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Liu Y, Miao R, Zou H, Hu Q, Yin S, Zhu F. Repetitive transcranial magnetic stimulation in central post-stroke pain: a meta-analysis and systematic review of randomized controlled trials. Front Neurosci 2024; 18:1367649. [PMID: 38933817 PMCID: PMC11199869 DOI: 10.3389/fnins.2024.1367649] [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: 01/09/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Background The rehabilitation of central post-stroke pain (CPSP) is a complex clinical challenge, and repetitive transcranial magnetic stimulation (rTMS) has been widely applied in the research of neurofunctional recovery following stroke. However, there is currently no reliable evidence-based medicine supporting the efficacy of rTMS in central post-stroke pain. This review aims to evaluate the effects of rTMS on central post-stroke pain. Methods Following the PRISMA guidelines, we conducted searches on PubMed, Cochrane Library, Embase, Web of Science, CNKI, and Wan Fang Data Knowledge Service Platform. We searched for randomized controlled trials (RCTs) investigating the use of rTMS in treating central post-stroke pain, and conducted screening based on inclusion and exclusion criteria. Characteristics of the included RCTs were extracted. The heterogeneity of the trials was assessed using the I2 statistic. Meta-analysis was performed using Stata 17 software. Bias risk and methodological quality were evaluated using the Cochrane RoB 2 tool and the Pedro scale. Results A total of six randomized controlled trials involving 288 patients met our inclusion criteria. In our analysis, rTMS was more effective in treating patients with CPSP compared to the placebo group (SMD=-1.15, 95% CI: -1.69, -0.61, P < 0.001). Furthermore, results from subgroup analysis indicated no statistically significant difference in the improvement of pain for durations exceeding 6 months when comparing rTMS to conventional treatment (SMD=-0.80, 95% CI: -1.63, 0.03, P = 0.059). Conclusion TMS can alleviate pain in CPSP patients and improve their motor function, but its effects on depression, anxiety, and MEP-latency are not significant. Systematic review registration https://www.crd.york.ac.uk/prospero/, CRD42024497530.
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Affiliation(s)
- Ying Liu
- Department of Acupuncture and Rehabilitation, Traditional Chinese Medicine Hospital of Renshou County, Meishan, China
| | - Runqing Miao
- Department of Preventive Treatment, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hui Zou
- Department of Acupuncture and Rehabilitation, Traditional Chinese Medicine Hospital of Renshou County, Meishan, China
| | - Qian Hu
- Department of Hematology, Meishan City People's Hospital, Meishan, China
| | - Shao Yin
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengya Zhu
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
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Tang X, Zhang N, Shen Z, Guo X, Xing J, Tian S, Xing Y. Transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis. Clin Rehabil 2024; 38:749-769. [PMID: 38425282 DOI: 10.1177/02692155241235336] [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] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To evaluate the efficacy and safety of transcranial direct current stimulation in poststroke patients with upper extremity motor dysfunction using a systematic review and meta-analysis. DATA SOURCES We searched the Web of Science, Cochrane Library, EMBASE, and PubMed for randomized controlled trials investigating the effects of both active and sham stimulation up until January 27, 2024. REVIEW METHODS Efficacy, including the upper extremity Fugl-Meyer Assessment, Action Research Arm Test, Barthel Index, and safety, were assessed. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the Physiotherapy Evidence Database Scale. Meta-analysis was performed using the RevMan 5.4 software. RESULTS Forty-four studies with 1555 participants were included. Transcranial direct current stimulation proved effective in improving upper extremity motor function (standardized mean difference = 0.22, 95% confidence interval: 0.12-0.32, P < 0.001) and Barthel Index (mean difference = 4.65, 95% confidence interval: 2.82-6.49, P < 0.001). Subgroup analysis revealed the highest transcranial direct current stimulation efficacy in patients with subacute stroke. Both anodal and cathodal stimulation were effective against upper extremity motor dysfunction. C3/C4 was the most effective stimulus target. Optimal stimulation parameters included stimulus current densities <0.057 mA/cm2 for 20-30 min and <30 sessions. Adverse effects and dropouts during follow-up showed that transcranial direct current stimulation is safe and feasible. CONCLUSIONS Our findings suggest that both anodal and cathodal stimulation were significantly effective in subacute stroke patients, particularly when preceding other treatments and when C3/C4 is targeted.
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Affiliation(s)
- Xian Tang
- Department of Rehabilitation Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Nan Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhiyuan Shen
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Xin Guo
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Jun Xing
- Department of Rehabilitation Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Shujuan Tian
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Yuan Xing
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
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Fernández-Sánchez J, Trujillo-Colmena D, Rodríguez-Castaño A, Lavín-Pérez AM, Del Coso J, Casado A, Collado-Mateo D. Effects of exercise on life satisfaction of people diagnosed with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:297. [PMID: 38637349 PMCID: PMC11026230 DOI: 10.1007/s00520-024-08486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE A cancer diagnosis is commonly associated with a decline in patient's life satisfaction and more pessimistic expectations about the future. The identification of strategies to improve life satisfaction in patients with cancer is of great interest to health practitioners since it may be associated with a better prognosis of cancer and higher survival rates. Previous meta-analyses and reviews concluded that exercise could significantly improve health-related quality of life in this population, but the effects of exercise on life satisfaction are still not well-known. This review aims to analyse the effects of exercise programs on life satisfaction in people with cancer and individuals who have overcome cancer. METHODS The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A thorough search of databases including Web of Science and PubMed/MEDLINE was carried out. Six studies (535 participants) in which the effect of an exercise program was compared to a non-exercise program control condition in patients with cancer were considered eligible. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI). RESULTS Exercise intervention improved satisfaction with life compared with a control condition (SMD = 1.28; p = 0.02 with a 95% CI of 0.22 to 2.34). CONCLUSION Exercise could be considered an effective tool to improve life satisfaction in patients with cancer. Hence, professionals might consider the possibility of integrating physical exercise into strategies aimed at enhancing the low life satisfaction often experienced by patients. PROSPERO CRD42023438146.
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Affiliation(s)
| | | | | | - Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain.
- GO fitLAB, Ingesport, Madrid, Spain.
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Arturo Casado
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Daniel Collado-Mateo
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
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Celorrio San Miguel AM, Roche E, Herranz-López M, Celorrio San Miguel M, Mielgo-Ayuso J, Fernández-Lázaro D. Impact of Melatonin Supplementation on Sports Performance and Circulating Biomarkers in Highly Trained Athletes: A Systematic Review of Randomized Controlled Trials. Nutrients 2024; 16:1011. [PMID: 38613044 PMCID: PMC11013451 DOI: 10.3390/nu16071011] [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: 02/27/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Melatonin (N-acetyl-5 methoxytryptamine) is an indolic neurohormone that modulates a variety of physiological functions due to its antioxidant, anti-inflammatory, and immunoregulatory properties. Therefore, the purpose of this study was to critically review the effects of melatonin supplementation in sports performance and circulating biomarkers related to the health status of highly trained athletes. Data were obtained by performing searches in the following three bibliography databases: Web of Science, PubMed, and Scopus. The terms used were "Highly Trained Athletes", "Melatonin", and "Sports Performance", "Health Biomarkers" using "Humans" as a filter. The search update was carried out in February 2024 from original articles published with a controlled trial design. The PRISMA rules, the modified McMaster critical review form for quantitative studies, the PEDro scale, and the Cochrane risk of bias were applied. According to the inclusion and exclusion criteria, 21 articles were selected out of 294 references. The dose of melatonin supplemented in the trials ranged between 5 mg to 100 mg administered before or after exercise. The outcomes showed improvements in antioxidant status and inflammatory response and reversed liver damage and muscle damage. Moderate effects on modulating glycemia, total cholesterol, triglycerides, and creatinine were reported. Promising data were found regarding the potential benefits of melatonin in hematological biomarkers, hormonal responses, and sports performance. Therefore, the true efficiency of melatonin to directly improve sports performance remains to be assessed. Nevertheless, an indirect effect of melatonin supplementation in sports performance could be evaluated through improvements in health biomarkers.
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Affiliation(s)
- Ana M. Celorrio San Miguel
- Department of Chemistry, Polytechnic Secondary Education High School, 42004 Soria, Spain;
- Doctoral School, University of León, Campus de Vegazana, 24071 Leon, Spain
| | - Enrique Roche
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University Miguel Hernandez, 03202 Elche, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain;
| | - María Herranz-López
- Institute of Research, Development, and Innovation in Healthcare Biotechnology of Elche (IDiBE), Miguel Hernández University (UMH), 03202 Elche, Spain;
| | - Marta Celorrio San Miguel
- Emergency Department, Línea de la Concepción Hospital, C. Gabriel Miró, 108, 11300 La Línea de la Concepción, Spain;
| | - Juan Mielgo-Ayuso
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain;
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Diego Fernández-Lázaro
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain;
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
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García-López H, Calle-Ortega F, García-Robles P, Del-Rey RR, Obrero-Gaitán E, Cortés-Pérez I. Effectiveness of transcutaneous electrical nerve stimulation improves pain intensity, disability and quality of life in patients with fibromyalgia syndrome: a systematic review with meta-analysis. Disabil Rehabil 2024:1-11. [PMID: 38511391 DOI: 10.1080/09638288.2024.2331069] [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: 12/27/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE The transcutaneous electrical nerve stimulation (TENS) is one of the most frequently electrophysical agents employed in reducing the impact of FMS. This meta-analysis intended to determine the effectiveness of TENS on pain, disability, and quality of life (QoL) in patients with FMS. METHODS According to PRISMA, we performed a meta-analysis (CRD42023456439), searching in PubMed Medline, PEDro, CINAHL Complete, Web of Science, and Scopus, since inception up to October 2023. This review focused on controlled clinical trials evaluating the effect of TENS on pain, disability, and QoL in patients with FMS. The pooled effect was estimated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95%CI). RESULTS Twelve studies, providing data from 944 patients, were included (PEDro score of 5.6 points). Meta-analyses showed that TENS interventions are effective in improving pain (SMD = -0.61; 95%CI -1 to -0.16); disability (SMD = -0.27; 95%CI -0.41 to -0.12); and physical dimension of QoL (SMD = 0.26; 95%CI 0.08 to 0.44). Additionally, when TENS is used as a unique therapy, it represents the best therapeutic option for improving pain, disability, and QoL. CONCLUSIONS This meta-analysis, including the largest number of studies, showed that TENS intervention is an effective therapy to reduce pain and disability and increase QoL in FMS patients.
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Affiliation(s)
- Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
| | - Fabián Calle-Ortega
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
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Liu Y, Yin S, Yang X, Luo S, Zhu F, Zeng Z, Hu Q, Xu L, Yu Q. Effects of Cerebellar Repetitive Transcranial Magnetic Stimulation in the Treatment of Post-Stroke Dysphagia: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. Eur Neurol 2024; 87:67-78. [PMID: 38432194 DOI: 10.1159/000538130] [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: 01/18/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION This study aimed to comprehensively evaluate the therapeutic efficacy of cerebellar repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of post-stroke dysphagia (PSD). METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed, Cochrane Library, Embase, and Web of Science to identify relevant randomized controlled trials (RCTs) investigating the application of cerebellar rTMS in the treatment of PSD. Inclusion and exclusion criteria were rigorously applied during the screening process, and pertinent characteristics of the included RCTs were meticulously extracted. The I2 statistic was employed to assess heterogeneity, and meta-analysis was conducted using Stata 17 software. The Cochrane Risk of Bias 2 tool and PEDro scale were utilized to evaluate bias risk and literature quality. RESULTS Our analysis encompassed a total of 5 RCTs involving 673 patients with dysphagia who met the inclusion criteria. The findings indicated a significant positive impact of cerebellar rTMS when combined with traditional swallowing exercises on PSD, demonstrating superior efficacy compared to conventional swallowing exercises in isolation. Furthermore, the study revealed no statistically significant differences based on stimulation site (unilateral vs. bilateral cerebellum), stimulation mode (rTMS vs. intermittent theta-burst stimulation), and stimulation frequency (5 Hz vs. 10 Hz). CONCLUSION The amalgamation of cerebellar rTMS with conventional swallowing exercises demonstrates notable efficacy, surpassing the outcomes achievable with traditional exercises alone. The sustained effectiveness observed underscores the potential of cerebellar rTMS as an innovative avenue in the field of neurorehabilitation for PSD. This study contributes valuable insights into the prospect of utilizing cerebellar rTMS as an adjunctive therapeutic strategy in the management of PSD, emphasizing its relevance for further exploration and clinical application.
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Affiliation(s)
- Ying Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinwei Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shanshan Luo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengya Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zijian Zeng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Hu
- Department of Hematology, Meishan People's Hospital, Meishan, China
| | - Li Xu
- Department of Rehabilitation, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Yu
- Department of Rehabilitation, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Wang F, Bai Y, Hua B, Zhou W, Wang X. Effect of different intensity exercises on cardiopulmonary function and quality of life of patients with chronic heart failure : A systematic review and meta-analysis. Herz 2024; 49:134-146. [PMID: 37552242 DOI: 10.1007/s00059-023-05202-5] [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: 03/03/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation has positive benefits for patients with chronic heart failure (CHF), but the choice of exercise intensity has been controversial. The aim of this systematic review and meta-analysis was to investigate the effects of different exercise intensities on cardiopulmonary function and quality of life (QoL) of patients with CHF. METHODS Randomized controlled trials (RCTs) of different exercise intensities applied to patients with CHF were searched in PubMed, Web of Science, the Cochrane Library, and Embase databases from inception to December 2021. Study selection and data extraction were performed simultaneously by two independent reviewers, using the Physiotherapy Evidence Database Scale (PEDro) for quality assessment of the included literature. The weighted mean differences (WMD) or standardized mean difference (SMD) were calculated by employing a fixed or random effects model. Other statistical analyses included subgroup analysis and sensitivity analysis. Quality of evidence was evaluated by the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) method. RESULTS Eight RCTs were included. Analyses reported no significant improvement in left ventricular ejection fractions (LVEF; WMD = 0.47, 95% CI [-4.10, 5.03], p = 0.841), peak oxygen uptake (peak VO2) (SMD = 0.38, 95% CI [-0.03, 0.80], p = 0.069) and 6‑min walking distance (6MWD) (WMD = 14.10, 95% CI [-9.51, 37.72], p = 0.242). Exercise interventions of varying intensity produced small-to-moderate beneficial effects on QoL (WMD = -4.99, 95% CI [-8.29, -1.68], p = 0.003), which appeared to be attenuated at long-term follow-up (WMD = 2.12, 95% CI [-2.91, 7.16], p = 0.409). CONCLUSION High-intensity exercise does not have a significant advantage over moderate-intensity exercise in improving cardiopulmonary function and aerobic capacity in patients with CHF. Beneficial changes in QoL from high-intensity exercise also appeared to decrease during long-term follow-up, indicating a cumulative effect of the efficacy of high-intensity exercise.
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Affiliation(s)
- Fengying Wang
- Cancer Institute, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Cardiology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bin Hua
- Department of Cardiology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenqin Zhou
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoyan Wang
- Department of Anus and Intestine, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Pinheiro MB, Reis AHS, Baldwin JN, Moseley AM, Bapat V, Chan CS, Kwok WS, Sherrington C. Quantity and quality are increasing but there's room for improvement: A scoping review of physical activity intervention trials. Braz J Phys Ther 2024; 28:101051. [PMID: 38574557 PMCID: PMC10999812 DOI: 10.1016/j.bjpt.2024.101051] [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: 11/14/2022] [Revised: 02/12/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Observing trends in research publications helps to identify the quantity and quality of research produced, as well as reveal evidence gaps. No comprehensive review of the quality and quantity of physical activity intervention trials has been conducted. OBJECTIVE We aimed to investigate i) the volume and quality (and changes in these over time) of randomized controlled trials evaluating physical activity interventions, and ii) the association between journal ranking and trial quality. METHODS We searched the Physiotherapy Evidence Database (PEDro) for trials investigating physical activity interventions (no restrictions for population, comparison, or language). Descriptive statistics were used to describe the volume and quality of trials. The association between journal ranking (Journal Impact Factor) and trial quality (PEDro Scale) was examined using Spearman's rho correlation. RESULTS We identified 1779 trials, of which 40% (n = 710) were published between 2016 and 2020. The mean (SD) total PEDro score was 5.3 (1.5) points out of 10, increasing over time from 2.5 (0.7) points in 1975-1980 to 5.6 (1.4) points in 2016-2020. Quality criteria that were least reported included blinding of intervention deliverers (therapists) (n = 3, 0.2%), participants (n = 21, 1.2%), or assessors (n = 541, 31%); concealed allocation to groups (n = 526, 30%); and intention to treat analysis (n = 764, 43%). There was a small correlation between trial quality and Journal Impact Factor (0.21, p < 0.001). CONCLUSION A large volume of trials has investigated physical activity interventions. The quality of these trial reports is suboptimal but improving over time. Journal ranking should not be used for selecting high quality trials.
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Affiliation(s)
- Marina B Pinheiro
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Ana Helena S Reis
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Departamento de Fisioterapia, Faculdade Ciências Médicas de Minas Gerais, Minas Gerais, Brazil
| | - Jennifer N Baldwin
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne M Moseley
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Vishwesh Bapat
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Courtney S Chan
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing S Kwok
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Australia
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Guo Y, Cheng T, Yang Z, Huang Y, Li M, Wang T. A systematic review and meta-analysis of balance training in patients with chronic ankle instability. Syst Rev 2024; 13:64. [PMID: 38347564 PMCID: PMC10860262 DOI: 10.1186/s13643-024-02455-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Chronic ankle instability (CAI) is a common yet serious problem for elder patients. This meta-analysis aimed to evaluate the effects of balance training for CAI, to provide evidence for the clinical treatment, and care of CAI patients. METHODS Two investigators searched PubMed, EMBASE, Science Direct, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Weipu Databases up to May 20, 2023, for randomized controlled trials (RCTs) on the effects of balance training for CAI. The mean difference (MD) with 95% confidence intervals (95%CIs) was calculated for each outcome with a fixed or random effect model. Review Manager 5.3 software was used for meta-analysis. RESULTS Nine RCTs involving 341 patients were included. Meta-analysis results showed that compared with blank controls, balanced training treatment of CAI could significantly improve the score of CAI [MD = 3.95, 95% CI (3.26, 4.64), P < 0.00001], SEBT-PM [MD = 4.94, 95% CI (1.88, 8.00), P = 0.002], SEBT-PL [MD = 5.19, 95% CI (1.57, 8.81), P = 0.005], and FAAM Sports [MD = 17.74, 95% CI (14.36, 21.11), P < 0.00001]. Compared with strength training, balance training treatment of CAI improved the score of CAIT [MD = 2.36, 95% CI (0.29, 4.44), P = 0.03], FAAM-ADL [MD = 4.06, 95% CI (1.30, 6.83), P = 0.004]. CONCLUSION The analysis outcomes indicate that balance training enhances daily activity capability, motor function, and dynamic balance to different extents. Additionally, when comparing the results of balance training and strength training, no significant difference was observed between the two methods in improving the dynamic stability of CAI patients. However, it is noteworthy that balance training exhibits a more pronounced impact on enhancing functional scale scores.
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Affiliation(s)
- Yiwei Guo
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, China
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China
- Department of Physical Therapy, Tongji University School of Medicine, Shanghai, China
| | - Tianyue Cheng
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China
- Department of Physical Therapy, Tongji University School of Medicine, Shanghai, China
- Jiading Town Street Community Health Service Center, Shanghai, China
| | - Zihao Yang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China
- Department of Physical Therapy, Tongji University School of Medicine, Shanghai, China
- Sanlin Community Health Service Center, Shanghai, China
| | - Yonglei Huang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China
| | - Ming Li
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China
| | - Taoli Wang
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, China.
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongi University School of Medicine, Shanghai, China.
- Department of Physical Therapy, Tongji University School of Medicine, Shanghai, China.
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Vella SP, Melman A, Coombs D, Maher CG, Swain MS, Monk E, Machado GC. The effectiveness of allied health and nurse practitioner models-of-care in managing musculoskeletal conditions in the emergency department: a systematic review and meta-analysis. BMC Emerg Med 2024; 24:13. [PMID: 38233743 PMCID: PMC10795385 DOI: 10.1186/s12873-023-00925-4] [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: 10/13/2023] [Accepted: 12/26/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Musculoskeletal conditions are the most common health condition seen in emergency departments. Hence, the most effective approaches to managing these conditions is of interest. This systematic review aimed to evaluate the effectiveness of allied health and nursing models of care for the management of musculoskeletal pain in ED. METHODS MEDLINE, EMBASE, CINAHL and LILACS databases were searched from inception to March 2023 for published randomised trials that compared the effectiveness of allied health and nursing models of care for musculoskeletal conditions in ED to usual ED care. Trials were eligible if they enrolled participants presenting to ED with a musculoskeletal condition including low back pain, neck pain, upper or lower limb pain and any soft tissue injury. Trials that included patients with serious pathology (e.g. malignancy, infection or cauda equina syndrome) were excluded. The primary outcome was patient-flow; other outcomes included pain intensity, disability, hospital admission and re-presentation rates, patient satisfaction, medication prescription and adverse events. Two reviewers performed search screening, data extraction, quality and certainty of evidence assessments. RESULTS We identified 1746 records and included 5 randomised trials (n = 1512 patients). Only one trial (n = 260) reported on patient-flow. The study provides very-low certainty evidence that a greater proportion of patients were seen within 20 min when seen by a physician (98%) than when seen by a nurse (86%) or physiotherapist (77%). There was no difference in pain intensity and disability between patients managed by ED physicians and those managed by physiotherapists. Evidence was limited regarding patient satisfaction, inpatient admission and ED re-presentation rates, medication prescription and adverse events. The certainty of evidence for secondary outcomes ranged from very-low to low, but generally did not suggest a benefit of one model over another. CONCLUSION There is limited research to judge the effectiveness of allied health and nursing models of care for the management of musculoskeletal conditions in ED. Currently, it is unclear as to whether allied health and nurse practitioners are more effective than ED physicians at managing musculoskeletal conditions in ED. Further high-quality trials investigating the impact of models of care on service and health outcomes are needed.
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Affiliation(s)
- Simon P Vella
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia.
- Royal Prince Alfred Hospital, Level 10N, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Alla Melman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Danielle Coombs
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Christopher G Maher
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Michael S Swain
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Elizabeth Monk
- St George Hospital Emergency Department, Sydney, Australia
| | - Gustavo C Machado
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
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11
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Cole JS, Olson AD, Dupont-Versteegden EE. The Effects of Massage Therapy in Decreasing Pain and Anxiety in Post-Surgical Patients With Breast Cancer: A Systematic Review and Meta-Analysis. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241245099. [PMID: 38633004 PMCID: PMC11022679 DOI: 10.1177/27536130241245099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024]
Abstract
Background Massage therapy is an effective non-pharmacological intervention in treating pain and anxiety of patients with cancer. Prior studies have reviewed the benefits of massage therapy in patients with breast cancer undergoing chemotherapy, radiation, and other patient-specific cancer treatments. What has yet to be examined is the effects of massage therapy on the pain and anxiety of patients with breast cancer after surgery. Objective : The purpose of this systematic review and meta-analysis was to examine the effect of massage therapy on post-surgical pain and anxiety in patients with breast cancer. Methods Systematic searches were performed using databases PubMed, CINAHL, and Medline (EBSCO), with no date constraint through September 30, 2023, to identify randomized control trials, randomized pilot, and quasi-experimental studies. The database searches retrieved 1205 titles, and after screening, 7 studies were chosen for full analysis using Cohen's d, 95% Confidence Interval (CI), and effect size. The heterogeneity of the studies was calculated in the meta-analysis using Cochran's Q equation. Results Massage therapy techniques reported were massage therapy, classic massage, reflexology, myofascial release, and myofascial therapy, and were performed at day 0 up to 16 weeks post-surgery. Massage therapy decreased pain and anxiety for patients in the massage group. Analyses showed a positive effect size using massage therapy as an intervention for pain and anxiety in women with breast cancer post-surgery. Overall effect size for pain was 1.057 with a P-value of <.0001, and overall effect size for anxiety was .673 with a P-value of <.0001. Conclusion The current evidence in this study reflects that massage therapy is effective as a non-pharmacological tool in decreasing post-surgical pain and anxiety in women with breast cancer.
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Affiliation(s)
- Jill S. Cole
- Rehabilitation and Health Sciences PhD Program, University of Kentucky, Lexington, KY, USA
| | - Anne D. Olson
- Rehabilitation and Health Sciences PhD Program, University of Kentucky, Lexington, KY, USA
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington, KY, USA
| | - Esther E. Dupont-Versteegden
- Rehabilitation and Health Sciences PhD Program, University of Kentucky, Lexington, KY, USA
- Center for Muscle Biology, Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
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12
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Ferreira RM. New evidence-based practice: Artificial intelligence as a barrier breaker. World J Methodol 2023; 13:384-389. [PMID: 38229944 PMCID: PMC10789101 DOI: 10.5662/wjm.v13.i5.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/24/2023] [Accepted: 11/08/2023] [Indexed: 12/20/2023] Open
Abstract
The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice, representing the gold standard for optimal patient care. However, despite widespread recognition of its significance, practical application faces various challenges and barriers, including a lack of skills in interpreting studies, limited resources, time constraints, linguistic competencies, and more. Recently, we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence. Although artificial intelligence has become increasingly integrated into our daily lives, some reluctance persists among certain segments of the public. This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice. It highlights how artificial intelligence can assist in staying updated with the latest evidence, enhancing clinical decision-making, addressing patient misinformation, and mitigating time constraints in clinical practice. The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare, leading to more precise diagnoses, personalized treatment plans, and improved doctor-patient interactions. This proposed synergy between evidence-based practice and artificial intelligence may necessitate adjustments to its core concept, heralding a new era in healthcare.
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Affiliation(s)
- Ricardo Maia Ferreira
- Department of Sports and Exercise, Polytechnic Institute of Maia (N2i), Maia 4475-690, Porto, Portugal
- Department of Physioterapy, Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra 3046-854, Coimbra, Portugal
- Department of Physioterapy, Polytechnic Institute of Castelo Branco, Dr. Lopes Dias Health School, Castelo Branco 6000-767, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & Innovation Center, Polytechnic Institute of Viana do Castelo, Melgaço, 4960-320, Viana do Castelo, Portugal
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13
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Aldajah S, Etoom M, Mysore SB, Alawneh A, Hadoush H, Al Jarrah M, Abdullahi A. Evidence- based physiotherapy practice in Jordan: Evaluation and identification of implementation factors. Physiother Theory Pract 2023; 39:2723-2739. [PMID: 35833380 DOI: 10.1080/09593985.2022.2098212] [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: 01/20/2021] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Evidence-based physiotherapy practice (EBPTP) is becoming increasingly important to improve patient outcomes and clinical decision-making in the physiotherapy profession. OBJECTIVE To evaluate the EBPTP in Jordan and identify the barriers to its implementation in clinical practice. METHOD The study used a cross-sectional survey of licensed physiotherapists working in Jordan using EBPTP self-reported questionnaire. Frequencies, percentages, and one sample Wilcoxon rank test were used to evaluate the EBPTP level. The EBPTP implementation was evaluated by demographic variations of participants, Spearman's correlation, and stepwise multiple linear regression analyses at 95% confidence interval. RESULTS A total of 210 participants completed the survey. All EBPTP questionnaire elements showed significant positive levels (p = .00) except facility support reflecting non-significant negative level (p = .08). The EBPTP implementation was at a significantly lower level of uptake (p = .00). Clinical decision-making was based mainly on personal experience. The EBPTP implementation was significantly correlated with elements of the EBPTP questionnaire and differed by personal/organizational characteristics. There were four significant predictors of EBPTP implementation: understanding of EBPTP terminologies, facility support, formal training in EBPTP, and being a clinical instructor. CONCLUSION The findings confirm a clear gap in EBPTP implementation among physiotherapists in Jordan. The EBPTP implementation factors were mainly based on education sectors and work facilities. Engagement of stakeholders and education sectors in EBPTP implementation is required to strengthen the standing of the physiotherapy profession in Jordan.
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Affiliation(s)
| | - Mohammad Etoom
- Division of Physical Therapy, Allied Medical Sciences Department, Aqaba University of Technology, Aqaba, Jordan
| | - Sunitha Bhagavathi Mysore
- Department of Physiotherapy, Fatima College of Health Sciences, Near Al Mafraq Hospital, Abu Dhabi, UAE
| | - Anoud Alawneh
- Division of Physical Therapy, Allied Medical Sciences Department, Aqaba University of Technology, Aqaba, Jordan
| | - Hikmat Hadoush
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Muhammed Al Jarrah
- Department of Physiotherapy, Fatima College of Health Sciences, Near Al Mafraq Hospital, Abu Dhabi, UAE
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
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ShahAli S, Kajbafvala M, Fetanat S, Karshenas F, Farshbaf M, Hegazy F, Shahabi S. Barriers and facilitators of evidence-based physiotherapy practice in Iran: A qualitative study. Musculoskeletal Care 2023; 21:1507-1528. [PMID: 37818988 DOI: 10.1002/msc.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND To facilitate evidence-based practice (EBP) in physiotherapy in Iran and guide future improvements, it is crucial to identify what barriers and facilitators exist in the current system from the physiotherapist's perspective. Therefore, the purpose of this study was to explore the barriers and facilitators of EBP in physiotherapy in Iran. METHODS This qualitative study was conducted using a phenomenological approach from January to July 2023 in Iran. The sampling process started with a purposive approach, and then an attempt was made to identify and interview more potential samples with the snowball approach. Thematic analysis was used to analyse the collected qualitative data. RESULTS 44 individuals, including 37 physiotherapists and seven faculty members, participated in this study. Several barriers and facilitators to evidence-based physiotherapy practice in Iran were found and then put into three themes: (1) individual factors, (2) practice environment factors, and (3) extra-organisational factors. The most common barriers were time/workload pressures, financial incentives, lack of motivation, weakness in English, managers' pressures, inadequate awareness among patients, infrastructure limitations, poor economic situation, Internet restrictions, inappropriateness of the educational curriculum, difficult access to scientific research, and lack of insurance coverage for up-to-date therapies. CONCLUSIONS Although most of the participants had a very positive view of physiotherapy based on scientific evidence, various obstacles have prevented this approach from being well implemented in Iran. Therefore, it is necessary to move towards minimising the existing barriers at the individual, practice environment, and extra-organisational levels by adopting effective multilateral policies.
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Affiliation(s)
- Shabnam ShahAli
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Kajbafvala
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sadaf Fetanat
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Karshenas
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Marzieh Farshbaf
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatma Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Carballo-Costa L, Quintela-Del-Río A, Vivas-Costa J, Costas R. Mapping the field of physical therapy and identification of the leading active producers. A bibliometric analysis of the period 2000- 2018. Physiother Theory Pract 2023; 39:2407-2419. [PMID: 35587366 DOI: 10.1080/09593985.2022.2073927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The objectives of the study were: 1) Describe the thematic structure and evolution of the field of physical therapy; 2) identify the main research producers (i.e. countries and institutions); and 3) compare their research output and citation impact. METHODS Papers related to physical therapy indexed in Web of Science (2000-2018) were identified to delineate the field, using keywords, journals, and citation networks. VOSviewer software, advanced bibliometric text mining, and visualization techniques were used to evaluate the thematic structure. We collected data about the country and institutional affiliation of all the authors and calculated production and citation impact indicators. RESULTS 85,697 papers were analyzed. Eleven thematic clusters were identified: 1) "health care and education"; 2) "biomechanics"; 3) "psychosocial, chronic pain and quality of life outcomes"; 4) "evidence-based physical therapy research methods"; 5) "traumatology and orthopedics"; 6) "neurological rehabilitation"; 7) "psychometrics and cross-cultural adaptation"; 8) "gait-balance analysis and Parkinson's disease"; 9) "exercise"; 10) "respiratory physical therapy"; and 11) "back pain." The United States, the United Kingdom, and Australia were the most productive countries. Netherlands, Norway, and Sweden had the highest citation impact. CONCLUSIONS Our bibliometric visualization approach makes it possible to comprehensively study the thematic structure of physical therapy. The ranking of producers has evolved and now includes China and Brazil. High research production does not imply a high citation impact.
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Affiliation(s)
- Lidia Carballo-Costa
- Department of Physical Therapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, Grupo de Investigación en Intervención Psicosocial y Rehabilitación Funcional, Campus de Oza, A Coruña, Spain
| | - Alejandro Quintela-Del-Río
- Universidade da Coruña, Departamento de Matemáticas, Faculty of Physiotherapy, Campus de Oza, A Coruña, Spain
| | - Jamile Vivas-Costa
- Department of Physical Therapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, Grupo de Investigación en Intervención Psicosocial y Rehabilitación Funcional, Campus de Oza, A Coruña, Spain
| | - Rodrigo Costas
- Centre for Science and Technology Studies (CWTS), Leiden University, Leiden, Netherlands
- Centre of Excellence in Scientometrics and Science, Technology and Innovation Policy, Stellenbosch University DST-NRF, Stellenbosch, South Africa
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16
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Harper B, Price P, Steele M. The efficacy of manual therapy on HRV in those with long-standing neck pain: a systematic review. Scand J Pain 2023; 23:623-637. [PMID: 37261845 DOI: 10.1515/sjpain-2023-0006] [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: 01/16/2023] [Accepted: 04/28/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Long-standing neck pain (LNP) is a clinical condition frequently encountered in the physical therapy clinic. LNP is a complex, multifactorial condition affecting multiple body systems including the autonomic nervous system (ANS). Traditionally, research on the impact of physical therapy on LNP has focused on self-report measures and pain scales. Heart rate variability (HRV) is an objective measure of the ANS, allowing for quantification of effects of treatment. This systematic review is intended to evaluate if manual therapy acutely affects heart rate variability in adults with long-standing neck pain. METHODS Pubmed, Medline, CINAHL, Google Scholar, Web of Science, and Cochrane library were used to retrieve the randomized controlled trials for this review between the years 2010-2021. Search terms included: chronic neck pain, neck pain, cervical pain, manual therapy, mobilization, manipulation, osteopathy, osteopathic or chiropractic. Heart rate variability, HRV, heart rate variation, effects, outcomes, benefits, impacts or effectiveness. RESULTS Of 139 articles located and screened, three full-text articles were selected for full qualitative synthesis, with a combined population of 112 subjects, 91 of which were female, with an average age of 33.7 ± 6.8 years for all subjects. MT techniques in three studies were statistically significant in improving HRV in people with LNP; however, techniques were differed across studies, while one study showed no benefit. The studies were found to be of high quality with PEDro scores ≥6. CONCLUSIONS Although no clear cause and effect relationship can be established between improvement in HRV with manual therapy, results supported the use of MT for an acute reduction in HRV. No one particular method of MT has proven superior, MT has been found to produce a statistically significant change in HRV. These HRV changes are consistent with decreased sympathetic tone and subjective pain.
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Affiliation(s)
- Brent Harper
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA, USA
- Department of Physical Therapy, Azusa Pacific University, Azusa, CA, USA
| | - Parker Price
- Department of Physical Therapy, Azusa Pacific University, Azusa, CA, USA
| | - Megan Steele
- Department of Physical Therapy, Azusa Pacific University, Azusa, CA, USA
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Santamaría G, Rodríguez I, Rodríguez-Pérez V, Cobreros-Mielgo R, Lantarón-Caeiro E, Seco-Casares M, Fernández-Lázaro D. Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain-A Systematic Review. Sports (Basel) 2023; 11:167. [PMID: 37755844 PMCID: PMC10536491 DOI: 10.3390/sports11090167] [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: 05/24/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of this study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from the PubMed, PEDro, and Scopus databases published up to September 2022. Based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASP and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as "good". In conclusion, the addition of hip muscle strengthening exercises iterating interacted with LBP, effectively improving pain and disability.
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Affiliation(s)
- Gema Santamaría
- Department of Anatomy and Radiology, Faculty of Health Sciences, Campus of Soria, University of Valladolid, 42003 Soria, Spain;
| | | | - Vicente Rodríguez-Pérez
- Faculty of Nursing and Physiotherapy, Department of Nursing and Physiotherapy, Universidad de Salamanca, C/ Donantes de Sangre s/n, 37007 Salamanca, Spain;
| | - Raúl Cobreros-Mielgo
- Institute of Biomedicine (IBIOMED), Physiotherapy Department, University of Leon, Campus de Vegazana, 24071 Leon, Spain;
| | - Eva Lantarón-Caeiro
- Physiotherapy Group FS1, Department of Functional Biology and Health Sciences, Faculty of Physical Therapy, University of Vigo, 36005 Pontevedra, Spain;
| | - Marina Seco-Casares
- Nursing Department, León University Assistance Complex (CAULE), Hospital of León, 24008 Leon, Spain
| | - Diego Fernández-Lázaro
- Department of Cellular Biology, Genetic, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus de Soria, 42003 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
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Fernández-Lázaro D, Fiandor EM, García JF, Busto N, Santamaría-Peláez M, Gutiérrez-Abejón E, Roche E, Mielgo-Ayuso J. β-Alanine Supplementation in Combat Sports: Evaluation of Sports Performance, Perception, and Anthropometric Parameters and Biochemical Markers-A Systematic Review of Clinical Trials. Nutrients 2023; 15:3755. [PMID: 37686787 PMCID: PMC10490143 DOI: 10.3390/nu15173755] [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: 08/15/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
β-alanine does not have an ergogenic effect by itself, but it does as a precursor for the synthesis of carnosine in human skeletal muscle. β-alanine and carnosine together help improve the muscles' functionality, especially in high-intensity exercises such as combat sports. Therefore, β-alanine could be considered a nutritional ergogenic aid to improve sports performance in combat athletes. We aimed to critically review clinical trial evidence on the impact of β-alanine supplementation on sports performance, perception, and anthropometric parameters, as well as circulating biochemical markers in combat athletes. This systematic review was conducted following the specific methodological guidelines of the Preferred Report Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), the PICOS question model, the Critical Review Form of McMaster, and the PEDro scale. Furthermore, the Cochrane risk-of-bias assessment tool was used. The search was carried out in the SCOPUS, Web of Science (WOS), and Medline (PubMed) databases for studies published from the beginning of the database until July 31, 2023. Of the 41 registers identified, only 7 met the established criteria and were included in this systematic review. Overall, performance parameters related to strength, power, total exercise work capacity, and combat-specific parameters were significantly improved (p < 0.05). Perception parameters increased non-significantly (p > 0.05). Regarding biochemical parameters, carnosine increased significantly (p < 0.05), pH decreased non-significantly (p > 0.05), and the results for blood bicarbonate and blood lactate were heterogeneous. Finally, there was a non-significant (p > 0.05) improvement in the anthropometric parameters of lean mass and fat mass. β-alanine supplementation appears to be safe and could be a suitable nutritional ergogenic aid for combat athletes.
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Affiliation(s)
- Diego Fernández-Lázaro
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain; (E.R.); (J.M.-A.)
| | - Emma Marianne Fiandor
- Faculty of Physical Activity and Sport Sciences, European University, 28670 Villaviciosa de Odón, Spain;
| | - Juan F. García
- Department of Mechanical, Informatics and Aerospatial Engineering, University of Leon, 24071 Leon, Spain
| | - Natalia Busto
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Mirian Santamaría-Peláez
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Eduardo Gutiérrez-Abejón
- Pharmacological Big Data Laboratory, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
- Pharmacy Directorate, Castilla y León Health Council, 47007 Valladolid, Spain
| | - Enrique Roche
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain; (E.R.); (J.M.-A.)
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University Miguel Hernández, 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Juan Mielgo-Ayuso
- Research Group “Nutrition and Physical Activity”, Spanish Nutrition Society “SEÑ”, 28010 Madrid, Spain; (E.R.); (J.M.-A.)
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
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Ahmed Hassanin M, Aly MG, Atef H, Marques-Sule E, Ahmed GM. Task-oriented training for upper limb functions in patients with multiple sclerosis: Systematic review and meta-analysis. Mult Scler Relat Disord 2023; 73:104625. [DOI: 10.1016/j.msard.2023.104625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/10/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
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Dos Reis AHS, de Oliveira ALM, Fritsch C, Zouch J, Ferreira P, Polese JC. Usefulness of machine learning softwares to screen titles of systematic reviews: a methodological study. Syst Rev 2023; 12:68. [PMID: 37061711 PMCID: PMC10105467 DOI: 10.1186/s13643-023-02231-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
OBJECTIVE To investigate the usefulness and performance metrics of three freely-available softwares (Rayyan®, Abstrackr® and Colandr®) for title screening in systematic reviews. STUDY DESIGN AND SETTING In this methodological study, the usefulness of softwares to screen titles in systematic reviews was investigated by the comparison between the number of titles identified by software-assisted screening and those by manual screening using a previously published systematic review. To test the performance metrics, sensitivity, specificity, false negative rate, proportion missed, workload and timing savings were calculated. A purposely built survey was used to evaluate the rater's experiences regarding the softwares' performances. RESULTS Rayyan® was the most sensitive software and raters correctly identified 78% of the true positives. All three softwares were specific and raters correctly identified 99% of the true negatives. They also had similar values for precision, proportion missed, workload and timing savings. Rayyan®, Abstrackr® and Colandr® had 21%, 39% and 34% of false negatives rates, respectively. Rayyan presented the best performance (35/40) according to the raters. CONCLUSION Rayyan®, Abstrackr® and Colandr® are useful tools and provided good metric performance results for systematic title screening. Rayyan® appears to be the best ranked on the quantitative and on the raters' perspective evaluation. The most important finding of this study is that the use of software to screen titles does not remove any title that would meet the inclusion criteria for the final review, being valuable resources to facilitate the screening process.
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Affiliation(s)
- Ana Helena Salles Dos Reis
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ana Luiza Miranda de Oliveira
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Fritsch
- Faculty of Medicine and Health, School of Health Sciences, Sydney Musculoskeletal Health, The Kolling Institute, The University of Sydney, Sydney, NSW, Australia
| | - James Zouch
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Paulo Ferreira
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Janaine Cunha Polese
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Sánchez-Delgado JC, Jácome-Hortúa AM, Yoshida de Melo K, Aguilar BA, Vieira Philbois S, Dutra de Souza HC. Physical Exercise Effects on Cardiovascular Autonomic Modulation in Postmenopausal Women-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032207. [PMID: 36767574 PMCID: PMC9916307 DOI: 10.3390/ijerph20032207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND The cardioprotective effect of physical exercise has been demonstrated in several studies. However, no systematic or updated analysis has described the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. AIM to describe the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. METHODS The Scopus, PubMed, and Embase databases were searched for randomized clinical trials published between January 2011 and December 2021, and regarding the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. Two independent authors processed the citations. The methodological quality was evaluated using the PEDRo scale. RESULTS Of the 91 studies identified, only 8 met the inclusion criteria, of which 7 had fair or poor methodological quality. The analyzed studies investigated the effects of functional training, whole-body vibration, muscular resistance, stretching, and aerobic exercises performed at home or at the gym. The majority of these exercise modalities showed improvements in heart-rate variability (HRV) indices and in the low-frequency band of blood pressure variability. The meta-analysis shows that exercise increased the standard deviation of instantaneous beat-to-beat variability (SD1) (mean difference (MD) = 3.99; 95% confidence interval (CI) = 1.22 to 6.77, n = 46; I2: 0%) and the standard deviation of long-term variability (SD2) (MD = 11.37; 95% CI = 2.99 to 19.75; n = 46; I2: 0%). CONCLUSIONS Aerobic exercise and some nonconventional training modalities may have beneficial effects on cardiovascular autonomic modulation in postmenopausal women. More high-quality studies are still needed to further confirm their efficacy and safety.
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Affiliation(s)
- Juan Carlos Sánchez-Delgado
- Grupo de Investigación Ser Cultura y Movimiento, Facultad de Salud, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia
| | | | - Kelly Yoshida de Melo
- Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Bruno Augusto Aguilar
- Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Stella Vieira Philbois
- Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Hugo Celso Dutra de Souza
- Laboratory of Physiology and Cardiovascular Physioterapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
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Einfluss von aktiven Übungsprogrammen und Aufbissschienen auf die kraniomandibuläre Dysfunktion. MANUELLE MEDIZIN 2023. [DOI: 10.1007/s00337-022-00931-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Zusammenfassung
Hintergrund
Rund 40 % der Weltbevölkerung sind von einer kraniomandibulären Dysfunktion (CMD) betroffen. Diese äußert sich durch Schmerzen, Bewegungseinschränkungen und/oder Kiefergelenkgeräusche und wird durch die große Varianz an Symptomen meist erst spät diagnostiziert und behandelt. Nicht selten kommt es zu Einschränkungen der Lebensqualität der Betroffenen. In der Behandlung der CMD spielen Physiotherapie und Schienenversorgung eine wichtige Rolle.
Ziel
Ziel dieser Arbeit ist es, die Auswirkungen von Heimübungsprogrammen (HÜs) und Schienentherapie (ST) auf die Hauptsymptome der CMD zu klären. Es soll herausgefunden werden, ob eine Kombination der beiden Therapien einen therapeutischen Mehrwert darstellt.
Material und Methoden
Mittels Literaturrecherche in den Datenbanken PubMed, PEDro und Cochrane wurden Studien recherchiert und nach Durchsicht adäquater Abstracts die Volltexte zusammengefasst und kritisch diskutiert.
Ergebnisse
Sowohl HÜs als auch ST führen zu einer Verbesserung der beschriebenen Symptome und der Lebensqualität. Bei myogener CMD zeigen HÜs einen besseren Therapieeffekt auf die Kiefergelenkbeweglichkeit. Bei der Diagnose Diskusverlagerung mit Reposition waren im Gegensatz dazu keine deutlichen Therapieerfolge feststellbar. In keiner der analysierten Studien ergab eine Kombination der beiden Interventionen einen Mehrwert. Bei der Analyse der Lebensqualität war die Vergleichbarkeit aufgrund unterschiedlicher und nicht optimaler Fragebögen nur beschränkt möglich. Vergleicht man die Ergebnisse der durchgeführten Maßnahmen in Bezug auf die Interventionsdauer, ließ sich feststellen, dass zu Beginn der Therapien bessere Ergebnisse erzielt wurden als nach längerer Behandlungszeit. Auch die Dropout-Raten nahmen bei längeren Follow-up-Zeiten zu.
Schlussfolgerungen
Eine individuelle Anpassung der HÜs fördert die Compliance und Therapieadhärenz. Aufgrund der aktuellen Studienlage wird davon ausgegangen, dass sowohl HÜs als auch ST angemessene Methoden darstellen, um Schmerzen und Kiefergelenkgeräusche zu reduzieren und eine Verbesserung der Kiefergelenkbeweglichkeit und Lebensqualität zu erzielen. Bei myogener CMD stellen HÜs eine adäquate, kostengünstige Alternative zur ST dar. Weitere Forschung ist notwendig, um die genaue Therapiewirkung auf die verschiedenen Diagnosegruppen zu analysieren. Bezüglich der Lebensqualität sind weitere Analysen mit adäquaten Fragebögen notwendig.
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23
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Alexa JM, Richter M, Bertsche T. Enhancing evidence-based Pharmacy: The quality of web-based information sources compared to the EVInews-database - A randomized controlled trial with German community pharmacists (Preprint). J Med Internet Res 2023. [DOI: 10.2196/45582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
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Ferlito JV, Rolnick N, Ferlito MV, De Marchi T, Deminice R, Salvador M. Acute effect of low-load resistance exercise with blood flow restriction on oxidative stress biomarkers: A systematic review and meta-analysis. PLoS One 2023; 18:e0283237. [PMID: 37083560 PMCID: PMC10121002 DOI: 10.1371/journal.pone.0283237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The purpose of this review was to analyze the acute effects of low-load resistance exercise with blood flow restriction (LLE-BFR) on oxidative stress markers in healthy individuals in comparison with LLE or high-load resistance exercise (HLRE) without BFR. MATERIALS AND METHODS A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. These searches were performed in CENTRAL, SPORTDiscus, EMBASE, PubMed, CINAHL and Virtual Health Library- VHL, which includes Lilacs, Medline and SciELO. The risk of bias and quality of evidence were assessed through the PEDro scale and GRADE system, respectively. RESULTS Thirteen randomized clinical trials were included in this review (total n = 158 subjects). Results showed lower post-exercise damage to lipids (SMD = -0.95 CI 95%: -1.49 to -0. 40, I2 = 0%, p = 0.0007), proteins (SMD = -1.39 CI 95%: -2.11 to -0.68, I2 = 51%, p = 0.0001) and redox imbalance (SMD = -0.96 CI 95%: -1.65 to -0.28, I2 = 0%, p = 0.006) in favor of LLRE-BFR compared to HLRE. HLRE presents higher post-exercise superoxide dismutase activity but in the other biomarkers and time points, no significant differences between conditions were observed. For LLRE-BFR and LLRE, we found no difference between the comparisons performed at any time point. CONCLUSIONS Based on the available evidence from randomized trials, providing very low or low certainty of evidence, this review demonstrates that LLRE-BFR promotes less oxidative stress when compared to HLRE but no difference in levels of oxidative damage biomarkers and endogenous antioxidants between LLRE. TRIAL REGISTRATION Register number: PROSPERO number: CRD42020183204.
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Affiliation(s)
- João Vitor Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States of America
| | - Marcos Vinicius Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
| | - Thiago De Marchi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Rafael Deminice
- Department of Physical Education, State University of Londrina, Londrina, Brazil
| | - Mirian Salvador
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias Do Sul, Caxias do Sul, Brazil
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25
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Sánchez-Delgado JC, Jácome-Hortúa AM, Uribe-Sarmiento OM, Philbois SV, Pereira AC, Rodrigues KP, Souza HCD. Combined effect of physical exercise and hormone replacement therapy on cardiovascular and metabolic health in postmenopausal women: A systematic review and meta-analysis. Braz J Med Biol Res 2023; 56:e12241. [PMID: 37194832 DOI: 10.1590/1414-431x2023e12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023] Open
Abstract
The cardioprotective effect of postmenopausal hormone replacement therapy (HRT) has been demonstrated in several studies. Similarly, physical exercise has yielded positive results. However, the effects of their combination remain inconclusive. This review describes the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We searched the Scopus, Web of Science, PubMed, and Embase databases and included randomized controlled trials published up to December 2021 on the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We identified 148 articles, of which only seven met the inclusion criteria (386 participants; 91 [23%] HRT + exercise; 104 [27%] HRT; 103 [27%] exercise; 88 [23%] placebo). The combined treatment further decreased systolic blood pressure (SBP) compared to the isolated effect of aerobic training (AT) (mean difference [MD]=-1.69; 95% confidence interval [CI]=-2.65 to -0.72, n=73). Nevertheless, it attenuated the decrease in diastolic blood pressure (DBP) (MD=0.78; 95%CI: 0.22-1.35, n=73), and the increase in peak oxygen consumption (VO2 peak) promoted by exercise (AT + HRT=2.8±1.4 vs AT + placebo=5.8±3.4, P=0.02). The combination of AT and oral HRT improved SBP. However, AT alone seemed to have a better effect on physical fitness and DBP in postmenopausal women.
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Affiliation(s)
- J C Sánchez-Delgado
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - A M Jácome-Hortúa
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - O M Uribe-Sarmiento
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | - S V Philbois
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A C Pereira
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - K P Rodrigues
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H C D Souza
- Laboratório de Cardiologia, Fisiologia e Fisioterapia, Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Methodological Quality of Physical Therapy-Related Trials Published in Open Access and Subscription Journal: A Cross-sectional Meta-Epidemiological Study. Am J Phys Med Rehabil 2023; 102:58-63. [PMID: 35440526 DOI: 10.1097/phm.0000000000002029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We aimed to compare the methodological quality of physical therapy-related trials published in open access with that of trials published in subscription-based journals, adjusting for subdiscipline, intervention type, endorsement of the Consolidated Standards of Reporting Trials, impact factor, and publication language. DESIGN In this meta-epidemiological study, we searched the Physiotherapy Evidence Database on May 8, 2021, to include any physical therapy-related trials published from January 1, 2020. We extracted variables such as Consolidated Standards of Reporting Trials endorsement, the Physiotherapy Evidence Database score, and publication type. We compared the Physiotherapy Evidence Database score between the publication types using a multivariable generalized estimating equation by adjusting for covariates. RESULTS A total of 2743 trials were included, with a mean total Physiotherapy Evidence Database score (standard deviation) of 5.8 (±1.5). Trials from open access journals had a lower total Physiotherapy Evidence Database score than those from subscription-based journals (5.5 ± 1.5 vs. 5.9 ± 1.5, mean difference = -0.4; 95% confidence interval = 0.3-0.5). Generalized estimating equation revealed that open access publication was significantly associated with the total Physiotherapy Evidence Database score (mean difference = -0.42; P < 0.001). CONCLUSIONS In the recent physical therapy-related trials, open access publications demonstrated lower methodological quality than subscription-based publications, although with a small difference.
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Adamson NJ, Tsuro M, Adams N. Ultrasound-guided versus landmark-guided subacromial corticosteroid injections for rotator cuff related shoulder pain: A systematic review of randomised controlled trials. Musculoskeletal Care 2022; 20:784-795. [PMID: 35510534 DOI: 10.1002/msc.1643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Rotator cuff related shoulder pain (RCRSP) is the most common presentation of shoulder pain within physiotherapy. Corticosteroid injections (CSI) have become increasingly popular to reduce pain, increase range of motion (ROM) and improve shoulder function. Evidence around the use of ultrasound-guided (USG) versus landmark-guided (LMG) CSIs remains controversial. OBJECTIVE The objective of this appraisal was to compare the effectiveness of each approach in the management of RCRSP. METHODS Cochrane, PubMed and CINAHL electronic databases were searched (from January 2014 to February 2021). Randomised controlled trials (RCTs) were included comparing USG to LMG CSIs for RCRSP. An independent reviewer selected the studies, extracted and synthesised the data. Two reviewers carried out a quality appraisal. Outcome measures were pain, function and ROM. RESULTS Four RCTs (n = 179 participants, n = 184 shoulders) were reviewed. Both USG and LMG groups showed statistically significant within group improvements in clinical outcomes. There were no significant differences between groups. Three studies were identified as being a 'low' risk of bias (RoB) and did not favour the use of ultrasound. One study did favour the use of ultrasound for improving function, although it was found to have 'high' RoB. Adverse events were seldom reported. CONCLUSION There is limited evidence to suggest using USG CSIs has a superior effect on clinical outcomes compared to LMG, though small sample sizes and lack of long-term follow-up limit the generalisability of the findings.
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Affiliation(s)
| | - Munyaradzi Tsuro
- Physiotherapy Department, Pilgrim Hospital, Boston and Sleaford Medical Group, Sleaford, Lincolnshire, UK
| | - Nicola Adams
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Almost one in five physiotherapy trials excluded people due to lack of language proficiency: A meta-epidemiological study. J Clin Epidemiol 2022; 152:13-22. [PMID: 36150549 DOI: 10.1016/j.jclinepi.2022.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/26/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective of the study was to examine the characteristics of randomized controlled trials (RCTs) evaluating physiotherapy interventions for low back pain (LBP) that specified a language-grounded eligibility criterion and the proportion of people being excluded consequently. STUDY DESIGN AND SETTING This is a meta-epidemiological study of RCTs evaluating at least one type of physiotherapy intervention for treatment or prevention of LBP. Records were retrieved from Physiotherapy Evidence Database (PEDro), LILACS, and SciELO from inception to May 2021. We retrieved metadata of each record from PEDro and extracted from included studies: country of recruitment, language-grounded eligibility criterion, and the number of consequent exclusions (if specified). RESULTS This study included 2,555 trials. A language-grounded eligibility criterion was specified in 463 trials (18.1%); the proportion was higher in trials conducted in North America and Europe, published after 2000, investigating cognitive and behavioral interventions, and including large sample size. Of these 463 trials, 75 trials (16.2%) reported a total number of 2,152 people being excluded due to lack of language proficiency, equivalent to 12.5% of randomized participants. CONCLUSION Nearly one in five physiotherapy clinical trials on LBP excludes people based on language proficiency, compromising the evidence to manage LBP in minority populations.
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Slattery B, Ackerman L, Jagadamma KC. Service evaluation of telehealth in a physiotherapy musculoskeletal setting: Patient outcomes and results from risk stratification. Musculoskeletal Care 2022; 20:977-990. [PMID: 35220671 DOI: 10.1002/msc.1623] [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: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Due to COVID-19 the ability to see all patients face-to-face (FTF) was removed. Services implemented telehealth to cater for patients requiring musculoskeletal care. A service evaluation was undertaken to assess the effectiveness of a mixed telehealth/FTF approach and identify if stratifying patients could help tailor intervention. METHODS Retrospective analysis of data collected from patients who were assessed by Musculoskeletal Physiotherapists in one Scottish health board was undertaken. Patients were divided into low, medium and high risk sub-groups through the Keele STarT MSK tool. Outcome measures for pain and musculoskeletal health were taken at baseline/discharge along with satisfaction/preference. Descriptive and Inferential statistical analysis was conducted to establish whether changes in the outcome measures within and between risk sub-groups were statistically significant. RESULTS Pain level difference from baseline to discharge demonstrated clinically and statistically significant improvements across all risk groups (N = 89). Musculoskeletal health demonstrated clinically significant improvements across all risk groups and statistically significant improvements in the medium/high risk groups but not the low risk. Patients with knee osteoarthritis and low back pain in the medium risk group had fewest appointments while patients with chronic shoulder pain had the most. The majority of patients were satisfied with all mediums but preferred FTF or an option between telehealth/FTF in the future. CONCLUSION Telehealth is a promising model of care when utilised in combination with FTF for patients with musculoskeletal conditions. Through stratification, identifying specific conditions and shared decision making it may be possible to treat certain patient groups via telehealth.
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Affiliation(s)
- Brian Slattery
- Department of Physiotherapy, NHS Lanarkshire, Coatbridge, UK
| | - Lyndsey Ackerman
- Department of Physiotherapy, Queen Margaret University, Musselburgh, UK
| | - Kavi C Jagadamma
- Department of Physiotherapy, Queen Margaret University, Musselburgh, UK
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Slagter L, Demyttenaere K, Verschueren P, De Cock D. The Effect of Meditation, Mindfulness, and Yoga in Patients with Rheumatoid Arthritis. J Pers Med 2022; 12:1905. [PMID: 36422081 PMCID: PMC9696072 DOI: 10.3390/jpm12111905] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVES Mind-body therapies (MBTs), including meditation, yoga, and mindfulness, create an interaction between the mind and body to enhance health. MBTs are perceived by both patients and healthcare professionals as valuable in the management of rheumatoid arthritis (RA), but the extent of this contribution is unclear, as are the patient subgroups who benefit most from MBTs. Therefore, this systematic literature review investigates the effects of meditation, mindfulness, and yoga in patients with RA. METHODS We searched four databases (PubMed, Embase, Web of Science (core collection, Chinese and Korean collection), and CINAHL). All studies were screened by two independent reviewers via the title/abstract/full text. The studies included any form of meditation/mindfulness/yoga as an intervention for RA. Animal studies, case reports, non-English articles, qualitative studies, conference abstracts, and articles without full-text access were excluded. Each study was assessed for its quality. RESULTS Out of 1527 potentially eligible records, 23 studies were included. All three MBTs showed various effects on patient-reported outcomes, such as vitality, functioning, and mental health, as well as on disease activity markers. Mindfulness-based interventions mainly reduced the subjective disease activity parameters (e.g., joint tenderness, morning stiffness, and pain), rather than the objective disease activity parameters (e.g., swollen joints and C-reactive protein (CRP)). RA patients with recurrent depression may benefit more from these non-pharmacological therapies than patients without recurrent depression. DISCUSSION This systematic literature review found that MBTs show added value in RA management, especially for patients with depressive symptoms. These non-pharmacological approaches, when used in addition to medication, might diminish polypharmacy in specific RA patient populations. Lay Summary: In recent decades, more attention has been given to the management of rheumatoid arthritis (RA) with options other than solely using medication. Such alternative options for patients to increase their quality of life are, for instance, meditation, yoga, and mindfulness. These examples of mind-body therapies (MBTs) are techniques that create an interaction between the mind and the bodily functions in order to obtain relaxation and enhance overall health. Although it is believed that these mind-body techniques are valuable in the management of RA, the extent of their contribution is still unclear, as is the question of if certain subgroups of patients benefit more from these complementary therapies. This systematic literature review investigated the effects of meditation, mindfulness, and yoga in patients with rheumatoid arthritis. A literature search was systematically performed within four different scientific databases by two independent reviewers. Out of 1527 potentially eligible articles, 23 studies were included. All three MBTs showed beneficial effects, which were mostly on the vitality, functioning, and mental health of patients with RA, but also on symptoms related to disease activity. RA patients with recurrent depression seemed to benefit more from these non-pharmacological therapies than patients without recurrent depression. Hence, we can conclude that MBTs show added value in the management of RA.
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Affiliation(s)
- Laura Slagter
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
| | - Koen Demyttenaere
- Department of Neurosciences, Psychiatry Research Group and University Psychiatric Center KU Leuven, Belgium University Psychiatric Center, KU Leuven, 3001 Leuven, Belgium
| | - Patrick Verschueren
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
- Department of Rheumatology, University Hospitals of Leuven, 3001 Leuven, Belgium
| | - Diederik De Cock
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1005 Brussels, Belgium
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Riley SP, Swanson BT, Shaffer SM, Sawyer SF, Cleland JA. Do Prospective Intent and Established Metrics Correlate with Journal Impact Factor in Musculoskeletal Physical Therapy Trials?: A Secondary Analysis of A Methodological Review. J Man Manip Ther 2022; 30:292-299. [PMID: 35188881 PMCID: PMC9487961 DOI: 10.1080/10669817.2022.2041285] [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: 01/08/2023] Open
Abstract
OBJECTIVES To determine if there are any statistically significant associations between: 1) randomized clinical trials (RCTs) investigating physical therapy musculoskeletal interventions, 2) journal impact factor (JIF), 3) frequency of RCT citation, 4) whether prospective intent was identifiable, and 5) the Physiotherapy Evidence Database (PEDro) scores. METHODS MEDLINE indexed RCTs addressing musculoskeletal interventions published between January 2016 and July 2020 in physical therapy journals were included. Two blinded reviewers identified the RCTs and extracted the variables of interest. RESULTS With a familywise alpha adjustment, there was no statistically significant correlation between JIF and number of citations (rho = 0.187; p = 0.0280). Statistically significant weak positive correlations were identified between the JIF and prospectively registered RCTs (rho = 0.240; p = 0.0046), JIF and PEDro scores (rho = 0.250; p = 0.0031), and PEDro scores and prospectively registered RCTs (rho = 0.335; p < 0.0001). CONCLUSION The findings of this study suggest that JIF and PEDro scores may not be accurate measures of RCT quality. Failing to ensure that published RCTs followed their prospective intent and using bibliometrics that fail to accurately measure what they propose appears to create untrustworthy preprocessed resources for practicing physical therapists during the evidence-based practice process. LEVEL OF EVIDENCE 1a.
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Affiliation(s)
- Sean P. Riley
- Doctor of Physical Therapy Program, Sacred Heart University, Fairfield, CT, USA,CONTACT Sean P. Riley Doctor of Physical Therapy Program, Sacred Heart University5151 Park Avenue Fairfield, Fairfield, CT06825USA
| | - Brian T. Swanson
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Stephen M. Shaffer
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Steven F. Sawyer
- Department of Rehabilitation Sciences and Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Tx, USA
| | - Joshua A. Cleland
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
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Fandim JV, Crowe-Owen L, Romanyshyn M, Chan SW. Reasons to become a volunteer rater for the Physiotherapy Evidence Database (PEDro). J Physiother 2022; 68:215-217. [PMID: 36244965 DOI: 10.1016/j.jphys.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Junior Vitorino Fandim
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), Sao Paulo, Brazil.
| | | | - Mykola Romanyshyn
- Department of Rehabilitation of Patients with Consequences of Diseases and Injuries of the Nervous System, Communal non-commercial enterprise "Kyiv Regional Clinical Hospital", Kyiv, Ukraine
| | - Stephen Ww Chan
- Allied Health Department, Hong Kong Children's Hospital, Hong Kong, China
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Karla Silva Pereira Gomes S, Malaguti C, Elias Filho J, Oliveira Caetano R, Vieira da Silva C, Medina Dutra de Oliveira T, Hespanhol L, Felício DC. Nasal dilator and physiological parameters associated to running performance: A systematic review and meta-analysis. J Sports Sci 2022; 40:2315-2326. [PMID: 36463536 DOI: 10.1080/02640414.2022.2151752] [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: 12/05/2022]
Abstract
Nasal dilators were created to expand the nasal valve area. The aim of this systematic review was to verify physiological parameters associated to running performance with the use of nasal dilators. This study was registered in PROSPERO (CRD42021225795). According to the PICOS framework studies were included: Population: healthy subjects; Intervention: nasal dilators; Comparison: control group, placebo, minimal intervention, health education or other intervention; Outcomes: cardiorespiratory parameters and subjective perceptions; Study: randomized controlled trials, repeated measures or within-subjects design. The databases searched were MEDLINE, EMBASE, CENTRAL The Cochrane Library, CINAHL, SPORTDiscus, Web of Science, PEDro and Scopus. The descriptors "Running", "Nasal Dilator", "Randomized Controlled Trial", and synonyms were used. The risk of bias was assessed using the PEDro scale. Random effects Der Simonian and Laird model were used. The assessment of the certainty of the evidence was carried out using the GRADE approach. Eleven articles were included. There was a difference in favour of the nasal dilator when compared to placebo for maximal oxygen uptake and rating of perceived exertion. The certainty of the evidence was very low. Future studies will probably have an impact on estimation of the effect.
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Affiliation(s)
- Suellen Karla Silva Pereira Gomes
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Carla Malaguti
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - José Elias Filho
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.,Programa de Pós Graduação em Educação Física, Faculdade de Educação Física da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Raphael Oliveira Caetano
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Christiano Vieira da Silva
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Túlio Medina Dutra de Oliveira
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Luiz Hespanhol
- Programas de Mestrado e Doutorado em Fisioterapia da Universidade Cidade de São Paulo (UNICID), São Paulo (SP), Brazil.,Department of Public and Occupational Health (DPOH), Amsterdam Public Health Research Institute (APH), Amsterdam Universities Medical Centers, location VU University Medical Center Amsterdam (VUmc), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam Movement Sciences, Amsterdam Universities Medical Centers, location VU University Medical Center Amsterdam (VUmc), Amsterdam, The Netherlands
| | - Diogo Carvalho Felício
- Programa de Pós Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
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Al Attar WSA, Bakhsh JM, Khaledi EH, Ghulam H, Sanders RH. Injury prevention programs that include plyometric exercises reduce the incidence of anterior cruciate ligament injury: a systematic review of cluster randomised trials. J Physiother 2022; 68:255-261. [PMID: 36244964 DOI: 10.1016/j.jphys.2022.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/05/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
QUESTION Do injury prevention programs that include plyometric exercises reduce the incidence of anterior cruciate ligament (ACL) injuries in sport? DESIGN Systematic review of (cluster) randomised trials with meta-analysis. PARTICIPANTS Sporting participants of any age, sex or competition level. INTERVENTIONS The experimental intervention was an injury prevention program that included plyometric exercises. The control intervention was the usual warm-up program, which did not include plyometric exercises. OUTCOME MEASURES Exposure-based ACL injury rates. RESULTS The initial search yielded 7,302 articles, of which nine met the inclusion criteria. All nine articles reported cluster randomised trials, providing data on 14,394 participants. The pooled results showed that injury prevention programs that include plyometric exercises reduce the risk of ACL injury by 60% per 1,000 hours of exposure compared with the control group, with an injury risk ratio (IRR) of 0.40 (95% CI 0.26 to 0.63). Data from subgroups of these trials estimated that this preventative effect may be stronger in males (IRR 0.21, 95% CI 0.07 to 0.62) and weaker in females (IRR 0.51, 95% CI 0.30 to 0.87), albeit with less precise estimates. Subgroup analysis also suggested a stronger effect on non-contact ACL injuries (IRR 0.34, 95% CI 0.18 to 0.65), whereas the effect on contact ACL injuries remained uncertain (IRR 0.59, 95% CI 0.15 to 2.30). CONCLUSIONS Injury prevention programs that incorporate plyometric exercises substantially decrease the risk of ACL injuries more than warm-up programs that do not include plyometric exercises. The preventive effect appears to be stronger among males and in the prevention of ACL injuries that do not involve contact with another player. PROSPERO CRD42020196982.
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia; Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia; Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland.
| | - Jumana M Bakhsh
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Ehdaa H Khaledi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia; Department of Physical Therapy, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Hussain Ghulam
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
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Evolution of the thematic structure and main producers of physical therapy interventions research: A bibliometric analysis (1986 to 2017). Braz J Phys Ther 2022; 26:100429. [PMID: 35868161 PMCID: PMC9307520 DOI: 10.1016/j.bjpt.2022.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/12/2022] [Accepted: 06/28/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Bibliometric studies are used to analyse and map scientific areas, and study the scientific output and impact of institutes and countries. OBJECTIVES Describe the thematic structure and evolution of the field of physical therapy interventions using articles indexed in Physiotherapy Evidence Database (PEDro). Also, identify and compare the main producers (countries, institutions) over time (research output, citation impact). METHODS Eligible articles were those indexed in PEDro (1986-2017) and matched to Web of Science. VOSviewer software, bibliometric text mining, and visualisation techniques were used to evaluate the thematic structure of the included articles. We collected data about authors' country and institutional affiliation, and calculated bibliometric indicators (production, citation impact). RESULTS A total of 29 090 articles were analysed. Eight topics were identified: "neurological rehabilitation"; "methods"; "exercise for prevention and rehabilitation of lifestyle diseases"; "assessment and treatment of musculoskeletal pain"; "physical activity", "health promotion and behaviour change"; "respiratory physical therapy"; "hospital, primary care and health economics"; "cancer and complementary therapies". The most productive countries were United States, United Kingdom, Australia, and Canada. The most impactful countries were United States, France, Finland, and Canada. The most productive institutions were University of Sydney, VU University of Amsterdam, University of Queensland, and University of Toronto. CONCLUSIONS The thematic structure of physical therapy interventions has evolved over time with "neurological rehabilitation", "methods", "exercise related to lifestyle diseases", and "physical activity" becoming increasingly important. Main producers of this research were traditionally located in North America and Europe but now include countries like China and Brazil.
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The effects of nitrate ingestion on high-intensity endurance time-trial performance: A systematic review and meta-analysis. J Exerc Sci Fit 2022; 20:305-316. [PMID: 35892115 PMCID: PMC9287610 DOI: 10.1016/j.jesf.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background/Objective Dietary nitrate ingestion extends endurance capacity, but data supporting endurance time-trial performance are unclear. This systematic review and meta-analysis evaluated the evidence for dietary nitrate supplementation to improve high-intensity endurance time-trial performance over 5–30 min on the premise that nitrate may alleviate peripheral fatigue over shorter durations. Methods A systematic literature search and data extraction was carried out following PRISMA guidelines and the PICOS framework within five databases: PubMed, ProQuest, ScienceDirect, Scopus and SPORTDiscus. Search terms used were: (nitrate OR nitrite OR beetroot) AND (high intensity OR all out) AND (time trial or total work done) AND performance. Results Twenty-four studies were included. Fifteen studies applied an acute supplementation strategy (4.1 mmol–15.2 mmol serving on one day), eight chronic supplementation (4.0 mmol–13.0 mmol per day over 3–15 days), and one applied both acute and chronic supplementation (8.0 mmol on one day and over 15 days). Standardised mean difference for time-trial ranging from 5 to 30 min showed an overall trivial effect in favour of nitrate (Hedges'g = 0.15, 95% CI -0.00 to 0.31, Z = 1.95, p = 0.05). Subgroup analysis revealed a small, borderline effect in favour of chronic nitrate intervention (Hedges'g = 0.30, 95% CI -0.00 to 0.59, Z = 1.94, p = 0.05), and a non-significant effect for acute nitrate intervention (Hedges'g = 0.10, 95% CI -0.08 to 0.28, Z = 1.11, p = 0.27). Conclusion Chronic nitrate supplementation improves time-trial performance ranging from 5 to 30 min.
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García-Collado A, Valera-Calero JA, Fernández-de-las-Peñas C, Arias-Buría JL. Effects of Ultrasound-Guided Nerve Stimulation Targeting Peripheral Nerve Tissue on Pain and Function: A Scoping Review. J Clin Med 2022; 11:3753. [PMID: 35807034 PMCID: PMC9267318 DOI: 10.3390/jcm11133753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023] Open
Abstract
This paper assesses the effects of percutaneous electrical nerve stimulation (PENS) on pain- and function-related outcomes by means of a scoping review of studies with single cases, case-series, quasi-experimental, and randomized or non-randomized trial designs. We consulted the PubMed, MEDLINE and EMBASE databases. Data were extracted by two reviewers. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale for experimental studies and the Joanna Briggs Institute (JBI) tool for case reports or cases series. Mapping of the results included: (1), description of included studies; (2), summary of results; and, (3), identification of gaps in the existing literature. Eighteen articles (five randomized controlled trials, one trial protocol, nine case series and three case reports) were included. The methodological quality of the papers was moderate to high. The conditions included in the studies were heterogeneous: chronic low back pain, lower limb pain after lumbar surgery, chronic post-amputation pain, rotator cuff repair, foot surgery, knee arthroplasty, knee pain, brachial plexus injury, elbow pain and ankle instability. In addition, one study included a healthy athletic population. Interventions were also highly heterogeneous in terms of sessions, electrical current parameters, or time of treatment. Most studies observed positive effects of PENS targeting nerve tissue against the control group; however, due to the heterogeneity in the populations, interventions, and follow-up periods, pooling analyses were not possible. Based on the available literature, PENS interventions targeting peripheral nerves might be considered as a potential therapeutic strategy for improving pain-related and functional outcomes. Nevertheless, further research considering important methodological quality issues (e.g., inclusion of control groups, larger sample sizes and comparatives between electric current parameters) are needed prior to recommending its use in clinical practice.
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Affiliation(s)
| | - Juan A. Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - José L. Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
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Hohenauer E, Freitag L, Herten M, Siallagan J, Pollock E, Taube W, Clijsen R. The Methodological Quality of Studies Investigating the Acute Effects of Exercise During Hypoxia Over the Past 40 years: A Systematic Review. Front Physiol 2022; 13:919359. [PMID: 35784889 PMCID: PMC9243659 DOI: 10.3389/fphys.2022.919359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
Exercise under hypoxia and the physiological impact compared to normoxia or hypoxia has gained attention in the last decades. However, methodological quality assessment of articles in this area is lacking in the literature. Therefore, this article aimed to evaluate the methodologic quality of trials studying exercise under hypoxia. An electronic search was conducted until December 2021. The search was conducted in PubMed, CENTRAL, and PEDro using the PICO model. (P) Participants had to be healthy, (I) exercise under normobaric or hypobaric hypoxia had to be (C) compared to exercise in normoxia or hypoxia on (O) any physiological outcome. The 11-item PEDro scale was used to assess the methodological quality (internal validity) of the studies. A linear regression model was used to evaluate the evolution of trials in this area, using the total PEDro score of the rated trials. A total of n = 81 studies met the inclusion criteria and were processed in this study. With a mean score of 5.1 ± 0.9 between the years 1982 and 2021, the mean methodological quality can be described as “fair.” Only one study reached the highest score of 8/10, and n = 2 studies reached the lowest observed value of 3/10. The linear regression showed an increase of the PEDro score of 0.1 points per decade. A positive and small tendency toward increased methodologic quality was observed. The current results demonstrate that a positive and small tendency can be seen for the increase in the methodological quality in the field of exercise science under hypoxia. A “good” methodological quality, reaching a PEDro score of 6 points can be expected in the year 2063, using a linear regression model analysis. To accelerate this process, future research should ensure that methodological quality criteria are already included during the planning phase of a study.
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Affiliation(s)
- Erich Hohenauer
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- *Correspondence: Erich Hohenauer,
| | - Livia Freitag
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
| | - Miriam Herten
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
| | - Julia Siallagan
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
| | - Elke Pollock
- Department of Physiotherapy, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Ron Clijsen
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland
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Ali MU, Fong KNK, Kannan P, Bello UM, Kranz GS. Effects of nonsurgical, minimally or noninvasive therapies for urinary incontinence due to neurogenic bladder: a systematic review and meta-analysis. Ther Adv Chronic Dis 2022; 13:20406223211063059. [PMID: 35321402 PMCID: PMC8935404 DOI: 10.1177/20406223211063059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/10/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: To determine the effects of nonsurgical, minimally or noninvasive therapies on urge urinary incontinence (UUI) symptoms and quality of life (QoL) in individuals with neurogenic bladder (NGB). Data Sources: Cochrane library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science databases were searched from inception to September 2021. Review Methods: Randomized controlled trials that compared therapies such as intravaginal electrical stimulation (IVES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous tibial nerve stimulation (TTNS), pelvic floor muscle training (PFMT), and behavioural therapy (BT) to control were included. Study screening, data extraction, and study quality assessments were performed by two independent authors. Results: Fourteen trials with 804 participants were included in the study after screening of 4281 potentially relevant articles. Meta-analyses revealed a significant effect of electrical stimulation on UUI due to multiple sclerosis (standardized mean difference (SMD): −0.614; 95% confidence interval (CI): −1.023, −0.206; p = 0.003) and stroke (SMD: −2.639; 95% CI: −3.804, −1.474; p = 0.000). The pooled analyses of TTNS (weighted mean difference (WMD): −12.406; 95% CI: −16.015, −8.797; p = 0.000) and BT (WMD: −9.117; 95% CI: −14.746, −3.487; p = 0.002) revealed significant effects of these interventions on QoL in people with Parkinson’s disease. However, meta-analyses revealed nonsignificant effects for PFMT (WMD: −0.751; 95% CI: −2.426, 0.924; p = 0.380) and BT (WMD: −0.597; 95% CI: −1.278, 0.083; p = 0.085) on UUI due to Parkinson’s disease. Conclusions: Our meta-analyses found electrical stimulation to be beneficial for improving the symptoms of UUI among people with multiple sclerosis and those with stroke. Our review also revealed that TTNS and BT might improve QoL for people with NGB due to Parkinson’s disease, although the effects of PFMT and BT on UUI warrant further investigation.
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Affiliation(s)
- Mohammed Usman Ali
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Medical Rehabilitation (Physiotherapy), University of Maiduguri, Maiduguri, Nigeria
| | - Kenneth Nai-Kuen Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Umar Muhammad Bello
- Centre for Eye and Vision Research (CEVR) Limited, Hong Kong, China; Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Physiotherapy, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Georg S. Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Park S, Tang A, Pollock C, Sakakibara BM. Telerehabilitation for lower extremity recovery poststroke: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e055527. [PMID: 35264359 PMCID: PMC8915270 DOI: 10.1136/bmjopen-2021-055527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Approximately 30% of individuals with stroke report unmet lower extremity recovery needs after formal hospital-based rehabilitation programmes have ended. Telerehabilitation can mitigate issues surrounding accessibility of rehabilitation services by providing ongoing support to promote recovery, however, no review exists that is specific to telerehabilitation for lower extremity recovery. This paper describes the protocol of a systematic review and meta-analysis that aims to describe and evaluate the effectiveness of lower extremity-focused telerehabilitation interventions on clinical outcomes poststroke. METHODS AND ANALYSIS A systematic review of relevant electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Google Scholar, PEDro, PubMed and Cochrane Library) between inception and February 2022 will be undertaken to identify eligible interventional studies published in English that compared telerehabilitation focusing on lower extremity recovery to another intervention or usual care for individuals living in the community with stroke. Clinical outcomes examined will include those related to physical function and impairment, activities and participation that are typically assessed in clinical practice and research. Two reviewers will independently screen results, identify studies to be included for review, extract data and assess risk of bias. Meta-analyses will be performed if sufficient data exist. Sensitivity analyses will be performed by removing studies with low methodological quality, and subgroup analyses will be performed if data allow by stratifying papers based on salient demographic or stroke factors and comparing results. The reporting of the review will follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence regarding various outcomes for telerehabilitation for lower extremity recovery poststroke will be assessed according to the Grading of Recommendation, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION No ethical approval or informed consent is needed for this systematic review. The findings of this review will be disseminated via peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021246886.
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Affiliation(s)
- Sarah Park
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Courtney Pollock
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Brodie M Sakakibara
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, British Columbia, Canada
- GF Strong Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
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Yuan R, Yuan Y, Wang L, Xin Q, Wang Y, Shi W, Miao Y, Leng SX, Chen K, Cong W. Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta-analysis. Front Pharmacol 2022; 13:744928. [PMID: 35264949 PMCID: PMC8899821 DOI: 10.3389/fphar.2022.744928] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/01/2022] [Indexed: 12/16/2022] Open
Abstract
Background: Metabolic syndrome (MetS) is characterized by the cooccurrence of obesity, insulin resistance, dyslipidaemia, and hypertension. Red yeast rice (RYR) preparations might be beneficial for the prevention and treatment of MetS. Objective: To implement a systematic review and meta-analysis to determine whether RYR preparations improve clinical endpoints and reduce risk factors for MetS. Methods: The PubMed, Cochrane Library, EMBASE, Scopus, China National Knowledge Infrastructure, Chinese VIP Information, and WanFang databases were searched for randomized controlled trials (published up to September 2020), and a meta-analysis was performed using fixed- or random-effects models. The primary outcome measures were mortality and major adverse cardiovascular events (MACEs), and the secondary outcome measures were biochemical parameters of blood glucose, blood lipids, and blood pressure. The registration number is CRD42020209186. Results: A total of 921 articles were identified, of which 30 articles were included in this article. RYR preparations group demonstrated significant improvements in MetS compared with control group. RYR preparations reduced the mortality and MACEs (RR = 0.62, 95% CI [0.49, 0.78]; RR = 0.54, 95% CI [0.43, 0.66]). In terms of blood glucose metabolism, fasting plasma glucose (FPG) (MD = -0.46 mmol/L, 95% CI [-0.71, -0.22]), haemoglobin A1c (HbA1c) (MD = -0.49, 95% CI [-0.71, -0.26]) and the homeostasis model assessment of insulin resistance (HOMA-IR) (MD = -0.93, 95% CI [-1.64, -0.21]) were decreased. Regarding the lipid metabolism, total cholesterol (TC) (MD = -0.74 mmol/L, 95% CI [-1.02, -0.46]), triglycerides (TG) (MD = -0.45 mmol/L, 95% CI [-0.70, -0.21]), and low-density lipoprotein cholesterol (LDL) (MD = -0.42 mmol/L, 95% CI [-0.78, -0.06]) were decreased, while high-density lipoprotein cholesterol (HDL) (MD = 0.14 mmol/L, 95% CI [0.09, 0.20]) was increased. Regarding blood pressure, the mean arterial pressure (MAP) (MD = -3.79 mmHg, 95% CI [-5.01, -2.57]) was decreased. In addition, RYR preparations did not increase the incidence of adverse reactions (RR = 1.00, 95% CI [0.69, 1.43]). Conclusion: RYR preparations reduce mortality, MACEs, and multiple risk factors for MetS without compromising safety, which supports its application for the prevention and treatment of MetS. However, additional high-quality studies are needed to provide more evidence for the effect of RYR on MetS due to the heterogeneity in this study. Systematic Review Registration: www.crd.york.ac.uk/PROSPERO, identifier CRD42020209186.
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Affiliation(s)
- Rong Yuan
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yahui Yuan
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lidan Wang
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiqi Xin
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ya Wang
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weili Shi
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Miao
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Sean Xiao Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Keji Chen
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weihong Cong
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Ferreira RM, Martins PN, Pimenta N, Gonçalves RS. Measuring evidence-based practice in physical therapy: a mix-methods study. PeerJ 2022; 9:e12666. [PMID: 35036149 PMCID: PMC8740513 DOI: 10.7717/peerj.12666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is considered the "holy grail" to manage patients by health practitioners (such as physical therapists). However, sometimes, patients are not treated with the best interventions for their condition. Although studies already explored the facilitators and barriers for this issue, they increase in the level of importance if the information gathered are context appropriated. As the profession is relatively new in Portugal, currently little is known about the implementation of EBP in Portuguese physical therapists context. So, the aim of this study is to know if the Portuguese physical therapists use an EBP, and collect and deeper understand the factors, barriers and facilitators associated with EBP. METHODS This study incorporated a mixed-methods design (quantitative and qualitative). In an attempt to ensure the correct population sample, a national professional association e-mail database and the e-mails of past students from national schools were requested. For the quantitative data it was choose an e-survey, adapted from the EBP: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists Portuguese version questionnaire, consisted of 55 close-ended questions. It was analyzed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was choose to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors (especially those found to be statistically significant in the logistic regression) and survey responses regarding the physical therapists' beliefs, attitudes, knowledge, and behaviors. The interviews were performed in an online software, where only audio contact was performed. The audios were anonymized and verbatim transcribed, and the texts explored by the thematic approach. RESULTS From the 277 physical therapists that shown interest in participating in the study, 193 fully completed the questionnaire and, from those, 10 participated in the interviews. The Portuguese physical therapists reported positive beliefs, attitudes, knowledge, and behaviors regarding EBP. Among the physical therapists characteristics it seems that age (younger therapists), education (participating in continuing education courses; belonging to practice-orientated organizations; having a doctorate degree; pursuing a higher academic degree; and being a clinical instructor), and workplace (working for someone else account; and academic sector) are the main factors in the Portuguese EBP implementation. The Portuguese physical therapists, beyond the physical therapists individual characteristics and workplace, also stated that evidence, patients, clinical experience, schools, country and physical therapy characteristics, may behave as facilitators or barriers when performing an EBP.
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Affiliation(s)
- Ricardo M Ferreira
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, Maia, Porto, Portugal.,Physical Therapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, São Martinho do Bispo, Coimbra, Portugal
| | - Pedro N Martins
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, Maia, Porto, Portugal.,Physical Exercise and Sports Department, Polytechnic Institute of Bragança, Bragança, Portugal
| | - Nuno Pimenta
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, Maia, Porto, Portugal
| | - Rui S Gonçalves
- Physical Therapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, São Martinho do Bispo, Coimbra, Portugal
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Toutain M, Gauthier A, Leconte P. Exercise therapy in the treatment of anorexia nervosa: Its effects depending on the type of physical exercise-A systematic review. Front Psychiatry 2022; 13:939856. [PMID: 36339831 PMCID: PMC9627498 DOI: 10.3389/fpsyt.2022.939856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/12/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND AND PURPOSE Clinical research focusing on the effectiveness of exercise therapy (ET) in patients with anorexia nervosa (AN) shows increasing interest in the last decade. The aim of this systematic review was to provide an overview of quantitative studies that have examined the impact of ET in AN patients and to examine its specific effects on physical and mental health according to the type of physical exercise (PE) practiced. METHODS The review was carried out based on the PRISMA 2020. Electronic databases PubMed, Web of Science, Embase, and Wiley were searched from inception to December 2021. Quantitative studies assessing the effects of ET interventions on AN patients were included and study quality was assessed using the PEDro scale. RESULTS A total of 27 studies were selected, including 13 randomized controlled trials. Regarding outcomes measured, results showed that aerobic and resistance exercise improved muscle strength, that mind-body PE decreased main symptoms of AN and mental health, and that combined PE reduced dysfunctional exercise and improved weight gain. CONCLUSION The findings suggest that ET intervention can induce benefits and has no deleterious effects on patients. In addition, specific effects on anorexia symptoms and physical and mental health have been observed according to the type of PE. However, this review reported several methodological weaknesses, including a lack of control group or randomization and statistical misconduct. Finally, ET intervention parameters were heterogeneous, and ET intervention generally lacked details, making reproducibility and comparability difficult. All these limitations underscore the need for a more rigorous methodology for further research.
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Affiliation(s)
- Marc Toutain
- UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie University, Caen, France
| | - Antoine Gauthier
- UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie University, Caen, France
| | - Pascale Leconte
- UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie University, Caen, France
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Monteiro NRO, Pegorari MS, Ohara DG, Ferreira VTK, Matos AP. The basis of information to guide clinical decision-making in knee osteoarthritis management: A survey with Brazilian physical therapists. J Eval Clin Pract 2021; 27:1216-1222. [PMID: 33386671 DOI: 10.1111/jep.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Several health information sources are available to assist physical therapists in the clinical decision-making process, with a notable increase in the importance of using evidence-based practice (EBP). The aim of this study is to investigate the health information sources most used by Brazilian physical therapists to guide their clinical decision making for knee osteoarthritis (OA) management, use of Physiotherapy Evidence Database (PEDro), knowledge about the existence of clinical practice guidelines (CPGs), and associated factors. METHODS A cross-sectional study using an electronic survey was conducted. Physical therapists registered in a Regional Physical Therapy Council in Brazil were invited to participate. Sociodemographic data, professional training, health information sources, frequency of use of PEDro, and knowledge about CPGs were collected. Descriptive analysis of the data was performed, and the chi square test and multinomial and binary logistic regression were used to verify association between the variables. RESULTS The survey was completed by 370 professionals. The three health information sources most used by Brazilian physical therapists were clinical experience, courses, and books. Among these professionals, only 12.1% use PEDro frequently, and 60.5% know that CPGs for knee OA management exist. Level of education was associated with PEDro use and knowledge about the existence of CPGs (P < .05). CONCLUSIONS The study results indicated a significant deficiency in engagement with research evidence by Brazilian physical therapists to guide their clinical decision making for knee OA. Further investigations on educational needs and the development of new strategies to narrow the gap between research evidence and clinical practice should be performed.
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Affiliation(s)
- Nívea Renata Oliveira Monteiro
- Ribeirão Preto Clinical Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Maycon Sousa Pegorari
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Daniela Gonçalves Ohara
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Vânia Tiê Koga Ferreira
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
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Kwak C, Seo JH, Oh Y, Han W. Efficacy of the Digit-in-Noise Test: A Systematic Review and Meta-Analysis. J Audiol Otol 2021; 26:10-21. [PMID: 34775699 PMCID: PMC8755436 DOI: 10.7874/jao.2021.00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background and Objectives Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis. Materials and Methods After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals. Results The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient’s hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient’s native language(s) than in other languages. Conclusions When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.
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Affiliation(s)
- Chanbeom Kwak
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea.,Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea
| | - Jae-Hyun Seo
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yonghee Oh
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | - Woojae Han
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea.,Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea
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The Unknown Prevalence of Postrandomization Bias in 15 Physical Therapy Journals: A Methods Review. J Orthop Sports Phys Ther 2021; 51:542-550. [PMID: 34546817 DOI: 10.2519/jospt.2021.10491] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To determine the prevalence of prospective clinical trial registration and postrandomization bias in published musculoskeletal physical therapy randomized clinical trials (RCTs). DESIGN A methods review. LITERATURE SEARCH Articles indexed in MEDLINE and published between January 2016 and July 2020 were included. STUDY SELECTION CRITERIA Two independent blinded reviewers identified the RCTs using Covidence. We included RCTs related to musculoskeletal interventions that were published in International Society of Physiotherapy Journal Editors member journals. DATA SYNTHESIS Data were extracted independently for the variables of interest from the identified RCTs by 2 blinded reviewers. The data were presented descriptively or in frequency tables. RESULTS One hundred thirty-eight RCTs were identified. One third of RCTs were consistent with their prospectively registered intent (49/138); consistency with prospectively registered intent could not be determined for two thirds (89/138) of the RCTs. Four RCTs (8%)reported inconsistent results with the primary aims and 7 (14%) with the outcomes from the prospective clinical trial registry, despite high methodological quality (Physiotherapy Evidence Database [PEDro] scale score). Differences between prospectively registered and non-prospectively registered RCTs for PEDro scale scores had a medium effect size (r = 0.30). Two of 15 journals followed their clinical trial registration policy 100% of the time; in 1 journal, the published RCTs were consistent with the clinical trial registration. CONCLUSION Postrandomization bias in musculoskeletal physical therapy RCTs could not be ruled out, due to the lack of prospective clinical trial registration and detailed data analysis plans. J Orthop Sports Phys Ther 2021;51(11):542-550. Epub 21 Sep 2021. doi:10.2519/jospt.2021.10491.
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Wong TH, Sim A, Burns SF. The Effect of Beetroot Ingestion on High-Intensity Interval Training: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:3674. [PMID: 34835931 PMCID: PMC8618171 DOI: 10.3390/nu13113674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
Dietary nitrate supplementation has shown promising ergogenic effects on endurance exercise. However, at present there is no systematic analysis evaluating the effects of acute or chronic nitrate supplementation on performance measures during high-intensity interval training (HIIT) and sprint interval training (SIT). The main aim of this systematic review and meta-analysis was to evaluate the evidence for supplementation of dietary beetroot-a common source of nitrate-to improve peak and mean power output during HIIT and SIT. A systematic literature search was carried out following PRISMA guidelines and the PICOS framework within the following databases: PubMed, ProQuest, ScienceDirect, and SPORTDiscus. Search terms used were: ((nitrate OR nitrite OR beetroot) AND (HIIT or high intensity or sprint interval or SIT) AND (performance)). A total of 17 studies were included and reviewed independently. Seven studies applied an acute supplementation strategy and ten studies applied chronic supplementation. The standardised mean difference for mean power output showed an overall trivial, non-significant effect in favour of placebo (Hedges' g = -0.05, 95% CI -0.32 to 0.21, Z = 0.39, p = 0.69). The standardised mean difference for peak power output showed a trivial, non-significant effect in favour of the beetroot juice intervention (Hedges' g = 0.08, 95% CI -0.14 to 0.30, Z = 0.72, p = 0.47). The present meta-analysis showed trivial statistical heterogeneity in power output, but the variation in the exercise protocols, nitrate dosage, type of beetroot products, supplementation strategy, and duration among studies restricted a firm conclusion of the effect of beetroot supplementation on HIIT performance. Our findings suggest that beetroot supplementation offers no significant improvement to peak or mean power output during HIIT or SIT. Future research could further examine the ergogenic potential by optimising the beetroot supplementation strategy in terms of dosage, timing, and type of beetroot product. The potential combined effect of other ingredients in the beetroot products should not be undermined. Finally, a chronic supplementation protocol with a higher beetroot dosage (>12.9 mmol/day for 6 days) is recommended for future HIIT and SIT study.
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Affiliation(s)
| | | | - Stephen F. Burns
- Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore; (T.H.W.); (A.S.)
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Gou Y, Lei H, Zeng Y, Tao J, Kong W, Wu J. The effect of Pilates exercise training for scoliosis on improving spinal deformity and quality of life: Meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e27254. [PMID: 34596121 PMCID: PMC8483862 DOI: 10.1097/md.0000000000027254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND It remains unclear if Pilates is conducive to reducing spinal deformity and improving patients' quality of life (QOL) with scoliosis. The aim of this study was to systematically review the published evidence to determine whether Pilates exercise training is an efficacious therapy for scoliosis. METHODS Searches was conducted in Medline, Embase, PubMed, Scopus, CINAHL, Physiotherapy Evidence Database (PEDro), Cochrane library, Baidu Scholar, and Green Medical to identify randomized studies that tested the effect of Pilates exercise training on Cobb angle, pain level, trunk range of motion (ROM), angle of trunk rotation, and QOL in idiopathic scoliosis. Separate meta-analyses were performed on the endpoints of these outcome measures. The PEDro scale was used to assess the methodological quality of the included studies. RESULTS This review included 10 randomized controlled trials (n = 359). PEDro scores ranged from 3 to 10, with the mean score across all articles being 5.3/10 and judged to be of fair quality. The results indicated that Pilates exercises was effective in reducing Cobb angle (standardized mean difference [SMD] = 1.23, 95% confidence interval [CI] = 0.11-2.35), angle of trunk rotation (SMD = 1.37, 95% CI = 1.01-1.73), and pain level (SMD = 2.78, 95% CI = 1.55-4.01), as well as improving trunk ROM (SMD = 1.23, 95% CI = 0.45-2.00), and QOL (SMD = 3.05, 95% CI = 2.59-3.51) in patients with scoliosis. CONCLUSION Pilates exercise training may reduce the Cobb angle and trunk rotation, relieve pain, increase trunk ROM, and improve QOL for patients with scoliosis. Due to the poor quality of the evidence, however, these results should be interpreted with caution.
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Has Reporting on Physical Therapy Interventions Improved in 2 Decades? An Analysis of 140 Trials Reporting on 225 Interventions. J Orthop Sports Phys Ther 2021; 51:503-509. [PMID: 34592833 DOI: 10.2519/jospt.2021.10642] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the completeness of reporting of physical therapy interventions in randomized controlled trials before and after publication of the Template for Intervention Description and Replication (TIDieR) checklist (a reporting guideline for interventions). DESIGN Meta-research. METHODS We searched 6 journals for trials using physical therapy interventions that were published in 2000 and 2018. Two independent assessors scored the TIDieR checklist and extracted descriptive information, including Physiotherapy Evidence Database (PEDro) scale scores. We identified control or treatment interventions, exercise-based interventions, and area of physical therapy. We performed a descriptive analysis and defined a priori a 20% difference between studies published in 2000 and 2018 as meaningful. We assessed correlations between TIDieR and PEDro scale scores for all interventions. RESULTS In total, 140 articles that met selection criteria evaluated 225 interventions (2000, n = 61; 2018, n = 164). Mean ± SD TIDieR score (2000, 7.52 ± 2.62; 2018, 8.26 ± 2.26) did not show a meaningful difference between years for all interventions (+5%), controls (+6%), treatment interventions (+6%), exercise-based interventions (+9%), or musculoskeletal (+4%) or neurological (+7%) physical therapy. For exercise interventions, number of sessions was reported more (+21%) in 2018 than in 2000. For musculoskeletal trials, 2 items were reported more completely in 2018 than in 2000 (materials, +29%; individual versus group, +22%) and 3 items were reported more completely in neurological trials (mode of delivery, +20%, [item 8.1] when +45%, and assessment of fidelity, +20%). The item "Who delivered the intervention?" was reported less completely (-23%) in 2018 than in 2000 in neurological trials. We found no correlation (r = 0.12) between PEDro scale score and TIDieR score. CONCLUSION There were few meaningful improvements in how physical therapy interventions were described after publication of the TIDieR reporting guideline. J Orthop Sports Phys Ther 2021;51(10):503-509. doi:10.2519/jospt.2021.10642.
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Lavín-Pérez AM, Collado-Mateo D, Mayo X, Liguori G, Humphreys L, Jiménez A. Can Exercise Reduce the Autonomic Dysfunction of Patients With Cancer and Its Survivors? A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:712823. [PMID: 34504462 PMCID: PMC8422989 DOI: 10.3389/fpsyg.2021.712823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Cancer therapies have increased patient survival rates, but side effects such as cardiotoxicity and neurotoxicity can lead to autonomic nervous and cardiovascular system dysfunction. This would result in a decrease in parasympathetic activity and the enhancement of sympathetic activity. Heart rate variability (HRV), which reflects autonomic modulation, is a valuable physiological tool since it correlates with cancer-related fatigue, stress, depression, and mortality in patients with cancer. Objective: This study aimed to analyze the effects of exercise programs on the autonomic modulation, measured by the HRV of patients with cancer and its survivors. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the quality of the articles was assessed with the Physiotherapy Evidence Database (PEDro) scale. The meta-analysis statistic procedure was performed by using RevMan software version 5.3. Results: From the 252 articles found, six studies were included in the review involving 272 participants aged 30–75 years. Exercise programs had a mean length of 10.4 ± 4.6 weeks, a frequency of 3 ± 1.4 days/week, and a mean duration of 78 ± 23.9 min. In time-domain HRV measures, exercise may increase in the SD of normal-to-normal intervals [p < 0.00001, with a mean difference (MD) of 12.79 ms from 9.03 to 16.55] and a decreased root mean square of successive R–R interval differences (p = 0.002, with an MD of 13.08 ms from 4.90 to 21.27) in comparison with control groups (CG). The frequency-domain data reveal that the exercise group (EG) improve significantly more than the CGs in low frequency [absolute power: p < 0.0001, with a standardized mean difference (SMD) of 0.97 from 0.61 to 1.34; relative power: p = 0.04, with an MD = −7.70 from −15.4 to −0.36], high-frequency [absolute power: p = 0.001, with a SMD of 1.49 from 0.32 to 2.66; relative power: p = 0.04, with an MD of 8.00 normalized units (n.u.) from 0.20 to 15.80], and low-to-high frequency ratio (p = 0.007 with an MD of −0.32 from −0.55 to −0.09). Conclusion: Exercise programs could lead to positive effects on the autonomic modulation of patients with cancer and its survivors. More beneficial changes may occur with resistance and endurance workouts. However, due to the low number of interventions performed, further research is needed to substantiate the findings and to provide additional insights regarding the exercise intensity required to increase the autonomic modulation of the patient.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- PhD International School, Program of Epidemiology and Public Health (Interuniversity), Rey Juan Carlos University, Móstoles, Spain.,Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain.,GO fitLAB, Ingesport, Madrid, Spain
| | | | - Xián Mayo
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Gary Liguori
- College of Health Sciences, University of Rhode Island, Kingston, NY, United States
| | - Liam Humphreys
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
| | - Alfonso Jiménez
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain.,GO fitLAB, Ingesport, Madrid, Spain.,Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
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