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Article pour les cliniciens

La marche pour la douleur chronique musculo-squelettique: revue systématique et méta-analyse.



  • O'Connor SR
  • Tully MA
  • Ryan B
  • Bleakley CM
  • Baxter GD
  • Bradley JM, et al.
Arch Phys Med Rehabil. 2015 Apr;96(4):724-734.e3. doi: 10.1016/j.apmr.2014.12.003. Epub 2014 Dec 19. (Review)
PMID: 25529265
Lire le résumé Lire résumé des données probantes
Disciplines
  • Médecine familiale (MF)/Médecine générale (MG)
    Relevance - 7/7
    Intérêt médiatique  - 6/7
  • Médecine interne générale - Soins primaires
    Relevance - 7/7
    Intérêt médiatique  - 6/7
  • - Médecine physique et réadaptation
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • - Gériatrie
    Relevance - 6/7
    Intérêt médiatique  - 4/7
  • - Rhumatologie
    Relevance - 5/7
    Intérêt médiatique  - 4/7

Résumé (en anglais)

OBJECTIVE: To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain.

DATA SOURCES: Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014.

STUDY SELECTION: Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group.

DATA EXTRACTION: Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system.

DATA SYNTHESIS: Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, =8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , -5.31; 95% CI, -8.06 to -2.56) and medium-term (mean difference, -7.92; 95% CI, -12.37 to -3.48) follow-up. Improvements in function were observed at short-term (mean difference, -6.47; 95% CI, -12.00 to -0.95), medium-term (mean difference, -9.31; 95% CI, -14.00 to -4.61), and long-term (mean difference, -5.22; 95% CI, -7.21 to -3.23) follow-up.

CONCLUSIONS: Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.


Commentaires cliniques (en anglais)

Geriatrics

This meta-analysis confirms what many already thought - walking can improve musculoskeletal pain.

Physical Medicine and Rehabilitation

Good review, as the information you get from it is relevant and useful.

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