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Effects of Manual Therapy on Musculoskeletal Diseases : A Meta-Analysis

근육뼈대계 질환에 대한 도수치료의 효과: 메타분석

  • Lee, Jeong-Woo (Dept. of Physical Therapy, Kwangju Women's University) ;
  • Gong, Gwang-Sik (Dept. of Physical Therapy, Dongshin University Korean Medicine Hospital) ;
  • Kim, Dong-Yeon (Sports Rehabilitation Center, Chung Yeon Korean Medicine Hospital) ;
  • Koh, Un (Dept. of Physical Therapy, Gwangju 365 Rehabilitation Hospital)
  • 이정우 (광주여자대학교 물리치료학과) ;
  • 공광식 (동신대학교 한방병원 물리치료실) ;
  • 김동연 (청연한방병원 스포츠 재활센터) ;
  • 고운 (광주 365 재활병원)
  • Received : 2021.02.05
  • Accepted : 2021.02.24
  • Published : 2021.02.28

Abstract

Purpose: The purpose of this meta-analysis was to examine the high-level evidence of the effects of manual therapy on musculoskeletal diseases. Methods: Domestic databases were searched for studies that conducted clinical trials associated with manual therapy on chronic musculoskeletal diseases. A total of 591 studies published between 2005 and 2018 were identified, with 18 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with pain and physical function. The 18 studies included in the study were evaluated by using the R meta-analysis (version 4.0). The quality of 18 randomized control trials was evaluated by using the Cochrane risk of bias (ROB). The effect sizes were computed as the corrected standardized mean difference (SMD). Subgroup and meta-regression analyses were also used. Egger's regression test was carried out in order to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were also conducted in order to analyze the data error. Results: The following factors showed the large effect size of manual therapy on chronic musculoskeletal diseases: pain (Hedges's g = 2.66; 95% CI = 1.47 ~ 3.85), and physical function (Hedges's g = 2.15; 95% CI: 1.22 ~ 3.08). The subgroup analysis only showed a statistical difference in the type of manual therapy (pain) and outcome (physical function). No statistically significant difference was found in the meta-regression analysis. Publication bias was found in the data, but the results of the trim-and-fill method showed that such bias did not largely affect the obtained data. Furthermore, there were no data errors in the cumulative meta-analysis and sensitivity analysis. Conclusion: This study provides evidence for the effectiveness of manual therapy on chronic musculoskeletal diseases in pain and physical function. Subgroup analysis suggests that only the type of manual therapy for pain and the type of outcome for physical function differed in effect size.

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