercise has more advantages in improving shoulder extension and external rotation function.Resistance training has the best effect in improving shoulder pain.

关 键 词：乳腺癌术后 肩关节活动度 水疗法 渐进式康复操 抗阻力训练 疼痛 康复疗法 网状Meta分析 

分 类 号：R473.6[医药卫生—护理学]