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Zhu GC, Chen KM, Belcastro F. Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults With Knee Osteoarthritis. Arch Phys Med Rehabil 2024; 105:953-962. [PMID: 37467937 DOI: 10.1016/j.apmr.2023.07.001] [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: 05/05/2023] [Revised: 06/06/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA). DATA SOURCES This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for network meta-analysis (NMA). Relevant randomized controlled trials were identified by searching 7 databases up to December 2022. STUDY SELECTION Inclusion criteria included (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2. DATA EXTRACTION NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI). DATA SYNTHESIS We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD=2.54 [95% CI: 1.23; 3.84], SMD=1.09 [95% CI: 0.27; 1.92], SMD=0.57 [95% CI: 0.06; 1.09]). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD=1.31 [95% CI: 0.12; 2.51]) and physical function disability (SMD=1.67 [95% CI: 0.01; 3.33]) in older adults with KOA, respectively. CONCLUSION Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.
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Affiliation(s)
- Guan-Cheng Zhu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, IA
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Molina-Álvarez M, Arribas-Romano A, Rodríguez-Rivera C, García MM, Fernández-Carnero J, Armijo-Olivo S, Goicoechea Garcia C. Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14021. [PMID: 36360901 PMCID: PMC9654326 DOI: 10.3390/ijerph192114021] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE Background: Evaluate whether the design of placebo control groups could produce different interpretations of the efficacy of manual therapy techniques. METHODS Nine databases were searched (EMBASE, CINAHL, PsycINFO, MEDLINE, PubMed, SCOPUS, WEB of SCIENCE, COCHRANE, and PEDro). Randomized placebo-controlled clinical trials that used manual therapy as a sham treatment on subjects suffering from pain were included. Data were summarized qualitatively, and meta-analyses were conducted with R. RESULTS 53 articles were included in the qualitative analysis and 48 were included in the quantitative analyses. Manipulation techniques did not show higher effectiveness when compared with all types of sham groups that were analyzed (SMD 0.28; 95%CI [-0.24; 0.80]) (SMD 0.28; 95%CI [-0.08; 0.64]) (SMD 0.42; 95%CI [0.16; 0.67]) (SMD 0.82; 95%CI [-0.57; 2.21]), raising doubts on their therapeutic effect. Factors such as expectations of treatment were not consistently evaluated, and analysis could help clarify the effect of different sham groups. As for soft tissue techniques, the results are stronger in favor of these techniques when compared to sham control groups (SMD 0.40; 95%CI [0.19, 0.61]). Regarding mobilization techniques and neural gliding techniques, not enough studies were found for conclusions to be made. CONCLUSIONS The literature presents a lack of a unified placebo control group design for each technique and an absence of assessment of expectations. These two issues might account for the unclear results obtained in the analysis.
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Affiliation(s)
- Miguel Molina-Álvarez
- Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain
| | - Carmen Rodríguez-Rivera
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
| | - Miguel M. García
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences, 30A, 49076 Osnabruck, Germany
- Faculties of Rehabilitation Medicine and Medicine and Dentistry, 3-48 Corbett Hall, Edmonton, AB T6G 2G4, Canada
| | - Carlos Goicoechea Garcia
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
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Sahraei F, Rahemi Z, Sadat Z, Zamani B, Ajorpaz NM, Afshar M, Mianehsaz E. The effect of Swedish massage on pain in rheumatoid arthritis patients: A randomized controlled trial. Complement Ther Clin Pract 2021; 46:101524. [PMID: 34953451 DOI: 10.1016/j.ctcp.2021.101524] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/22/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Joint pain is one of the most common symptoms in rheumatoid arthritis patients and require medical attention. The purpose of this study was to assess the effects of Swedish massage on pain and painkiller consumption in rheumatoid arthritis patients. MATERIALS AND METHODS A total of 60 patients participated in the experiment, with half assigned to the control group (n = 30) and half to the experimental (n = 30) group using the block randomization method. On patients in the experimental group, a 30-min Swedish massage was performed regularly for eight weeks: twice a week for the first four weeks, and three times a week for the last four weeks. The control group received routine care. The visual analogue scale-pain was used to measure pain in the two groups at three points of time: before the beginning of the experiment, immediately after the last session, and one month after the last session of the intervention. RESULTS The analysis of covariance showed that there were significant differences between the two groups' mean scores of pain and painkiller consumption immediately after and one month after the last session of the intervention (p = 0.01). Furthermore, in the experimental group, the mean scores of pain and painkiller consumption decreased over the three points of time (p < 0.05). CONCLUSION Swedish massage can be effective in reducing pain and the need to use painkillers in rheumatoid arthritis patients.
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Affiliation(s)
- Farideh Sahraei
- Trauma Nursing Research Center, Department of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Rahemi
- School of Nursing, Clemson University, South Carolina, 605 Grove Road, Greenville, SC, 29605, USA
| | - Zohreh Sadat
- Trauma Nursing Research Center, Department of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Batool Zamani
- Autoimmune Diseases Research Center, Department of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Neda Mirbagher Ajorpaz
- Autoimmune Diseases Research Center, Department of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
| | - Mohamad Afshar
- Trauma Nursing Research Center, Department of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Elaheh Mianehsaz
- Clinical Research Center, Department of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Wu Q, Zhao J, Guo W. Efficacy of massage therapy in improving outcomes in knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 46:101522. [PMID: 34890892 DOI: 10.1016/j.ctcp.2021.101522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/14/2021] [Accepted: 11/30/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND and purpose: Massage therapy is being used for knee osteoarthritis. However, level-1 evidence is lacking. This systematic review and meta-analysis aimed to synthesize evidence on the effect of massage therapy on knee osteoarthritis. METHODS PubMed, Embase, Ovid, Springer, and Google Scholar databases were searched up to May 8, 2021 for randomized controlled trials comparing massage with controls for knee osteoarthritis. Review manager was used for a random-effect meta-analysis. Risk of bias was assessed using the Cochrane collaboration risk assessment tool and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS Twelve studies with 737 participants were included. After 1-4 weeks of therapy, there was a significant reduction in pain and stiffness scores in the massage group and after 6-8 weeks of therapy, there was a significant reduction in stiffness and functionality scores. There was no significant difference in outcomes with long-term therapy. A statistically significant reduction in stiffness scores was seen with aromatherapy massage. Aromatherapy massage was not superior to standard massage. The overall quality of evidence according to GRADE was low to moderate for standard massage therapy and very low for aromatherapy. CONCLUSION Massage therapy may lead to some improvement in pain, stiffness, and functionality scores in the short term but not in long term. Aromatherapy massage was not found to be any better than standard massage therapy. Current evidence is limited by methodological heterogeneity amongst trials and small sample size of the studies.
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Affiliation(s)
- Qiling Wu
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Jie Zhao
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Weili Guo
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China.
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Szabo SD, Levine D, Marcellin-Little DJ, Sidaway BK, Hofmeister E, Urtuzuastegui E. Cryotherapy Improves Limb Use But Delays Normothermia Early After Stifle Joint Surgery in Dogs. Front Vet Sci 2020; 7:381. [PMID: 32719817 PMCID: PMC7350525 DOI: 10.3389/fvets.2020.00381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To evaluate the short-term efficacy and safety of cold compression therapy (CCT) relative to a soft padded bandage (SPB) in dogs undergoing surgery to manage cranial cruciate ligament injury. Methods:Dogs were randomized into groups that received CCT or SPB after surgery. Weight bearing was measured using a weight distribution platform before and the day after surgery. Stifle joint flexion and extension were measured using a goniometer before and the day after surgery. Rectal temperatures were measured every 15 min for 2 h after surgery and the morning after surgery. Mechanical nociceptive thresholds (MNT) were measured using an algometer the day after surgery. Findings in both groups were compared using a mixed model ANOVA. Results:20 dogs were enrolled: 10 in the CCT and 10 in the SPB group. Dogs undergoing CCT had more stifle joint flexion (P = 0.008) and weight bearing (P < 0.001) after surgery than dogs with SPB. MNT after surgery correlated statistically with stifle joint flexion after surgery (r = -0.315, P = 0.014), extension after surgery (r = 0.310, P = 0.016), and weight bearing after surgery (r = 0.314, P = 0.003). Return to normothermia was delayed in the CCT group, with temperatures ~0.5°C (1.0°F) lower 105 (P = 0.018) and 120 min (P = 0.013) after surgery. Conclusion:Relative to bandaging, CCT had a positive short-term impact on stifle flexion and weight bearing. CCT delayed warming after surgery but dogs were only mildly hypothermic [0.5°C [1.0°F]].
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Affiliation(s)
- Stephanie D Szabo
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - David Levine
- Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Denis J Marcellin-Little
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Brian K Sidaway
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States.,Incise Veterinary Surgery, Peoria, AZ, United States
| | - Erik Hofmeister
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States.,College of Veterinary Medicine, Auburn University, Auburn, AL, United States
| | - Erica Urtuzuastegui
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
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