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Brazilian Journal of Physical Therapy 2023Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint.
OBJECTIVE
To evaluate the effectiveness of hip interventions on pain and disability in patients with LBP in the short-, medium-, and long-term.
METHODS
PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in November 2022. Randomized controlled trials involving hip-targeted interventions compared to specific low back interventions in patients with LBP were selected. The outcomes were pain intensity and disability. The quality of the studies was assessed with the risk of bias tool. GRADE was used to rate the certainty of evidence. Meta-analyses were conducted using random effects models.
RESULTS
A total of 2581 studies were screened. Eight were included in the meta-analysis involving 508 patients with LBP. The results provided very low certainty that both hip strengthening and hip stretching improved pain (MD = -0.66; 95% CI -0.86, -0.48; I:0%) (MD = -0.55; 95% CI -1.02, -0.08) and disability (SMD = -0.81; 95% CI -1.53, -0.10; I: 80%) (SMD = -1.03; 95% CI -1.82, -0.25) in the short-term, respectively. No benefits were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence.
CONCLUSIONS
Very low certainty evidence suggest a positive effect of hip strengthening in isolation or combined with specific low back exercise and hip stretching combined with specific low back exercise for decreasing pain intensity and disability in the short-term, in patients with LBP.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42022303173.
Topics: Humans; Chronic Pain; Low Back Pain; Exercise Therapy; Pain Measurement; Disabled Persons
PubMed: 37037144
DOI: 10.1016/j.bjpt.2023.100502 -
Rehabilitation Psychology May 2023People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have... (Meta-Analysis)
Meta-Analysis
PURPOSE
People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have not changed key statistics such as unemployment rates. Previous research has focused on explicit attitudes, generally found to be positive, prompting investigation into factors such as implicit bias. This systematic review and meta-analysis investigated implicit bias toward PWD and associated factors.
METHOD
Forty-six peer-reviewed studies published between January 2000 and April 2020 utilizing the Implicit Association Test were included. Of these, 12 studies met the inclusion criteria for meta-analysis.
RESULTS
A significant moderate pooled effect (mean difference = 0.503, 95% CI [0.497-0.509], < .001) was found, suggesting moderate negative implicit attitudes toward general disability. Negative implicit attitudes were also found toward physical, and intellectual disability. PWD were implicitly stereotyped as incompetent, cold, and "child-like." Findings were inconsistent for factors associated with bias including age, race, sex, and individual differences. Contact with PWD may be associated with implicit bias; however, measures were inconsistent.
CONCLUSION
This review has found moderate negative implicit biases toward PWD, however, factors associated with this bias remain unclear. Further research should investigate implicit bias toward specific disability groups and strategies to shift such biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Bias, Implicit; Quality of Life; Disabled Persons; Bias
PubMed: 37079819
DOI: 10.1037/rep0000493 -
Journal of Back and Musculoskeletal... 2023Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength.
OBJECTIVE
This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength.
METHODS
We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence.
CONCLUSIONS
Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.
Topics: Adult; Humans; Low Back Pain; Exercise Therapy; Resistance Training; Disabled Persons; Pain Measurement
PubMed: 37458013
DOI: 10.3233/BMR-220301 -
Journal of Rehabilitation Medicine Aug 2018Rehabilitation services are increasingly targeting involvement in daily life. In the International Classification of Functioning, Disability and Health this is referred... (Review)
Review
BACKGROUND
Rehabilitation services are increasingly targeting involvement in daily life. In the International Classification of Functioning, Disability and Health this is referred to as "participation". How-ever, questions have arisen regarding the conceptualization of participation, and consensus is lacking.
METHODS
The first phase of this study is a critical review of the literature to detect recurring conceptual problems in the application of participation and how researchers deal with these. The second phase is a systematic review to identify how participation measures are operationalized.
RESULTS
The critical review found possible solutions to 4 recurring key limitations: (i) how to deal with ambiguity and vagueness regarding the term "participation"; (ii) how to differentiate between activity and participation; (iii) what is the current empirical knowledge about the subjective aspects of participation; (iv) what are the different ways to measure participation. The systematic review found 18 instruments operationalizing participation in different ways: (i) unidimensional: frequency of performing activities; (ii) unidimensional: limitations in experiencing participation when performing activities; (iii) multidimensional: multiple subjective dimensions when performing activities; and (iv) multidimensional: objective and subjective dimensions.
DISCUSSION AND CONCLUSION
Notwithstanding an increasing body of knowledge, some issues remain unclear and how participation is measured is subject to debate. This results in difficulties in the use of participation in clinical practice. However, insight into the current body of knowledge and awareness of shortcomings might help clinicians who aim to apply participation in practice.
Topics: Activities of Daily Living; Disability Evaluation; Disabled Persons; Humans
PubMed: 29944165
DOI: 10.2340/16501977-2363 -
Journal of Advanced Nursing Dec 2023To identify the components and characteristics of health literacy interventions for people with disabilities and to explore the outcomes in terms of health literacy... (Review)
Review
AIMS
To identify the components and characteristics of health literacy interventions for people with disabilities and to explore the outcomes in terms of health literacy competencies.
DESIGN
A mixed-method systematic literature review.
REVIEW METHODS
The search results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The quality appraisal was guided by the Mixed Methods Appraisal Tool. The contents of each intervention were mapped to the health literacy intervention model and the outcomes were annotated using the integrated model of health literacy.
DATA SOURCES
The literature search was conducted using several electronic databases, including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO in December 2022.
RESULTS
Ten studies were selected for this systematic literature review. Seven studies were quantitative, two were qualitative and one was a mixed-methods study. The four components of the health literacy interventions included empowering individuals with low-health literacy (n = 10), strengthening individuals' social support system (n = 3), improving communication with health professionals (n = 1) and reducing barriers to access health systems (n = 3). No intervention addressed improving health professionals' health literacy competencies. Health literacy competencies identified as outcomes in the studies included access (n = 1), understand (n = 7), appraise (n = 1) and apply (n = 9) the health information.
CONCLUSIONS
The significant findings of this systematic literature review provide baseline data and evidence for developing health literacy interventions for people with disabilities. However, this review demonstrates that only a handful of intervention studies have addressed the low-health literacy of people with disabilities. Further and more rigorous interventions addressing health literacy for people with diverse disabilities are warranted.
IMPACT
This review provides insights into how health literacy interventions can be tailored to the type of disability. Further, efforts should be expanded to comprehensively promote all the four core competencies of health literacy to reduce health disparities for individuals living with disabilities.
NO PATIENT OR PUBLIC CONTRIBUTION
Systematic literature review.
Topics: Humans; Health Literacy; Health Personnel; Communication; Disabled Persons
PubMed: 37503718
DOI: 10.1111/jan.15805 -
Pain Medicine (Malden, Mass.) Mar 2023The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS).
METHODS
Six databases (PubMED, CINAHL, Biosis, Web of Science, SPORTDiscus, and Cochrane Central Register of Controlled Trials) were searched after the study had been registered in PROSPERO. The authors included randomized clinical trials investigating the clinical effects of DN in combination with other conservative interventions for SAPS. Outcomes included pain and disability.
RESULTS
Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N = 538). A random-effects model was used to analyze between-group effects. Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability. Standard mean differences ranged from -0.57 (moderate) to -1.29 (large) for pain and -0.69 (moderate) to -1.07 (large) for disability, favoring groups receiving DN in addition to conservative treatment. Four of the eight studies were rated as having unclear or high risk of bias.
CONCLUSION
The meta-analysis suggests that various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct-comparison studies are needed to determine whether one application of DN is superior to another.
Topics: Humans; Dry Needling; Shoulder Pain; Disabled Persons; Pain Measurement
PubMed: 36018263
DOI: 10.1093/pm/pnac131 -
British Journal of Sports Medicine Dec 2015In recent years, Kinesio tape has been used to support injured muscle and joints, and relieve pain. We compared the pain and disability in individuals with chronic... (Comparative Study)
Comparative Study Meta-Analysis Review
Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application.
INTRODUCTION
In recent years, Kinesio tape has been used to support injured muscle and joints, and relieve pain. We compared the pain and disability in individuals with chronic musculoskeletal pain who were treated with Kinesio taping with those using minimal or other treatment approaches.
METHODS
Searches of eight major electronic databases were conducted. Data for pain and disability scores were extracted. Meta-analyses (wherever possible) with either a fixed or random effect(s) model, standardised mean differences (SMDs) and tests of heterogeneity were performed.
RESULTS
Seventeen clinical-controlled trials were identified and included in the meta-analyses. When compared to minimal intervention, Kinesio taping provided superior pain relief (pooled SMD=-0.36, 95% CI -0.64 to -0.09, p=0.009) but the pooled disability scores were not significantly different (pooled SMD=-0.41, 95% CI -0.83 to 0.01, p=0.05). No significant differences were found when comparing Kinesio taping to other treatment approaches for pain (pooled SMD=-0.44, 95% CI -1.69 to 0.82, p=0.49) and disability (pooled SMD=0.08, 95% CI -0.27 to 0.43, p=0.65).
DISCUSSION
Kinesio taping is superior to minimal intervention for pain relief. Existing evidence does not establish the superiority of Kinesio taping to other treatment approaches to reduce pain and disability for individuals with chronic musculoskeletal pain.
Topics: Athletic Tape; Chronic Pain; Disabled Persons; Humans; Low Back Pain; Musculoskeletal Pain; Neck Pain; Randomized Controlled Trials as Topic; Shoulder Pain; Time Factors
PubMed: 25595290
DOI: 10.1136/bjsports-2014-094151 -
International Journal of Environmental... Dec 2022Physical function is one of the most important constructs assessed in health-related quality of life (HRQOL), and it could be very useful to assess movement ability from... (Review)
Review
Physical function is one of the most important constructs assessed in health-related quality of life (HRQOL), and it could be very useful to assess movement ability from the perspective of the patient. The objective of this study was to compare the content of the domains related to mobility covered by the HRQOL questionnaires based on the International Classification of Functioning, Disability and Health (ICF) and to evaluate their quality according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. For this, a systematic review was carried out in the databases Scopus, Web of Science and Science Direct. The inclusion criteria were development and/or validation studies about generic HRQOL measures, and the instruments had to include items related to mobility and studies written in English or Spanish. The comparison of content was performed using the ICF coding system. A total of 3614 articles were found, 20 generic HRQOL instruments were identified and 120 (22.4%) mobility-related items were found. Walking was the most represented category. Low-quality evidence on some measurement properties of the generic HRQOL instruments was revealed. The CAT-Health is a useful questionnaire to be used in rehabilitation due to its psychometric properties and its content.
Topics: Humans; Quality of Life; Disabled Persons; Activities of Daily Living; Surveys and Questionnaires; Walking; Psychometrics
PubMed: 36554369
DOI: 10.3390/ijerph192416493 -
Occupational and Environmental Medicine Jan 2020The aim of this study was to determine the associations of body mass index (BMI) with all-cause and cause-specific disability retirement. Literature searches were... (Meta-Analysis)
Meta-Analysis
The aim of this study was to determine the associations of body mass index (BMI) with all-cause and cause-specific disability retirement. Literature searches were conducted in PubMed, Embase and Web of Science from their inception to May 2019. A total of 27 (25 prospective cohort and 2 nested case-control) studies consisting of 2 199 632 individuals qualified for a meta-analysis. Two reviewers independently assessed the methodological quality of the included studies. We used a random effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses. There were a large number of participants and the majority of studies were rated at low or moderate risk of bias. There was a J-shaped relationship between BMI and disability retirement. Underweight (hazard ratio (HR)/risk ratio (RR)=1.20, 95% CI 1.02 to 1.41), overweight (HR/RR=1.13, 95% CI 1.07 to 1.19) and obese individuals (HR/RR=1.52, 95% CI 1.36 to 1.71) were more commonly granted all-cause disability retirement than normal-weight individuals. Moreover, overweight increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.26, 95% CI 1.15 to 1.39) and cardiovascular diseases (HR=1.73, 95% CI 1.24 to 2.41), and obesity increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.66, 95% CI 1.42 to 1.94), mental disorders (HR=1.29, 95% CI 1.04 to 1.61) and cardiovascular diseases (HR=2.80, 95% CI 1.85 to 4.24). The association between excess body mass and all-cause disability retirement did not differ between men and women and was independent of selection bias, performance bias, confounding and adjustment for publication bias. Obesity markedly increases the risk of disability retirement due to musculoskeletal disorders, cardiovascular diseases and mental disorders. Since the prevalence of obesity is increasing globally, disease burden associated with excess body mass and disability retirement consequently are projected to increase. : CRD42018103110.
Topics: Body Mass Index; Cardiovascular Diseases; Disabled Persons; Humans; Mental Disorders; Musculoskeletal Diseases; Obesity; Odds Ratio; Overweight; Prospective Studies; Retirement
PubMed: 31467042
DOI: 10.1136/oemed-2019-105876 -
Japan Journal of Nursing Science : JJNS Apr 2020The integrated evidence on diabetes self-care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a... (Review)
Review
AIM
The integrated evidence on diabetes self-care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a disability. This study aims to identify factors influencing self-care behaviors in adults with diabetes and a disability based on a thorough review of the current evidence.
METHODS
This review followed the Cochrane guidelines for systematic review research and complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. To find eligible articles, five electronic databases-PubMed, Embase, CINAHL, Psych-articles, and the Cochrane Library-were searched, from the beginning of the chronological period covered by each database to June 2017. Four researchers independently conducted study selections, extracted data, and assessed the data quality.
RESULTS
Twenty studies were reviewed to identify barriers to and facilitators of diabetes self-care behaviors. For people with developmental disabilities, the most prominent facilitator of self-care behaviors was the support they received for the behaviors. For people with visual impairments, that facilitator was the use of helpful assistive devices that take advantage of another sense. The main barriers to self-care behaviors were mobility limitation for people with physical disabilities and lack of accessibility for people with visual impairments.
CONCLUSIONS
This review has identified barriers to and facilitators of diabetes self-care behaviors by type of disability. Healthcare services need to be tailored to these facilitators and barriers, and differentiated by type of disability.
Topics: Adult; Diabetes Mellitus; Disabled Persons; Humans; Self Care
PubMed: 31691458
DOI: 10.1111/jjns.12289