TY - JOUR
T1 - Physiotherapy interventions may relieve pain in individuals with central neuropathic pain: a systematic review and meta-analysis of randomised controlled trials.
AU - Kannan, Priya
AU - Bello, Umar Muhammad
AU - Winser, Stanley John
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This review was supported by the Dean’s reserve fund obtained by Dr Priya Kannan (Reference: ZVSV) Hong Kong Polytechnic University, Dean’s reserve fund.
Publisher Copyright:
© The Author(s), 2022.
PY - 2022/2
Y1 - 2022/2
N2 - Objectives: To evaluate the effectiveness of any form of physiotherapy intervention for the management of central neuropathic pain (cNeP) due to any underlying cause. Methods: Multiple databases were searched from inception until August 2021. Randomised controlled trials evaluating physiotherapy interventions compared to a control condition on pain among people with cNeP were included. Methodological quality and the quality of evidence were assessed using the Physiotherapy Evidence Database Scale and the Grading of Recommendations, Assessment, Development, and Evaluation tool, respectively. Results: The searches yielded 2661 studies, of which 23 randomised controlled trials met the inclusion criteria and were included in the meta-analyses. Meta-analyses of trials examining non-invasive neurostimulation revealed significant reductions in pain severity due to spinal cord injury (SCI; standardised mean difference (SMD): −0.59 (95% confidence interval [CI]: −1.07, −0.11), p = 0.02) and phantom limb pain (weighted mean difference (WMD): −1.57 (95% CI: −2.85, −0.29), p = 0.02). The pooled analyses of trials utilising acupuncture, transcutaneous electrical nerve stimulation (TENS), and mirror therapy showed significant reductions in pain severity among individuals with stroke (WMD: −1.46 (95% CI: −1.97, −0.94), p < 0.001), multiple sclerosis (SMD: −0.32 (95% CI: −0.57, −0.06), p = 0.01), and phantom limb pain (SMD: −0.74 (95% CI: −1.36, −0.11), p = 0.02), respectively. Exercise was also found to significantly reduce pain among people with multiple sclerosis (SMD: −1.58 (95% CI: −2.85, −0.30), p = 0.02). Conclusion: Evidence supports the use of non-invasive neurostimulation for the treatment of pain secondary to SCI and phantom limb pain. Beneficial pain management outcomes were also identified for acupuncture in stroke, TENS in multiple sclerosis, and mirror therapy in phantom limb pain.
AB - Objectives: To evaluate the effectiveness of any form of physiotherapy intervention for the management of central neuropathic pain (cNeP) due to any underlying cause. Methods: Multiple databases were searched from inception until August 2021. Randomised controlled trials evaluating physiotherapy interventions compared to a control condition on pain among people with cNeP were included. Methodological quality and the quality of evidence were assessed using the Physiotherapy Evidence Database Scale and the Grading of Recommendations, Assessment, Development, and Evaluation tool, respectively. Results: The searches yielded 2661 studies, of which 23 randomised controlled trials met the inclusion criteria and were included in the meta-analyses. Meta-analyses of trials examining non-invasive neurostimulation revealed significant reductions in pain severity due to spinal cord injury (SCI; standardised mean difference (SMD): −0.59 (95% confidence interval [CI]: −1.07, −0.11), p = 0.02) and phantom limb pain (weighted mean difference (WMD): −1.57 (95% CI: −2.85, −0.29), p = 0.02). The pooled analyses of trials utilising acupuncture, transcutaneous electrical nerve stimulation (TENS), and mirror therapy showed significant reductions in pain severity among individuals with stroke (WMD: −1.46 (95% CI: −1.97, −0.94), p < 0.001), multiple sclerosis (SMD: −0.32 (95% CI: −0.57, −0.06), p = 0.01), and phantom limb pain (SMD: −0.74 (95% CI: −1.36, −0.11), p = 0.02), respectively. Exercise was also found to significantly reduce pain among people with multiple sclerosis (SMD: −1.58 (95% CI: −2.85, −0.30), p = 0.02). Conclusion: Evidence supports the use of non-invasive neurostimulation for the treatment of pain secondary to SCI and phantom limb pain. Beneficial pain management outcomes were also identified for acupuncture in stroke, TENS in multiple sclerosis, and mirror therapy in phantom limb pain.
KW - central neuropathic pain
KW - neuropathy
KW - pain
KW - physiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85127986507&partnerID=8YFLogxK
U2 - 10.1177/20406223221078672
DO - 10.1177/20406223221078672
M3 - Journal article
SN - 2040-6223
VL - 13
SP - 1
EP - 10
JO - Therapeutic Advances in Chronic Disease
JF - Therapeutic Advances in Chronic Disease
ER -