Riassunto dello studio

Fourteen randomized controlled trials with a total of 1112 patients were included in this meta-analysis comparing traditional Chinese manipulation (n=568) to other conservative therapies (i.e., rest, ice, compression, elevation [RICE] therapy, cold compression, oral analgesics, electromagnetic wave irradiation, functional exercise, kinesiotaping) (n=544). The pooled outcomes of interest included the total effective rate, Baird-Jackson scores, Takakura scores, pain scores on a Visual Analogue Scale (VAS), and the American Orthopaedic Foot and Ankle Society (AOFAS) scores. A subgroup analysis by the type of Chinese manipulation, specifically rotating-traction-poking manipulation and other manipulation techniques, was performed for outcomes of effective rate and VAS pain scores. Results revealed statistically significantly favourable pooled effective rates in the manipulation group, both in the overall meta-analysis and the subgroup analyses by manipulation technique (p<0.0001 for all). Pooled Baird-Jackson scores (p<0.0001) and AOFAS scores (p<0.0001) were statistically significantly in favour of the Chinese manipulation group, whilst pooled Takakura scores were not statistically different between groups (p=0.32). For VAS pain scores, the overall meta-analysis and sub-group analysis for rotating-traction-poking manipulation revealed statistically significantly favourable VAS pains scores in the manipulation group compared to the control group (p=0.01 for both). However, for the sub-group analysis of the other manipulation techniques, no statistical significant differences in pooled VAS pain scores were observed between the two groups (p=0.18).