Effects of resistance exercise therapy on pain and function in patients with cervical spondylotic radiculopathy: a meta-analysis

doi:10.12307/2026.529

Abstract

Abstract: OBJECTIVE: In recent years, resistance exercise therapy as a means of rehabilitation has attracted much attention, but its therapeutic effect on cervical radiculopathy is still controversial. This study evaluated the clinical efficacy of resistance exercise in the treatment of cervical radiculopathy through a systematic meta-analysis.
METHODS: A comprehensive search was conducted in CNKI, VIP, WanFang, Chinese Biomedical Literature Database, PubMed, Web of Science, Cochrane Library and Embase for clinical randomized controlled trials related to resistance exercise in the treatment of cervical radiculopathy. The search time was from the establishment of each database to November 30, 2024. The resistance training group (experimental group) used resistance exercise or resistance exercise as the main intervention method. The control group received other rehabilitation therapy except resistance exercise. Outcome measures included total effective rate, visual analog scale score, Neck Disability Index, Tanaka Symptom Scale for Cervical Spondylosis, cervical joint motion, and recurrence rate. Cochrane bias risk assessment tool and physical therapy evidence database scale were used to determine the quality of the included references. Meta-analysis was performed using RevMan 5.4 software and Stata 17.0.
RESULTS: (1) Finally, 9 RCTs were included, including a sample size of 673 cases. GRADE evidence quality evaluation showed that the total effective rate was medium level of evidence, while visual analog scale score, Neck Disability Index, Tanaka Symptom Scale for Cervical Spondylosis score, joint motion, and recurrence rate were low level of evidence. (2) The results of meta-analysis showed that the total effective rate in the experimental group was higher than that in the control group (RR=1.22, 95% confidence interval [CI]=1.06-1.41, P=0.005). (3) The visual analog scale score in the experimental group was better than that in the control group (mean difference [MD]=-0.72, 95% CI=-0.98 to -0.46, P < 0.000 01). The Neck Disability Index in the experimental group was better than that in the control group (MD=-2.57, 95% CI=-4.13 to -1.02, P=0.001). The Tanaka Symptom Scale for Cervical Spondylosis score in the experimental group was better than that in the control group (MD=3.83, 95% CI=3.55-4.10, P < 0.000 01). Cervical joint motion: the anterior flexion joint motion of the experimental group was better than that of the control group (MD=2.86, 95% CI=2.30-3.43, P < 0.000 01); the posterior extension joint motion of the experimental group was better than that of the control group (MD=5.23, 95% CI=3.81-6.64, P < 0.000 01). The range of motion of the left rotator joint in the experimental group was better than that in the control group (MD=7.15, 95% CI=5.43-8.87, P < 0.000 01); the range of motion of the right rotator joint in the experimental group was better than that in the control group (MD=5.45, 95% CI=3.59-7.31, P < 0.000 01). The range of motion of the left flexion joint in the experimental group was better than that in the control group (MD=3.35, 95% CI=1.98-4.72, P < 0.000 01); the range of motion of the right flexion joint in the experimental group was better than that in the control group (MD=3.91, 95% CI=2.65-5.17, P < 0.000 01). The recurrence rate in the experimental group was lower than that in the control group (RR=0.22, 95% CI=0.06-0.80, P=0.02).
CONCLUSION: Resistance exercise can effectively improve the pain of patients with cervical radiculopathy, promote the recovery of cervical vertebra function and reduce the recurrence rate. However, the evidence level of the methodological quality and outcome indicators of the included studies is low, and more high-quality and large-sample randomized controlled trials are needed for further research and confirmation in the future.

Key words: resistance exercise, cervical radiculopathy, meta-analysis, exercise therapy, pain, cervical spine function, muscle strength, randomized controlled trial

CLC Number:

Li Hanyue, Li Yini, Xiang Linmei, Li Sen. Effects of resistance exercise therapy on pain and function in patients with cervical spondylotic radiculopathy: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(4): 987-996.

Figures/Tables 10

2.1 检索结果和文献筛选经过对数据库的检索，初步筛选出文献共计306篇。在去除重复文献63篇后，通过阅读剩余文献的标题和摘要，进一步剔除了200篇文献，最终得到43篇文献。对这些文献进行全文阅读，并依据纳入及排除标准进行评估后，剔除了34篇文献，最终确定纳入9篇文献[20-28]，见图2。 2.2 纳入研究的基本特征经过筛选，共有9篇文献符合纳入及排除标准，涉及患者总数为672例，其中试验组主要采取抗阻运动作为干预手段，而对照组则接受除抗阻运动之外的其他保守治疗，具体信息见表1。6项研究报告了总有效率[20-21，23-24，27-28]，8项研究报告了目测类比评分[20-26，28]，4项研究报告了颈部功能障碍指数[20，22，24-25]，2项研究报告了田中靖久颈椎病症状量表评分[24-25]，2项研究报告了颈椎前屈后伸关节活动度[22，25]，2项研究报告了颈椎左右旋转、左右侧屈关节活动度[23，25]，2项研究报告了复发率[25，28]。 2.3 纳入文献方法学质量评价结果依据Cochrane偏倚风险评估工具，纳入的9篇文献全部采用了随机方法，所有文献均未提到是否进行分配隐藏措施；其中1篇文献采用盲法[26]，1篇文献报道了盲法的高风险[21]，1篇文献结局指标评估者进行盲法评估[21]；所有文献均无选择性报告或数据不完整且均未提到其他偏倚来源，结果见图3。依据物理治疗证据数据库量表评分标准，8篇纳入文献整体质量较高，集中在6-7分[20-25，27-28]，1篇文献为高质量文献[26]，物理治疗证据数据库量表评分结果见表2。 2.4 Meta分析结果 2.4.1 总有效率纳入的6项研究报道了总有效率，共412名受试者[20-21，23-24，27-28]。如图4显示，异质性检验为P=0.01，I2=66%，Meta分析"

型颈椎病患者的颈椎功能障碍指数(MD=-2.57，95%CI=-4.13至-1.02，P=0.001)。 2.4.4 田中靖久颈椎病症状量表评分纳入的2项研究报道了田中靖久颈椎病症状量表评分，共102例患者[24-25]。如图7显示，异质性检验为P=0.90，I2=0%，Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者的田中靖久颈椎病症状量表评分(MD=3.83，95%CI=3.55-4.10，P < 0.000 01)。 2.4.5 关节活动度 (1)前屈关节活动度：纳入的2项研究报道了颈椎前屈关节活动度，共138例患者[22，25]。如图8显示，异质性检验为P=0.45，I2=0%；Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者颈椎前屈关节活动度(MD=2.86，95%CI=2.30-3.43，P < 0.000 01)。 (2) 后伸关节活动度：纳入的2项研究报道了颈椎后伸关节活动度，共138例患者[22，25]。如图9显示，异质性检验为P=0.13，I2=56%；Meta分析结果显示：抗阻运动能够显著改善患者颈椎后伸关节活动度(MD= 5.23，95%CI=3.81-6.64，P < 0.000 01)。 (3)左旋转关节活动度：纳入的2项研究报道了颈椎左旋转关节活动度，共122例患者[23，25]。如图10显示，异质性检验为P=0.97，I2=0%；Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者颈椎左旋转关节活动度(MD=7.15，95%CI=5.43-8.87，P < 0.000 01)。 (4)右旋转关节活动度：纳入的2项研究报道了颈椎右旋转关节活动度，共122例患者[23，25]。如图11显示，异质性检验为P=0.98，I2=0%；Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者颈椎右旋转关节活动度(MD=5.45，95%CI=3.59-7.31，P < 0.000 01)。 (5)左侧屈关节活动度：纳入的2项研究报道了颈椎左侧屈关节活动度，共122例患者[23，25]。如图12显示，异质性检验为P=0.18，I2=44%，Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者颈椎左侧屈关节活动度(MD=3.35，95%CI=1.98-4.72，P < 0.000 01)。 (6)右侧屈关节活动度：纳入的2项研究报道了颈椎右侧屈关节活动度，共122例患者[23，25]。如图13显示，异质性检验为P=0.19，I2=41%， Meta分析结果显示：与对照组相比，抗阻运动能够显著改善患者颈椎右侧屈关节活动度(MD=3.91，95%CI=2.65-5.17，P < 0.000 01)。 2.4.6 复发率纳入的2项研究报道了复发率，共83例患者[25，28]。如图14显示，异质性检验为P=0.43，I2=0%，Meta分析结果显示：与对照组相比，抗阻运动能够显著降低神经根型颈椎病患者的复发率(RR=0.22，95%CI=0.06-0.80，P=0.02)。 2.5 亚组分析为进一步揭示主要结局指标的稳健性以及可能的异质性来源，根据以下方面进行亚组分析：①对照组的干预措施；②试验组的抗阻运动干预时间。见表3。"

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