An umbrella review of the efficacy of different physical therapy modalities for post-traumatic stress disorder (PTSD)

This study’s aim was to assess the efficacy of different physiotherapy modalities for the treatment of post-traumatic stress disorder using an umbrella review. As of June 2024, we have published evidence in PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov , China National Knowledge Infrastructure (CNKI), Wanfang and Sinomed for meta-analyses of randomized controlled trials. This article compared all eligible meta-analyses to gain a comprehensive understanding of the current state of research. Reporting quality was assessed using the AMSTAR 2 tool and certainty of evidence was assessed using the GRADE tool. A total of seven meta-analyses of different physiotherapy treatments were included. This study’s evidence suggests that non-invasive brain stimulation and acupuncture may be associated with improvements in PTSD, depressive, and anxiety symptoms. However, the certainty of the evidence is predominantly low or very low according to GRADE, due to small sample sizes, substantial methodological limitations, and considerable heterogeneity across trials and meta-analyses. At present, these modalities should be regarded as adjunctive or experimental options, rather than established first-line treatments, and their use in clinical practice should be limited to carefully selected patients and experienced centers until more robust evidence becomes available. Future large-scale trials with greater diversity and improved quality of efficacy meta-analyses are necessary for the treatment of PTSD. • Transcranial magnetic stimulation therapy and acupuncture are effective in the treatment of post-traumatic stress disorder • We selected We found that transcranial magnetic stimulation and acupuncture were effective in treating symptoms of depression and anxiety in the comorbidity of PTSD • We searched for all physical therapy treatments for PTSD and screened them according to the availability of corresponding systematic reviews. We selected the highest quality literature from each PICO for analysis.