1.Effect of therapeutic exercise on posture control and muscular function around ankle in patients with functional ankle instability: a meta-analysis
Liangwei CHAI ; Hua LIU ; Qiuyu HUANG ; Ximei SUN ; Kaiyang LI ; Jing MA
Chinese Journal of Rehabilitation Theory and Practice 2022;28(11):1278-1287
ObjectiveTo explore the effect of exercise on the postural control and muscular function around the ankle in patients with functional ankle instability (FAI) with meta-analysis. MethodsRandomized controlled trials about therapeutic exercise for FAI published before December, 2021 were searched from PubMed, EBSCO, SPORTdiscus, Medline, Science Direct, Springlink, Web of Science, Embase CNKI, VIP and Wanfang Data. The quality and evidence grades of the researches were evaluated by two researchers, and the outcomes were analyzed with RevMan 5.4. ResultsFourteen randomized controlled trials were finally included, involving 434 subjects. Compared with no exercise intervention, therapeutic exercise might significantly improve the movement of center of pressure whether with eye-open or eye-closed (eye-open, SMD = -0.28, 95%CI -0.46 to -0.09, P = 0.003; eye-closed, SMD = -0.24, 95%CI -0.40 to -0.09, P = 0.001); while therapeutic exercise might also enhance the activation of the peroneus longus before dynamic task (SMD = 0.38, 95%CI 0.05 to 0.71, P = 0.03), and activation of the peroneus longus (SMD = 0.53, 95%CI 0.16 to 0.90, P = 0.005) and tibialis anterior (SMD = 0.47, 95%CI 0.10 to 0.84, P = 0.01) after dynamic task. There was neither significant difference in the activation of the tibialis anterior (SMD = 0.48, 95%CI -0.14 to 1.11, P = 0.13), nor the peak torque ratio of eversion to inversion isokinetic strength (SMD = -0.15, 95%CI -0.46 to 0.16, P = 0.340) before dynamic task between the two groups. ConclusionTherapeutic exercise can decrease movement of center of pressure, enable anticipatory contraction of peroneus longus before dynamic tasks and compensatory contraction of peroneus longus and tibialis anterior after tasks, to make it easier to deal with external interference, maintain articular stability and prevent re-injury.
2.Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis
Ximei SUN ; Hua LIU ; Liangwei CHAI ; Kaiyang LI ; Jing MA
Chinese Journal of Rehabilitation Theory and Practice 2023;29(2):214-222
ObjectiveTo systematically analyze the effect of therapeutic exercise on neck function and quality of life in patients with neck pain and forward head posture. MethodsRandomized controlled trials about the effects of exercise training on forward head posture and neck pain were searched from PubMed, Web of science, Embase, Medline, Science Direct, EBSCO, Springlink, CNKI, VIP, and Wanfang Data from database establishment to April, 2022. The literature was screened by two researchers independently. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software was used for meta-analysis. ResultsA total of 416 patients from eleven literatures were included. Level 1a evidence indicated scapula stability training could effectively improve cranial vertebral angle (MD = 3.62, 95%CI 2.41 to 4.83, P < 0.001), and relieve pain (MD = 1.32, 95%CI 0.18 to 2.46, P = 0.02). Level 1b evidence indicated scapula stability training could reduce functional disability (MD = -0.92, 95%CI -1.11 to -0.74, P < 0.001). Level 1b evidence indicated deep cervical flexor training could improve cranial vertebral angle (MD = -0.83, 95%CI -1.56 to -0.10, P = 0.03), relieve pain (MD = 0.93, 95%CI 0.54 to 1.32, P < 0.001), and improve neck functional disability (MD = 2.17, 95%CI 1.39 to 2.95, P < 0.001). ConclusionScapula stability training and deep cervical flexor training can effectively improve cranial vertebral angle, relieve neck pain, and improve neck function.