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Baker RT, Martonick NJP, Smitley MC, Ludwig CM, Reeves AJ. Instrument-Assisted Soft Tissue Mobilization 2-Handed Grip Force Production Consistency During Simulated Treatment: A Technical Report. J Sport Rehabil 2024:1-8. [PMID: 39179227 DOI: 10.1123/jsr.2023-0337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 08/26/2024]
Abstract
CONTEXT Instrument-assisted soft tissue mobilization (IASTM) continues to increase in popularity and utilization among manual therapists. Despite its popularity, little is known about the consistency in peak or average forces that clinicians apply when performing IASTM treatments with a 2-handed grip. The purpose of this study was to examine intraclinician consistency in peak and average forces when applying a 2-handed IASTM grip. DESIGN Randomized crossover study conducted in a university biomechanics laboratory. METHODS Five (5) licensed athletic trainers with prior IASTM training used 5 different IASTM instruments to apply simulated treatment. Average peak forces (Fpeak) and average mean forces (Fmean) were collected via force plate for all 5 IASTM instruments with a skin simulant attached. Descriptive statistics, coefficients of variation (CVs), box and density plots, and Bland-Altman plots were assessed. RESULTS The clinicians' average Fpeak ranged from 3.0 N to 11.6 N and average Fmean from 1.9 N to 8.1 N. Fpeak CVs for all instruments ranged from 14% to 31%, and Fmean CVs ranged from 15% to 35%. Bland-Altman plots indicated that for both Fpeak and Fmean, 97% of the data points fell within the limits of agreement across instruments and clinicians. Mean differences across instruments ranged from 0.9 N (91.8 g) to 4.1 N (418.1 g) for Fpeak and from 1.0 N (102.0 g) to 2.8 N (285.5 g) for Fmean. Thus, CVs, box and density plots, and Bland-Altman plots supported general force application consistency. CONCLUSION Trained IASTM clinicians produced consistent treatment application forces (ie, Fpeak and Fmean) within treatment sessions during 2-handed simulated application.
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Affiliation(s)
- Russell T Baker
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
- WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA
| | - Nickolai J P Martonick
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
- WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA
| | - Matthew C Smitley
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | | | - Ashley J Reeves
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
- WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA
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Ikeda N, Hiratsuka K, Isaka T. Effect of 6-Week Instrument-Assisted Soft Tissue Mobilization on Joint Flexibility and Musculotendinous Properties. Sports (Basel) 2024; 12:150. [PMID: 38921844 PMCID: PMC11209483 DOI: 10.3390/sports12060150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Instrument-assisted soft tissue mobilization (IASTM) stimulates soft subcutaneous tissues by applying pressure to the skin with a specialized bar or spurtle-like instrument. No studies have verified whether several weeks of continuous IASTM alone can alter joint flexibility and musculotendinous properties in healthy participants. We examined the effect of a 6-week IASTM program on joint flexibility and the musculotendinous properties of the lower limbs. Fourteen healthy men (aged 19-35 years) who participated in a 6-week IASTM program (3 days weekly) for the soft tissue of the posterior aspect of one lower leg were included. The other leg served as the control. Before and after the intervention, we measured the maximal ankle joint dorsiflexion angle (dorsiflexion range of motion: DFROM) and maximal passive torque (MPT), a measure of stretch tolerance. We measured muscle and tendon stiffness using shear wave elastography on the gastrocnemius and Achilles tendon. IASTM significantly increased the DFROM and MPT (p < 0.05 for both). However, no significant changes were observed in muscle and tendon stiffness. None of the parameters changed significantly in the control group. The 6-week IASTM program increased stretch tolerance and joint flexibility but did not change muscle and tendon stiffness.
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Affiliation(s)
- Naoki Ikeda
- Institute for General Education, Ritsumeikan University, 1-1-1 Noji-Higashi, Kusatsu 525-8577, Shiga, Japan;
| | - Kazuya Hiratsuka
- Institute for General Education, Ritsumeikan University, 1-1-1 Noji-Higashi, Kusatsu 525-8577, Shiga, Japan;
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-Higashi, Kusatsu 525-8577, Shiga, Japan;
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Tang S, Sheng L, Xia J, Xu B, Jin P. The effectiveness of instrument-assisted soft tissue mobilization on range of motion: a meta-analysis. BMC Musculoskelet Disord 2024; 25:319. [PMID: 38654270 PMCID: PMC11036573 DOI: 10.1186/s12891-024-07452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To evaluate the effectiveness of instrument-assisted soft tissue mobilization (IASTM) on range of motion (ROM). METHODS We performed a literature search of the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 23, 2023. Randomized controlled trials that compared treatment groups receiving IASTM to controls or IASTM plus another treatment(s) to other treatment(s) among healthy individuals with or without ROM deficits, or patients with musculoskeletal disorders were included. The Cochrane risk of bias tool was used to assess the risk of bias. RESULTS Nine trials including 450 participants were included in the quantitative analysis. The IASTM was effective in improving ROM in degree in healthy individuals with ROM deficits and patients with musculoskeletal disorders (n=4) (MD = 4.94, 95% CI: 3.29 to 6.60), and in healthy individuals without ROM deficits (n=4) (MD = 2.32, 95% CI: 1.30 to 3.34), but failed to improve ROM in centimeter in healthy individuals with ROM deficits (n=1) (MD = 0.39, 95% CI: -1.34 to 2.11, p=0.66, I2 = 88%). CONCLUSIONS IASTM can improve ROM in degree in healthy individuals with or without ROM deficits, or in patients with musculoskeletal disorders (with very low to low certainty). TRIAL REGISTRATION The PROSPERO registration ID is CRD42023425200.
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Affiliation(s)
- Sien Tang
- The Fourth Rehabilitation Hospital of Shanghai, No. 995 Kangding Road, Jing'an District, Shanghai, 200000, China.
| | - Li Sheng
- The Fourth Rehabilitation Hospital of Shanghai, No. 995 Kangding Road, Jing'an District, Shanghai, 200000, China
| | - Jinming Xia
- The Fourth Rehabilitation Hospital of Shanghai, No. 995 Kangding Road, Jing'an District, Shanghai, 200000, China
| | - Bing Xu
- The Fourth Rehabilitation Hospital of Shanghai, No. 995 Kangding Road, Jing'an District, Shanghai, 200000, China
| | - Peiyong Jin
- The Fourth Rehabilitation Hospital of Shanghai, No. 995 Kangding Road, Jing'an District, Shanghai, 200000, China
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Bostan A, Kaya P. Effect of instrument-assisted soft tissue mobilization combined with exercise therapy on pain and muscle endurance in patients with chronic neck pain: a randomized controlled study. J Man Manip Ther 2024; 32:131-140. [PMID: 37272310 PMCID: PMC10956932 DOI: 10.1080/10669817.2023.2213989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/06/2023] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVES The use of instrument-assisted soft tissue mobilization (IASTM) has been documented to be effective for improving pain and function, but it is unclear whether it helps improve muscle performance in musculoskeletal diseases. This study investigated the effects of IASTM combined with exercise therapy on muscle endurance and pain intensity in patients with chronic neck pain. METHODS Forty-eight individuals with chronic neck pain were randomly divided into exercise therapy (ET, n = 24) and combined therapy (CT, n = 24) groups. For 4 weeks, each group underwent exercise therapy 3 days a week for a total of 12 sessions. The ET group received exercise therapy only. The CT group received IASTM combined with exercise therapy twice per week for a total of 8 sessions. The muscle endurance of the participants was assessed with the Deep Neck Flexor Muscle Endurance (DNFE) test and pain intensity with Visual Analogue Scale (VAS) at baseline and post-treatment. RESULTS While both groups showed significant improvement in pain intensity (p < 0.05), the CT group showed a greater effect size for pain (CT group: Cohen's d = 3.28; ET group: Cohen's d = 2.12). The CT group showed significant improvement for muscle endurance (p < 0.05), whereas the ET group did not (p > 0.05). CONCLUSION In the current study, the IASTM intervention combined with ET improved pain and muscular endurance in participants with chronic neck pain compared to exercise therapy alone. As an alternative method, IASTM intervention before exercise seems to increase the short-term recovery effect in chronic neck pain conditions.
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Affiliation(s)
- Aysegul Bostan
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Bahcesehir University, Istanbul, Turkey
| | - Pinar Kaya
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istanbul Medipol University, Istanbul, Turkey
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Liu Y, Wang Y. A comparative study of the efficacy of instrument-assisted soft tissue mobilization and massage techniques in patients with patellofemoral joint pain. Front Med (Lausanne) 2023; 10:1305733. [PMID: 38020090 PMCID: PMC10679753 DOI: 10.3389/fmed.2023.1305733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The aim of this study was to compare the clinical efficacy of instrument-assisted soft tissue mobilization (IASTM) and manipulative therapy Tui-na techniques in the treatment of patients with patellofemoral joint pain syndrome, and to evaluate their impact on pain relief, functional improvement, and joint range of motion. Methods In this study, 25 patients with patellofemoral pain syndrome were enrolled, comprising of an intervention group of 13 patients who received IASTM treatment and a control group of 12 patients who received Tui-na manipulation therapy. The treatment cycle lasted for 4 weeks, featuring two interventions per week. Before treatment, the visual analog pain scale (VAS) of the knee, Lysholm score of the knee, modified Thomas test (MTT), and maximum isometric strength of the extensor muscles of the lower limbs were measured and recorded for both groups. After the first and last treatments, the aforementioned indexes were reassessed, and the maximum isometric muscle strength of the lower extremity extensors was measured only after 4 weeks of treatment had been completed. Results There was no significant difference in the basic information of the two intervention groups (p > 0. 05). After the first treatment and 4 weeks of treatment, the Lysholm score in both groups significantly improved (p < 0. 05), indicating that both interventions can improve the function of patients' lower limbs. However, the Lysholm score in the IASTM group significantly increased compared with that of the massage group after 4 weeks of treatment, indicating that its improvement in functional performance is superior. Both groups showed significant improvement in knee joint pain after the first treatment and 4 weeks of treatment (p < 0. 05), with the IASTM group having a lower VAS score and better pain improvement after 4 weeks of treatment. The strength of the two intervention groups significantly increased after the maximum isometric muscle strength test of the lower limb extensor muscles before and after 4 weeks of treatment (p < 0. 05). After the MTT test, the extension angle, deviation angle, and hip abduction angle of the tested legs in the two intervention groups were significantly reduced (p < 0. 001), indicating an improvement in lower limb joint mobility. Conclusion Instrument-assisted soft tissue mobilization treatment and Tui-na manipulation therapy significantly reduced pain, improved knee flexibility, and increased range of motion of the lower extremity in patients with PFPS. However, IASTM treatment significantly improved pain and function and sustained pain in the short to medium-term post-trial period. Clinical trial registration www.isrctn.com, ISRCTN88098928.
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Affiliation(s)
- Yang Liu
- SchoolGraduate School of Wuhan Sports University, Wuhan Sports University, Wuhan, China
| | - Yidan Wang
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, Malaysia
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Cheatham SW, Martonick N, Krumpl L, Baker RT. The Effects of Light Pressure Instrument-Assisted Soft Tissue Mobilization at Different Rates on Grip Strength and Muscle Stiffness in Healthy Individuals. J Sport Rehabil 2023:1-6. [PMID: 37142408 DOI: 10.1123/jsr.2022-0356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/08/2023] [Accepted: 03/05/2023] [Indexed: 05/06/2023]
Abstract
CONTEXT Instrument-assisted soft tissue mobilization (IASTM) is a popular myofascial treatment utilized by health care professionals. Currently, there is a lack of research on the effects of a light pressure IASTM treatment on the forearm region. The purpose of this study was to explore the effects of a light pressure IASTM technique at different application rates on grip strength and muscle stiffness. This study was considered exploratory with the goal of establishing methodology for future controlled studies. DESIGN Observational pretest and posttest clinical study. METHODS Twenty-six healthy adults underwent one light pressure IASTM treatment to their dominant forearm muscles. Participants were allocated to 2 groups of 13 based upon treatment rate: 60 beats per minute and 120 beats per minute. Participants were tested pretreatment and posttreatment for grip strength and tissue stiffness via diagnostic ultrasound. One-way analyses of covariance were used to assess group differences posttreatment for grip strength and tissue stiffness. RESULTS Statistically significant posttreatment changes for grip strength and tissue stiffness were not found. Despite the nonstatistical significance, there were small decreases in grip strength and tissue stiffness. Faster (120 beats/min) IASTM application may have produced clinically meaningful decreases in grip strength along with a small decrease in tissue stiffness. CONCLUSIONS This report helps to establish methodology for future controlled studies on this topic. Sports medicine professionals should consider these results as exploratory and interpret them with caution. Future research is needed to confirm these findings and begin to postulate possible neurophysiological mechanisms.
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Affiliation(s)
- Scott W Cheatham
- Department of Kinesiology, California State University Dominguez Hills, Carson, CA,USA
| | | | - Lukas Krumpl
- Department of Movement Sciences, University of Idaho, Moscow, ID,USA
| | - Russell T Baker
- Department of Movement Sciences, University of Idaho, Moscow, ID,USA
- Idaho WWAMI Medical Education Program, University of Idaho, Moscow, ID,USA
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Weber P, Klingler W, Schleip R, Weber N, Joisten C. The Influence of a Single Instrument-Assisted Manual Therapy (IAMT) for the Lower Back on the Structural and Functional Properties of the Dorsal Myofascial Chain in Female Soccer Players: A Randomised, Placebo-Controlled Trial. J Clin Med 2022; 11:jcm11237110. [PMID: 36498690 PMCID: PMC9736370 DOI: 10.3390/jcm11237110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Instrument-assisted manual therapy (IAMT) is indicated to improve flexibility, reduce pain, and induce hyperaemia locally and along myofascial chains. The underlying effects are largely unclear. This randomised, placebo-controlled pilot study aimed to gain first insights into these effects, primarily on the structural level, through ultrasonography. Methods: 67 healthy female soccer players aged 20.9 (±3.9) years were examined after right lumbar intervention (IAMT: intervention group (IG), heat application: comparison group (CG), pressure-less placebo: placebo group (PG)). Ultrasonography (absolute movement and shear motion), flexibility tests (passive straight leg raise test (PSLR), lumbar and thoracic double inclinometry), and superficial skin temperature were recorded before (t0), immediately (t1) and 45 min after the intervention (t2). Results: IAMT decreased the absolute mobility of the superficial lamina and its shear motion to the superficial fascia compared with the PG (t1; p < 0.05). PSLR improved in the IG compared with the CG (t2) and PG (t1, t2; p < 0.05). The temperature increased in the IG and CG compared with the PG (t1, t2) and in the CG compared with the IG (t1; p < 0.05). Conclusion: IAMT of the lumbar back briefly reduces absolute mobility of the superficial lamina and its shear motion to the superficial fascia, improves flexibility, and increases the temperature.
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Affiliation(s)
- Patrick Weber
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, 50933 Cologne, Germany
- PANOVIA Medical Cooperative Society, 50354 Hürth, Germany
- Correspondence:
| | - Werner Klingler
- Anaesthesiology, SRH Hospitals Sigmaringen, 72488 Sigmaringen, Germany
- Experimental Anaesthesiology, Ulm University, 89081 Ulm, Germany
- Clinical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Robert Schleip
- Conservative and Rehabilitative Orthopaedics, Department of Sport and Health Sciences, Technical University of Munich, 80809 Munich, Germany
- Department for Medical Professions, Diploma University of Applied Sciences, 37242 Bad Sooden-Allendorf, Germany
| | - Nadine Weber
- PANOVIA Medical Cooperative Society, 50354 Hürth, Germany
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, 50933 Cologne, Germany
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Cadellans-Arróniz A, López-de-Celis C, Rodríguez-Sanz J, Pérez-Bellmunt A, Labata-Lezáun N, González-Rueda V, Llurda-Almuzara L, Rodríguez-Rubio PR. Immediate effects of diacutaneous fibrolysis in athletes with hamstring shortening. A randomized within-participant clinical trial. PLoS One 2022; 17:e0270218. [PMID: 35788212 PMCID: PMC9255769 DOI: 10.1371/journal.pone.0270218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Diacutaneous fibrolysis is a non-invasive instrumental physiotherapeutic technique, used to treat mechanical or inflammatory pain and normalize function in the musculoskeletal system. Different studies have reported positive effects on range of motion, strength or function in musculoskeletal disorders, mainly in the upper extremity. The incidence and recurrence rates of hamstring injuries are high in many sports. However, there are no studies assessing these parameters in the hamstring and gluteus maximus in athletes. Objective. To evaluate the immediate and 30 minutes post-treatment effects of a single diacutaneous fibrolysis session on hamstring length, flexibility, muscle strength, myoelectrical activity and lower limb performance in athletes with hamstring shortening. Methods A randomized within-participant clinical trial. Sixty-six athletes with hamstring shortening were recruited. A single session of diacutaneous fibrolysis was applied following the cetripetal protocol to the gluteus maximus, biceps femoris and semitendinosus of for the experimental lower limb, whereas the control limb was not treated. Hamstring length (Passive knee extension test), hamstring and low back flexibility (Modified back saver sit and reach test), hamstring and gluteus maximus strength and electrical activity (dynamometry and surface electromyography, respectively) and lower limb performance (Countermovement Jump) were tested before treatment (T0), after treatment (T1), and 30 minutes post-treatment (T2). Results We only found a statistically significant difference between T0-T2 for the hamstring length favouring the experimental limbs (p<0.001). There were no statistically significant changes for hamstring and lower back flexibility, strength and electrical activity outcomes between groups. In the countermovement jump, we found a decrease of 0.58 cm in the high jump and a decrease of 9.19 N in the power jump at T1. These values recovered and improved at T2. However, these changes were not statistically significant (p>0.05). Conclusions A single session of diacutaneous fibrolysis in athletes with hamstring shortening, following the centripetal protocol for the posterior part of the thigh, produces improvements in hamstring length 30 minutes after, and in gluteus maximus strength immediately and 30 minutes after the treatment. It seems to have no effects on the overall hamstring and lower back flexibility or myoelectric activity. Importantly, the lower limb performance was not impaired after the treatment.
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Affiliation(s)
- Aïda Cadellans-Arróniz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina, Barcelona, Spain
- * E-mail:
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
| | - Noé Labata-Lezáun
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
| | - Vanessa González-Rueda
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Luis Llurda-Almuzara
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Barcelona, Spain
| | - Pere Ramón Rodríguez-Rubio
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Barcelona, Spain
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Research on the Protection of Extensor and Flexor Muscles in the Waist and Back of Competitive Athletes. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7378953. [PMID: 35832853 PMCID: PMC9273441 DOI: 10.1155/2022/7378953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/09/2022] [Accepted: 06/23/2022] [Indexed: 01/01/2023]
Abstract
In the past, in the study of special sports quality of heavy antagonistic sports events, the study of strength quality training was emphasized. The transformation of athletes' strength quality to special strength was highlighted, and the special exercises which tended to be consistent with the characteristics of wrestling events were added. However, in competition and training, athletes' spine bears a heavy load. Long-term static contraction of lumbar muscles can lead to excessive local load and injury of lumbar muscles. In this paper, the test results of athletes' joints are analyzed, and the waist protection scheme for athletes' strength training is obtained. First of all, solve the problem of athletes' action mode and improve athletes' muscle endurance. All special sports quality evaluation can reach a good level. Then, enhance athletes' explosive power. Thus, all special sports quality evaluations can reach an excellent level. It is concluded that the waist and back are the key parts to support their participation in various sports, maintain body balance, and realize power transmission. Through the study, it is found that there are significant differences in the muscle strength indexes of the maximum strength of the waist and back of athletes of different levels, which fully proves the characteristics of the maximum strength of the waist and back. Through the test, we can understand the flexion and extension strength, range, speed, force, and flexion and extension ratio of athletes' joints and take timely optimization measures according to the test results to avoid sports injuries in training. It has a key guiding significance for the measurement, analysis, and evaluation of athletes' joint muscle strength, as well as rehabilitation training after injury and prevention of reinjury.
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Nazari G, Bobos P, Lu SZ, Reischl S, Sharma S, Le CY, Vader K, Held N, MacDermid JC. Effectiveness of instrument-assisted soft tissue mobilization for the management of upper body, lower body, and spinal conditions. An updated systematic review with meta-analyses. Disabil Rehabil 2022; 45:1608-1618. [PMID: 35611579 DOI: 10.1080/09638288.2022.2070288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To critically appraise randomized controlled trials (RCTs) on Instrument-Assisted Soft Tissue Mobilisation (IASTM) and quantify the effects of IASTM compared with other treatment individuals with or without pathologies on function, pain, and range of motion. MATERIALS AND METHODS We search four electronic databases from January 1999 to January 2022 and included RCTs of healthy participants/athletes and people with upper, lower, or spinal conditions, who received IASTM versus other active treatment for clinical outcomes (function, pain, and range of motion). RESULTS Forty-six RCTs were considered eligible for data analysis. Effects of IASTM plus other treatment versus other treatment on function and pain intensity were not statistically significant or clinically meaningful (very low quality, SMD -0.28, 95% CI -0.66 to 0.09) and (very low quality, SMD -0.05, 95% CI -0.53 to 0.43) at up to one-year follow-up respectively. No clinically meaningful improvements were found on range of motion outcomes. Out of the 46 included RCTs, only 10 assessed and reported IASTM-related adverse events. CONCLUSION Evidence of very low-quality certainty does not support the efficacy of IASTM in individuals with or without various pathologies on function, pain, and range of motion in the management of upper body, lower body, or spinal conditions. IMPLICATIONS FOR REHABILITATIONThe included RCTs had a high risk of bias and were assessed as very-low quality evidence for all the included outcomes.IASTM does not lead to clinically meaningful improvements in function, pain, or range of motion in individuals with upper body, lower body, and spinal conditions.The publication of IASTM trials in suspected predatory journals is increasing.The available evidence on IASTM does not support its use to improve function, pain, or range of motion in individuals with upper body, lower body, and spinal conditions.Health care practitioners should consider other evidence-based management strategies (physical activity and exercise) to improve function, pain, or range of motion in individuals with musculoskeletal injuries and disorders.Given the rise of publications on IASTM in suspected predatory journals, health care practitioners should be judicious to examine the legitimacy of a journal when searching for evidence on IASTM treatment technique.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.,School of Rehabilitation Therapy, Faculty of Health Science, Queen's University, Kingston, ON, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Pavlos Bobos
- Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, ON, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Steve Ze Lu
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Stephanie Reischl
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada
| | - Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia.,Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Otago Medical School, Dunedin, New Zealand
| | - Christina Y Le
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | - Kyle Vader
- School of Rehabilitation Therapy, Faculty of Health Science, Queen's University, Kingston, ON, Canada
| | - Nicholas Held
- School of Rehabilitation Therapy, Faculty of Health Science, Queen's University, Kingston, ON, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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11
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Hartnett DA. Gua sha therapy in the management of musculoskeletal pathology: a narrative review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.2011581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Davis A. Hartnett
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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Cheatham SW, Baker RT, Larkins LW, Baker JG, Casanova MP. Clinical Practice Patterns Among Health Care Professionals for Instrument-Assisted Soft Tissue Mobilization. J Athl Train 2021; 56:1100-1111. [PMID: 34662422 DOI: 10.4085/1062-6050-047-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Instrument-assisted soft tissue mobilization (IASTM) is a popular myofascial intervention used by health care professionals. OBJECTIVE To document IASTM clinical practice patterns among health care professionals in the United States. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A total of 853 members of the National Athletic Trainers' Association (n = 249) and the American Physical Therapy Association (n = 604). MAIN OUTCOME MEASURE(S) Responses to a 55-item electronic survey that assessed 4 areas, namely, IASTM training and experience, IASTM application, perception of IASTM in practice, and demographic information. RESULTS Most (n = 705, 83%) of the 853 respondents used IASTM in their practice, and they had an average of 15 years of work experience. Approximately 86% (n = 731) reported completing some type of formal training, and 61% (n = 518) had completed some type of informal training. Respondents used >34 different IASTM tools. Seventy-one percent (n = 606) indicated either not knowing how to quantify the amount of force applied by the tool during treatment or not trying to quantify. Fifteen percent (n = 128) estimated a force ranging from 100 to 500g. The treatment time for a specific lesion and location ranged from 1 to ≤5 minutes, with an average total treatment time of 14.46 ± 14.70 minutes. Respondents used 31 different interventions before or after IASTM. Approximately 66% (n = 564) reported following treatment recommendations, and 19% (n = 162) described rarely or never following recommendations learned during training. A total of 94% (n = 801) recounted using some type of clinical outcome measure to assess their treatment. Cluster analysis identified 3 distinct cluster groupings among professionals, with most (89%, n = 729/818) indicating that IASTM was an effective treatment. CONCLUSIONS This survey documented the IASTM practice patterns of health care professionals. Cluster profiles characterized group differences in IASTM training and clinical application. The gaps among research, clinical practice, and training need to be bridged to establish IASTM best practices.
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Affiliation(s)
| | - Russell T Baker
- Department of Movement Sciences, University of Idaho, Moscow, ID.,University of Washington School of Medicine, WWAMI Medical Education Program, Moscow, ID
| | | | - Jayme G Baker
- Department of Movement Sciences, University of Idaho, Moscow, ID
| | - Madeline P Casanova
- Department of Movement Sciences, University of Idaho, Moscow, ID.,University of Washington School of Medicine, WWAMI Medical Education Program, Moscow, ID
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The Effects of Instrument-Assisted Soft Tissue Mobilization, Tissue Flossing, and Kinesiology Taping on Shoulder Functional Capacities in Amateur Athletes. J Sport Rehabil 2021; 30:1028-1037. [PMID: 33837162 DOI: 10.1123/jsr.2020-0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/03/2021] [Accepted: 02/06/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Instrument-assisted soft tissue mobilization (IASTM), tissue flossing, and kinesiology taping are increasingly popular treatments among athletes for improving functional performance, despite limited evidence for their efficacy. OBJECTIVE Previous research regarding the efficacy of soft tissues and neuromuscular techniques on improving functional capacity of shoulder joints in athletes has yielded conflicting results. We examined the immediate and short-term effects of IASTM, flossing, and kinesiology taping on the functional capacities of amateur athletes' shoulders. DESIGN Randomized controlled study. SETTING Clinical assessment laboratory. PARTICIPANTS Eighty amateur overhead athletes (mean [SD]: age = 23.03 [1.89]; weight = 78.36 [5.32]; height = 1.77 [.11]). INTERVENTIONS We randomly assigned participants to 4 research sub-groups in which they received the following treatments on their dominant shoulders: IASTM (n = 20), flossing (n = 20), both IASTM and flossing (n = 20), and kinesiology tape (n = 20). Nondominant shoulders served as controls. MAIN OUTCOME MEASURE We evaluated participants-before, immediately after, and 45 minutes after the therapeutic interventions-with the following tests: internal and external shoulder rotation range of motion, isokinetic strength and total work, the functional throwing performance index, and the one-arm seated shot put throw performance. RESULTS All therapeutic interventions significantly improved the strength and functional performance of the dominant shoulder in comparison with the control (P < .005) immediately after and 45 minutes after the treatment. The IASTM led to significantly greater improvement in shoulder internal rotation than kinesiology taping immediately after (P = .049) and 45 minutes after the treatment (P = .049). We observed no significant differences between the other treatment interventions (P > .05). CONCLUSION Findings from the current study support the use of novel soft tissue and neuromuscular techniques for the immediate and short-term improvement of the shoulder functional capacities in amateur overhead athletes.
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Bobos P, MacDermid JC, Nazari G, Lalone EA, Ferreira L, Grewal R. Joint Protection Programmes for People with Osteoarthritis and Rheumatoid Arthritis of the Hand: An Overview of Systematic Reviews. Physiother Can 2021; 73:56-65. [PMID: 35110824 PMCID: PMC8774950 DOI: 10.3138/ptc-2019-0037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Purpose: Joint protection has been introduced as a self-management strategy for people with rheumatoid arthritis (RA) and osteoarthritis (OA) of the hand. The purpose of this study was to conduct an overview of systematic reviews (SRs) and critically appraise the evidence to establish the current effectiveness of joint protection for people with hand RA and OA. Method: A comprehensive search was conducted of six databases from January 2008 to May 2018. SRs that evaluated the effectiveness of joint protection for people with hand arthritis were eligible for inclusion. The A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 checklist was used to assess the methodological quality of each SR. Results: Nine SRs were included: two were rated as high quality, and seven were rated as low quality. Seven of the nine did not take into account risk of bias when interpreting or discussing their findings, six did not assess publication bias, and five did not register their protocol. The high-quality reviews found no clinically important benefit of joint protection for pain, hand function, and grip strength levels. The low-quality reviews reported improvements in function, pain, grip strength, fatigue, depression, self-efficacy, joint protection behaviours, and disease symptoms in people with RA. Conclusions: High-quality evidence from high-quality reviews found a lack of any clinically important benefit of joint protection programmes for pain, hand function, and grip strength outcomes, whereas low-quality evidence from low-quality reviews found improvements in these outcomes.
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Affiliation(s)
- Pavlos Bobos
- Department of Health and Rehabilitation Sciences, Western’s Bone and Joint Institute
- Department of Clinical Epidemiology and Health Care Research, Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto
| | - Joy C. MacDermid
- School of Physical Therapy
- Roth | McFarlane Hand & Upper Limb Centre, St. Joseph’s Health Care, London
- School of Rehabilitation Science, McMaster University, Hamilton, Ont
| | - Goris Nazari
- Department of Health and Rehabilitation Sciences, Western’s Bone and Joint Institute
| | - Emily A. Lalone
- Faculty of Engineering, Department of Mechanical and Materials Engineering, Western University
| | - Louis Ferreira
- Roth | McFarlane Hand & Upper Limb Centre, St. Joseph’s Health Care, London
| | - Ruby Grewal
- Roth | McFarlane Hand & Upper Limb Centre, St. Joseph’s Health Care, London
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Comparison of the Graston Technique® With Instrument-Assisted Soft Tissue Mobilization for Increasing Dorsiflexion Range of Motion. J Sport Rehabil 2020; 30:587-594. [PMID: 33238244 DOI: 10.1123/jsr.2019-0397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Limited dorsiflexion (DF) range of motion (ROM) is commonly observed in both the athletic and general populations and is a predisposing factor for lower extremity injury. Graston Technique® (GT) is a form of instrument-assisted soft tissue mobilization (IASTM), used commonly to increase ROM. Evidence of the long-term effects of GT on ROM is lacking, particularly comparing the full GT protocol versus IASTM alone. OBJECTIVE To evaluate the effectiveness of 6 sessions of the GT or IASTM compared with a control (CON) group for increasing closed-chain DF ROM. DESIGN Cohort design with randomization. SETTING Athletic training clinic. PATIENTS OR OTHER PARTICIPANTS A total of 23 physically active participants (37 limbs) with <34° of DF. Participants' limbs were randomly allocated to the GT, IASTM, or CON group. INTERVENTION Participants' closed-chain DF ROM (standing and kneeling) were assessed at baseline and 24-48 hours following their sixth treatment. Participants in the CON group were measured at baseline and 3 weeks later. The intervention groups received 6 treatments during a 3-week period, whereas the CON group received no treatment. The GT group received a warm-up, instrument application, stretching, and strengthening of the triceps surae. The IASTM group received a warm-up and instrument application. MAIN OUTCOME MEASURES Closed-chain DF was assessed with a digital inclinometer in standing and kneeling. RESULTS A significant difference between groups was found in the standing position (P = .03) but not in kneeling (P = .15). Post hoc testing showed significant improvements in DF in standing following the GT compared with the control (P = .02). CONCLUSIONS The GT significantly increases ankle DF following 6 treatments in participants with DF ROM deficits; however, no differences were found between GT and IASTM. The GT may be an effective intervention for clinicians to consider when treating patients with DF deficits.
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Cadellans-Arróniz A, Llurda-Almuzara L, Campos-Laredo B, Cabanas-Valdés R, Garcia-Sutil A, López-de-Celis C. The effectiveness of diacutaneous fibrolysis on pain, range of motion and functionality in musculoskeletal disorders: A systematic review and meta-analysis. Clin Rehabil 2020; 35:481-491. [PMID: 33103930 DOI: 10.1177/0269215520968056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the effectiveness of diacutaneous fibrolysis in reducing musculoskeletal disorders symptoms such as pain, range of motion and functionality. DATA SOURCES A systematic review of MEDLINE, Cochrane, PEDro and Science Direct was conducted until September 2020. REVIEW METHODS Computerized search strategy was performed to identify randomized controlled trials applying diacutaneous fibrolysis, on subjects with musculoskeletal disorders. Eligible articles and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by Risk of Bias 2 tool from the Cochrane Collaboration and Physiotherapy Evidence Database. Outcomes assessed were pain intensity, range of motion and functionality. RESULTS Search strategy identified 98 potential randomized control trials and six studies involving 386 participants, were finally included. Diacutaneous fibrolysis intervention added to usual physiotherapy treatment was compared to control group. Pain intensity immediately after treatment showed a pooled Standard Mean Difference (SMD) of -0.58 with 95% confidence interval (CI) from -1.12 to -0.04, and in the longest follow-up SMD was -0.63 with 95% CI (-1.21 to -0.05). Functionality showed a pooled SMD of -1.02 with 95% CI (-1.67 to -0.36) immediately after intervention and a SMD of -0.84 with 95% CI (-1.54 to -0.14). Range of motion could not be included in the quantitative synthesis. CONCLUSION Diacutaneous fibrolysis is an effective treatment, when combined with conventional physiotheraphy, reducing pain immediately after treatment and long term follow-up and improving function in both, short and long term in musculoskeletal disorders.
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Affiliation(s)
- Aida Cadellans-Arróniz
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain
| | - Luis Llurda-Almuzara
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain
| | - Berta Campos-Laredo
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain
| | - Rosa Cabanas-Valdés
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain
| | - Alex Garcia-Sutil
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain
| | - Carlos López-de-Celis
- Facultat de Medicina i Ciències de la Salut, Universitat Intenacional de Catalunya, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primaria de Salut Jordi Gol i Gurina, Barcelona, Spain
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Lu Z, Nazari G, MacDermid JC, Modarresi S, Killip S. Measurement Properties of a 2-Dimensional Movement Analysis System: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 101:1603-1627. [DOI: 10.1016/j.apmr.2020.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 11/29/2022]
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Nazari G, MacDermid JC, Bobos P, Furtado R. Psychometric properties of the Single Assessment Numeric Evaluation (SANE) in patients with shoulder conditions. A systematic review. Physiotherapy 2020; 109:33-42. [PMID: 32858378 DOI: 10.1016/j.physio.2020.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Musculoskeletal injuries (i.e. shoulder pain) is the third most commonly reported symptom. The development of the Single Assessment Numeric Evaluation (SANE) scale has presented clinicians and researchers with a more efficient approach in measuring function. Therefore, it is important to establish the reliability, validity and responsiveness properties of this scale, prior to its application in research and clinic. OBJECTIVES To identify, critically appraise and synthesize the reported psychometric properties of the SANE scale in patients with shoulder related pathologies. DATA SOURCES Medline, Embase, Scopus and CINAHL databases from inception till February 2019 were searched. Two independent reviewers carried out the systematic electronic searches in each database and screened the retrieved studies and assessed their eligibility. STUDY SELECTION OR ELIGIBILITY CRITERIA Randomized/prospective studies, that included patients with shoulder joint related pathologies, that reported on the psychometric properties (reliability, validity, responsiveness) of SANE scale. STUDY APPRAISAL AND SYNTHESIS METHODS The "Quality Appraisal for Clinical Measurement Research Reports Evaluation Form" - a 12-item structured clinical measurement specific appraisal tool was used to assess studies. A qualitative synthesis was performed, and main results summarized based on the shoulder conditions, reported properties and study quality. RESULTS Nine studies were included. The quality ranged from 82% to 95% - very good to excellent quality. SANE scale reliability measures indicated excellent reliability properties. The Intra-class Correlation Coefficient (ICC) was ≥0.80 and Standard Error of Measurement (SEM) ranged from 4.23 to 7.82 points. Validity measures displayed correlations of 0.50-0.88 (moderate to very strong correlations) between the SANE scale and other patient reported outcomes (American Shoulder and Elbow Surgeons, Rowe score, Simple Shoulder Test, Physical Function Computerized Adaptive Test). Four studies assessed SANE scale responsiveness measures. Effect sizes of 1.5 and 0.83; and minimal clinically important differences that ranged from 27.25 to 37.05 (anchor-based approach) and 11.80 to 18.1 (distribution-based approach) were reported. LIMITATIONS Caution must be used when interpreting our ICCs values. CONCLUSION IMPLICATIONS OF KEY FINDINGS Very good to excellent quality evidence indicated that the SANE scale demonstrates evidence of a reliable, valid and responsive tool in patients with shoulder related pathologies. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42018117874.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Pavlos Bobos
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, ON, Canada
| | - Rochelle Furtado
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, ON, Canada
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Withdrawn: Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 28:e1859. [PMID: 32808409 DOI: 10.1002/pri.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/28/2020] [Accepted: 05/23/2020] [Indexed: 11/11/2022]
Abstract
Withdrawal: Noha Elserty & Dina Othman Shokri Morsi Galal, Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study, 2020, e1859 (https://onlinelibrary.wiley.com/doi/10.1002/pri.1859). The above article, published online on 18 August 2020 in Wiley Online Library (wileyonlinelibrary.com), has been withdrawn by agreement between the authors, the journal Editor in Chief Dr. Geert Verheyden, and John Wiley & Sons Ltd. The withdrawal has been agreed due to inappropriate and unlicensed use of a registered trademark technique and tool. This article was first retracted on 22 January 2021 but has now been withdrawn to protect the trademark.
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Nazari G, MacDermid JC, Bobos P. Conservative versus Surgical Interventions for Shoulder Impingement: An Overview of Systematic Reviews of Randomized Controlled Trials. Physiother Can 2020; 72:282-297. [PMID: 35110797 DOI: 10.3138/ptc-2018-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Numerous systematic reviews (SRs) of randomized controlled trials (RCTs) have emerged that investigate the effectiveness of conservative (supervised exercises) versus surgical (arthroscopic subacromial decompression) interventions for patients with shoulder impingement; however, there are disparities in the quality of the evidence synthesized. The purpose of this study was to conduct an overview of SRs of RCTs to critically appraise the evidence and establish the current state of effectiveness of conservative versus surgical interventions on clinical outcomes among patients with shoulder impingement. Method: The MEDLINE, EMBASE, CINAHL, and PubMed electronic databases were searched for January 2008 to September 2018, and we found SRs of RCTs of patients with shoulder impingement, subacromial pain syndrome, or subacromial impingement syndrome who had received conservative versus surgical interventions to improve outcomes. Two authors extracted the data, and two independent review authors assessed the risk of bias and quality. Results: A total of 15 SRs were identified. One was rated as high quality, 7 as moderate quality, 5 as low quality, and 2 as critically low quality. The results were in line with one another, indicating that no differences in outcomes existed between conservative and surgical interventions among patients with shoulder impingement. Conclusion: There were no clinically important or statistically significant differences in outcomes between conservative versus surgical interventions among patients with subacromial impingement syndrome. To enhance clinical outcomes in this patient population, shoulder-specific exercises that aim to improve muscle strength and flexibility must be considered as the first line of conservative treatment.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ont
| | - Pavlos Bobos
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University
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Bobos P, Ziebart C, Furtado R, Lu Z, MacDermid JC. Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis. J Orthop 2020; 21:40-48. [PMID: 32082038 DOI: 10.1016/j.jor.2020.01.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
Objective The purpose of this systematic review was to critically appraise and synthesize the psychometric properties of the Global Rating of Change (GRoC) scales on the assessment of patients with low back pain (LBP), upper extremity and lower extremity disorders. Methods A search was performed in 4 databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. Eligible articles were appraised using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form. Results The 8 eligible studies included participants with orthopedic lumbar spine impairments (n = 52,767), patients with work-related musculoskeletal disorders (n = 1944), patients with low back pain (n = 183) and individuals with upper extremity disorders (n = 151). Risk of bias was ranging from "adequate" to "very good" and quality was found excellent for all studies. Based on pooled data, test-retest reliability of 11-item GRoC for patients with low back pain was found excellent ICC = 0.84, 95% CI: 0.65 to 0.94. Test-retest reliability in patients with shoulder pain was found fair to good ICC of 0.62 in a 15-point GRoC scale. Seven studies (n = 7) examined the convergent validity between GRoC and another outcome measure. Minimum important change on the Portuguese version of Global Perceived Effect (GPE) for patients with LBP was 2.5 points out of 11 points. Conclusions The current pool of clinical measurement studies indicates that the GRoC has excellent test-retest reliability for patients with low back pain, shoulder pain and with lumbar spine disorders. However, the validity of it as a reference standard in responsiveness studies or as an accurate overall assessment of change has been questioned. While future studies might provide more insight into its measurement properties, this limitation is unlikely to change. Therefore, we suggest that future responsiveness in the studies that want a global indicator measure need to use an additional measure to mitigate recall bias. Prospero registration number CRD 42020149122.
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Affiliation(s)
- Pavlos Bobos
- Western's Bone and Joint Institute, School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Canada
| | - Christina Ziebart
- Western's Bone and Joint Institute, School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Rochelle Furtado
- Western's Bone and Joint Institute, School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Ze Lu
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- Western's Bone and Joint Institute, School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Nazari G, Lu S, MacDermid JC. Psychometric Properties of Performance-Based Functional Tests in Patients With Shoulder Pathologies: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 101:1053-1063. [PMID: 31891713 DOI: 10.1016/j.apmr.2019.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/19/2019] [Accepted: 11/16/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To identify, critically appraise, and synthesize the reported psychometric properties of shoulder performance-based functional tests in patients with shoulder diseases. DATA SOURCES MEDLINE, Embase, Scopus, and Cumulative Index to Nursing and Allied Health databases from inception until March 2019 were searched. STUDY SELECTION Randomized/prospective studies of patients with shoulder diseases that reported on the psychometric properties (reliability, validity, responsiveness) of performance-based functional tests (Standardized Index of Shoulder Function [FI2S], Functional Impairment Test-Hand and Neck/Shoulder/Arm, Closed Kinetic Chain Upper Extremity Stability Test, Timed Functional Arm and Shoulder Test, Shoulder Function Index [SFInX], and hand to neck, scapula, and opposite scapula). DATA EXTRACTION We used the Consensus-Based Standards for the Selection of Health Measurement Instruments 2018 guideline for systematic reviews. We performed a qualitative synthesis in which the results were summarized based on reported measurement properties and study quality. DATA SYNTHESIS Eight eligible studies were included with 28 measures (16 reliability; 10 validity; 2 responsiveness). Performance-based functional tests reliability (test-retest, intra- and interrater) measures indicated excellent reliability properties. Intraclass correlation coefficient (ICC) was ≥0.83 and standard error of the mean (SEM) ranged from 0.03-13.3 points. Validity (construct/convergent/concurrent) measures displayed correlations of -0.76 to 0.91 between performance-based functional tests and other patient-reported outcomes (Disabilities of the Arm, Shoulder, and Hand, Constant, Shoulder Pain and Disability Index). Two studies assessed the responsiveness measures performance-based functional tests. Effect sizes of 0.44 and 1.50 and minimal clinically important differences of 10.3 using the anchor-based approach were reported. CONCLUSIONS The FI2S and the SFInX are reliable, valid, and responsive in patients with shoulder-related diseases.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada.
| | - Steve Lu
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada
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23
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Nazari G, Bobos P, Lu S, MacDermid JC. Psychometric properties of the single assessment numeric evaluation in patients with lower extremity pathologies. A systematic review. Disabil Rehabil 2019; 43:2092-2099. [PMID: 31775536 DOI: 10.1080/09638288.2019.1693641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To identify, critically appraise and synthesize the reported psychometric properties of the Single Assessment Numeric Evaluation in patients with lower extremity pathologies. DATA SOURCES Medline, Embase, Scopus and CINAHL databases from inception till May 2019 were searched. STUDY SELECTION OR ELIGIBILITY CRITERIA Studies that included patients with lower extremity pathologies that reported on the measurement properties of the Single Assessment Numeric Evaluation were included. DATA EXTRACTION Individual studies were appraised by two independent authors to summarize the quality of available evidence, using the COSMIN 2018 guidelines for systematic reviews of patient reported outcome measures. The results were descriptively summarized and reported. DATA SYNTHESIS Nine eligible studies were included. The Single Assessment Numeric Evaluation reliability measures indicated coefficients of variation <1% (doubtful quality; indeterminate properties). Validity measures displayed correlations of 0.51-0.88 between the Single Assessment Numeric Evaluation and International Knee Documentation Committee, Western Ontario/McMaster Universities Osteoarthritis Index, Knee Outcome Survey, and Revised Foot Function Index. Two measurement studies assessed the Single Assessment Numeric Evaluation responsiveness measures. Effect sizes of ≥1.75; and minimal clinically important differences of 7.0 (6 months) and 19.0 (12 months) follow ups were reported. CONCLUSION Adequate quality evidence with sufficient measurement properties demonstrated that the Single Assessment Numeric Evaluation is a valid tool in assessing perception of condition in female participants with knee injuries and in military population patients with ankle sprains.Implications for rehabilitationSingle Assessment Numeric Evaluation is a valid and responsive tool in assessing perception of condition in female participants with knee injuries.Single Assessment Numeric Evaluation is a valid tool in assessing perception of condition in military population patients with ankle sprains.
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Affiliation(s)
- Goris Nazari
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Pavlos Bobos
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Steve Lu
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Joy C MacDermid
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Canada
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Bobos P, MacDermid J, Nazari G, Furtado R. Psychometric properties of the global rating of change scales in patients with neck disorders: a systematic review with meta-analysis and meta-regression. BMJ Open 2019; 9:e033909. [PMID: 31772112 PMCID: PMC6886942 DOI: 10.1136/bmjopen-2019-033909] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review was to critically appraise and synthesise the psychometric properties of Global Rating of Change (GROC) scales for assessment of patients with neck pain. DESIGN Systematic review. DATA SOURCES A search was performed in four databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. DATA EXTRACTION AND SYNTHESIS Eligible articles were appraised using Consensus-based Standards for the selection of health Measurement Instruments checklist and the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form. RESULTS The search obtained 16 eligible studies and included in total 1533 patients with neck pain. Test-retest reliability of global perceived effect (GPE) was very high (intraclass correlation coefficient=0.80 to 0.92) for patients with whiplash. Pooled data of Pearson's r indicated that GROC scores were moderately correlated with neck disability change scores (0.53, 95% CI: 0.47 to 0.59). Pooled data of Spearman's correlations indicated that GROC scores were moderately correlated with neck disability change scores (0.56, 95% CI: 0.41 to 0.68). CONCLUSIONS This study found excellent quality evidence of very good-to-excellent test-retest reliability of GPE for patients with whiplash-associated disorders. Evidence from very good-to-excellent quality studies found that GROC scores are moderately correlated to an external criterion patient-reported outcome measure evaluated pre-post treatment in patients with neck pain. No studies were found that addressed the optimal form of GROC scales for patients with neck disorders or compared the GROC to other options for single-item global assessment. PROSPERO REGISTRATION NUMBER CRD42018117874.
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Affiliation(s)
- Pavlos Bobos
- Western's Bone and Joint Institute, School of Physical Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
- Institute of Health Policy Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Toronto, Ontario, Canada
| | - Joy MacDermid
- Western's Bone and Joint Institute, School of Physical Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Goris Nazari
- Western's Bone and Joint Institute, School of Physical Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Rochelle Furtado
- Western's Bone and Joint Institute, School of Physical Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
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Measurement Properties of the Hand Grip Strength Assessment: A Systematic Review With Meta-analysis. Arch Phys Med Rehabil 2019; 101:553-565. [PMID: 31730754 DOI: 10.1016/j.apmr.2019.10.183] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/09/2019] [Accepted: 10/12/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to critically appraise, compare, and summarize the quality of the measurement properties of grip strength (GS) in patients with musculoskeletal, neurologic, or systemic conditions and healthy participants without these conditions. DATA SOURCES We followed the Consensus-based Standards for the Selection of Health Measurement Instruments guideline. To identify studies on measurement properties of GS, we searched the MEDLINE, Embase, Cumulative Index to Nursing and Allied Health, Physiotherapy Evidence, and Cochrane Library databases from inception until June 2019. Meta-analyses were carried out using a random effects model and 95% CIs were calculated. STUDY SELECTION Studies were included if they reported at least 1 measurement property of hand GS in a population with musculoskeletal, neurologic, and systemic conditions or a healthy population without these conditions. DATA EXTRACTION The extracted data included the study population, setting, sample size, measurement evaluated, and the test interval. DATA SYNTHESIS Twenty-five studies were included with 1879 participants. The pooled results indicated excellent intraclass correlation coefficient (ICC) of 0.92 (95% CI, -0.88-0.94 for healthy participants without any conditions, ICC of 0.95 (95% CI, -0.93-0.97) for upper extremity conditions, and an ICC of 0.96 (95% CI, -0.94-0.97) for patients with neurologic conditions. Minimum clinically important difference (MCID) scores for hand GS were 5.0 kg (dominant side) and 6.2 kg (nondominant side) for patients post stroke, 6.5 kg for the affected side after distal radius fracture, 10.5 lb and 10 kPa for immune-mediated neuropathies, 17 kg for patients with lateral epicondylitis, and 0.84 kg (affected side) and 1.12 kg (unaffected side) in the carpometacarpal osteoarthritis group; MCID GS estimates were 2.69-2.44 kg in the healthy group without conditions. CONCLUSION Our synthesized evidence indicated that GS assessment is a reliable and valid procedure among healthy participants as well as across various clinical populations. Furthermore, our MCID summary scores provided useful information for evaluating (clinical importance) new interventions regarding hand GS.
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Effectiveness of home fire safety interventions. A systematic review and meta-analysis. PLoS One 2019; 14:e0215724. [PMID: 31107902 PMCID: PMC6527231 DOI: 10.1371/journal.pone.0215724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/09/2019] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To assess the effectiveness of Home Fire Safety (HFS) interventions versus other interventions/no interventions/controls on HFS knowledge and behaviour at short-, intermediate- and long-term follow ups. DESIGN Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES MEDLINE, EMBASE and PubMed databases were searched from January 1998 to July 2018, and studies retrieved. PARTICIPANTS Toddlers, children (primary or secondary school), teenagers or adults. INTERVENTIONS/COMPARISON HFS interventions compared to other interventions / no interventions / controls. OUTCOMES HFS knowledge and behaviour. RESULTS 10 studies were identified (8 RCTs and 2 prospective cohort). Two studies assessed the effects of HFS interventions vs no interventions on HFS knowledge at up to 4 months follow up in school children and demonstrated significant difference between groups (very low quality, 2 RCTs, 535 participants, SMD 0.38, 95% CI: 0.21 to 0.55, p < 0.001). One study examined the effects of different modes of HFS interventions (computer-based vs instructor-led) on HFS knowledge and behaviour immediately post-intervention in adults and displayed no significant difference between groups (HFS knowledge; very low quality, 1 RCT, 68 participants, SMD -0.02, 95% CI: -0.50 to 0.45, p = 0.92) and (HFS behaviour; very low quality, 1 RCT, 68 participants, SMD 0.06, 95% CI: -0.41 to 0.54, p = 0.79) respectively. CONCLUSION The limited evidence supports the use of HFS interventions to improve HFS knowledge and behaviour in children, families with children and adults.
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