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Archives of Physical Medicine and... May 2022To evaluate the effectiveness of mirror therapy (MT) for phantom limb pain (PLP). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the effectiveness of mirror therapy (MT) for phantom limb pain (PLP).
DATA SOURCES
PubMed, EMBASE, Ovid MEDLINE, Scopus, Cochrane Library, Physiotherapy Evidence Database, CNKI, and WanFang Data were used to search for studies published up to March 31, 2021.
STUDY SELECTION
Randomized controlled trials (RCTs) comparing the pain intensity of MT for PLP were performed. A total of 2094 articles were found. Among them, 10 were eligible for the final analysis.
DATA EXTRACTION
The quality of the RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale by 2 independent reviewers. Outcome data were pooled according to follow-up intervals (1, 3, 6, and 12mo). Duration times were used as a basis for distinguishing subgroups. The primary evaluation was by visual analog scale. The PEDro scale was used to assess the methodological quality of studies.
DATA SYNTHESIS
Meta-analysis revealed a statistically significant decrease in pain in the MT group vs the control group within 1 month (I=0%; standardized mean difference [SMD]=-0.46, 95% confidence interval [CI], -0.79 to -0.13; P = .007). The patients with pain for longer than 1 year benefited more from MT (I=0%; SMD=-0.46; 95% CI, -0.85 to -0.07; P = .02).
CONCLUSIONS
MT has beneficial effects for patients with PLP in the short-term, as evidenced by their improved pain scores. There was no evidence that MT had a long-term effect, but that may be a product of limited data. For patients with long-term PLP, MT may be an effective treatment.
Topics: Humans; Mirror Movement Therapy; Pain Measurement; Phantom Limb; Physical Therapy Modalities; Treatment Outcome
PubMed: 34461084
DOI: 10.1016/j.apmr.2021.07.810 -
The Journal of Orthopaedic and Sports... Jun 2024We aimed to quantify the proportion not attributable to the specific effects (PCE) of physical therapy interventions for musculoskeletal pain. Intervention systematic... (Meta-Analysis)
Meta-Analysis Review
Which Portion of Physiotherapy Treatments' Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-Analysis of Randomized Placebo-Controlled Trials.
We aimed to quantify the proportion not attributable to the specific effects (PCE) of physical therapy interventions for musculoskeletal pain. Intervention systematic review with meta-analysis. We searched Ovid, MEDLINE, EMBASE, CINAHL, Scopus, PEDro, Cochrane Controlled Trials Registry, and SPORTDiscus databases from inception to April 2023. Randomized placebo-controlled trials evaluating the effect of physical therapy interventions on musculoskeletal pain. Risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB 2). The proportion of physical therapy interventions effect that was not explained by the specific effect of the intervention was calculated, using the proportion not attributable to the specific effects (PCE) metric, and a quantitative summary of the data from the studies was conducted using the random-effects inverse-variance model (Hartung-Knapp-Sidik-Jonkman method). Sixty-eight studies were included in the systematic review (participants: n = 5238), and 54 placebo-controlled trials informed our meta-analysis (participants: n = 3793). Physical therapy interventions included soft tissue techniques, mobilization, manipulation, taping, exercise therapy, and dry needling. Placebo interventions included manual, nonmanual interventions, or both. The proportion not attributable to the specific effects of mobilization accounted for 88% of the immediate overall treatment effect for pain intensity (PCE = 0.88, 95% confidence interval [CI]: 0.57, 1.20). In exercise therapy, this proportion accounted for 46% of the overall treatment effect for pain intensity (PCE = 0.46, 95% CI: 0.41, 0.52). The PCE in manipulation excelled in short-term pain relief (PCE = 0.81, 95% CI: 0.62, 1.01) and in mobilization in long-term effects (PCE = 0.86, 95% CI: 0.76, 0.96). In taping, the PCE accounted for 64% of disability improvement (PCE = 0.64, 95% CI: 0.48, 0.80). The outcomes of physical therapy interventions for musculoskeletal pain were significantly influenced by factors not attributable to the specific effects of the interventions. Boosting these factors consciously to enhance therapeutic outcomes represents an ethical opportunity that could benefit patients. .
Topics: Humans; Musculoskeletal Pain; Randomized Controlled Trials as Topic; Physical Therapy Modalities; Exercise Therapy
PubMed: 38602164
DOI: 10.2519/jospt.2024.12126 -
The Journal of Orthopaedic and Sports... Sep 2018The Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy have an ongoing effort to create evidence-based clinical practice...
The Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline focuses on the exercise-based prevention of knee injuries. J Orthop Sports Phys Ther. 2018;48(9):A1-A42. doi:10.2519/jospt.2018.0303.
Topics: Anterior Cruciate Ligament Injuries; Athletic Injuries; Exercise Therapy; Humans; Knee Injuries; Physical Therapy Modalities
PubMed: 30170521
DOI: 10.2519/jospt.2018.0303 -
Journal of Bodywork and Movement... Jan 2015Myofascial release (MFR) is a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore... (Review)
Review
INTRODUCTION
Myofascial release (MFR) is a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function. Anecdotal evidence shows great promise for MFR as a treatment for various conditions. However, research to support the anecdotal evidence is lacking.
OBJECTIVE
To critically analyze published randomized controlled trials (RCTs) to determine the effectiveness of MFR as a treatment option for different conditions.
DATA SOURCES
Electronic databases: MEDLINE, CINAHL, Academic Search Premier, Cochrane library, and Physiotherapy Evidence Database (PEDro), with key words myofascial release and myofascial release therapy. No date limitations were applied to the searches.
STUDY SELECTION
Articles were selected based upon the use of the term myofascial release in the abstract or key words. The final selection was made by applying the inclusion and exclusion criteria to the full text. Studies were included if they were English-language, peer-reviewed RCTs on MFR for various conditions and pain.
DATA EXTRACTION
Data collected were number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine's Levels of Evidence scale.
CONCLUSIONS
The literature regarding the effectiveness of MFR was mixed in both quality and results. Although the quality of the RCT studies varied greatly, the result of the studies was encouraging, particularly with the recently published studies. MFR is emerging as a strategy with a solid evidence base and tremendous potential. The studies in this review may help as a respectable base for the future trials.
Topics: Complementary Therapies; Humans; Massage; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Therapy, Soft Tissue; Trigger Points
PubMed: 25603749
DOI: 10.1016/j.jbmt.2014.06.001 -
Acta Reumatologica Portuguesa Jul 2019The aim of the present systematic review and meta-analysis is to know, based on the available randomized controlled trials, if the non-surgical and non-pharmacological... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of the present systematic review and meta-analysis is to know, based on the available randomized controlled trials, if the non-surgical and non-pharmacological interventions commonly used for knee osteoarthritis (OA) patients are effective and which are the most effective ones.
MATERIAL AND METHODS
RCTs were identified through electronic databases respecting the following terms to guide the search strategy: PICO (Patients - Humans with knee OA; Intervention - Non-surgical and non-pharmacological interventions; Comparison - Pharmacological, surgical, placebo, no intervention, or other non-pharmacological/non-surgical interventions; Outcomes - Pain, physical function and patient global assessment). The methodological quality of the selected publications was evaluated using the PEDro and GRADE scales. Additionally, a meta-analysis was performed using the RevMan. Only studies with similar control group, population characteristics, outcomes, instruments and follow-up, were compared in each analysis.
RESULTS
Initially, 52 RCTs emerge however, after methodological analysis, only 39 had sufficient quality to be included. From those, only 5 studies meet the meta-analysis criteria. Exercise (especially resistance training) had the best positive effects on knee OA patients. Pulsed Electromagnetic Fields and Moxibustion showed to be the most promising interventions from the others. Balance Training, Diet, Diathermy, Hydrotherapy, High Level Laser Therapy, Interferential Current, Mudpack, Neuromuscular Electrical Stimulation, Musculoskeletal Manipulations, Shock Wave Therapy, Focal Muscle Vibration, stood out, however more studies are needed to fully recommend their use. Other interventions did not show to be effective or the results obtained were heterogeneous.
CONCLUSIONS
Exercise is the best intervention for knee OA patients. Pulsed Electromagnetic Fields and Moxibustion showed to be the most promising interventions from the others options available.
Topics: Humans; Osteoarthritis, Knee; Physical Therapy Modalities; Treatment Outcome
PubMed: 31356585
DOI: No ID Found -
Seminars in Arthritis and Rheumatism Dec 2020The management of wrist and hand's tenosynovitis remains challenging and needs to be individualized. Physical modalities are accepted among conservative treatments, but...
OBJECTIVES
The management of wrist and hand's tenosynovitis remains challenging and needs to be individualized. Physical modalities are accepted among conservative treatments, but there is currently no systematic assessment of their role and efficacy. The aim of this review is to analyze the literature including studies dealing with the use of physical modalities in De Quervain disease, Dupuytren disease and trigger finger, in order to obtain indications for everyday clinical practice.
METHODS
A systematic literature search of the following databases was conducted: MEDLINE (through PubMed), Cochrane Library, PEDro and Scopus. All kind of papers, except for case reports and case series, were included, due to the small amount of scientific evidence in literature about this topic. The inclusion criteria were papers regarding the effectiveness of conservative treatment with physical modalities of adult humans affected by De Quervain disease, Dupuytren disease and trigger finger. The review included articles in English language published before 10 May 2020. The exclusion criteria were papers whose topic were surgery or conservative treatment with therapeutic tools different from physical modalities for hand and wrist's tenosynovitis.
RESULTS
The literature search identified 2422 papers, but only 15 were included in this review. While 10 of the 15 studies (66.6%) were RCTs, only 2 had a lower risk of bias according to the Cochrane library assessment tool. For the conservative treatment of De Quervain disease 7 papers were found, studying ultrasound therapy, low level laser therapy, phonoporesis, and anodyne therapy, alone or associated. For Dupuytren disease 3 papers were found, studying extracorporeal shock wave therapy (ESWT), temperature controlled high energy adjustable multi-mode emission laser, electron beam therapy and radiofrequency. For trigger finger 5 papers were found, studying ESWT and ultrasound therapy.
CONCLUSIONS
Laser therapy and therapeutic ultrasound were the most used and effective physical therapies for De Quervain tenosynovitis. ESWT was found the most efficient and safe therapy for Dupuytren disease; radiotherapy, electron beam therapy, targeted radiofrequency and laser therapy could be promising therapeutic options at Dupuytren's onset. ESWT turned out to be the most frequent physical mean used for functional improvement and pain control in trigger finger. However, more high-quality studies are still needed to further define evidence-based practice for patients with trigger finger, Dupuytren disease, and De Quervain disease.
Topics: Adult; Conservative Treatment; Humans; Physical Therapy Modalities; Tenosynovitis; Wrist; Wrist Joint
PubMed: 33065423
DOI: 10.1016/j.semarthrit.2020.08.006 -
Journal of Huntington's Disease 2017A number of studies evaluating physical therapy and exercise interventions in Huntington's disease have been conducted over the past 15 years. However, an assessment of... (Review)
Review
BACKGROUND
A number of studies evaluating physical therapy and exercise interventions in Huntington's disease have been conducted over the past 15 years. However, an assessment of the quality and strength of the evidence in support of these interventions is lacking.
OBJECTIVE
The purpose of this systematic review was to investigate the effectiveness of physical therapy and exercise interventions in people with Huntington's disease, and to examine the perceptions of patients, families and caregivers of these interventions.
METHODS
This mixed-methods systematic review utilized the Joanna Briggs Institute (JBI) approach and extraction tools to evaluate the literature from January 2003 until May 2016. The review considered interventions that included exercise and physical therapy interventions, and included both quantitative and qualitative outcome measures.
RESULTS
Twenty (20) studies met the inclusion criteria, including eighteen (18) that had quantitative outcome measures and two (2) that utilized qualitative methods. JBI Levels of evidence for the 18 quantitative studies were as follows: Eight studies were at evidence Level 1, seven were at Level 2, two were at Level 3, and one was at Level 4.
CONCLUSIONS
Our review suggests that there is preliminary support for the benefits of exercise and physical activity in Huntington's disease in terms of motor function, gait speed, and balance, as well as a range of physical and social benefits identified through patient-reported outcomes. Variability in mode of intervention as well as outcome measures limits the interpretability of these studies, and high-quality studies that incorporate adaptive trial designs for this rare disease are needed.
Topics: Exercise Therapy; Female; Humans; Huntington Disease; Male; Outcome Assessment, Health Care; Physical Therapy Modalities
PubMed: 28968244
DOI: 10.3233/JHD-170260 -
PM & R : the Journal of Injury,... Nov 2020Freezing of gait (FOG) is a major cause of falls and disability in Parkinson disease (PD). As FOG only partially improves in response to dopaminergic medication,...
INTRODUCTION
Freezing of gait (FOG) is a major cause of falls and disability in Parkinson disease (PD). As FOG only partially improves in response to dopaminergic medication, physical therapy is an important element of its management.
OBJECTIVE
To assess the evidence for the physical interventions for FOG and gait impairments and to establish recommendations for clinical practice.
LITERATURE SURVEY
This review follows the guidelines for systematic reviews: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Systematic search in PubMed, Embase, Physiotherapy Evidence Databases, and CINAHL for randomized controlled trials of PT interventions for FOG in PD patients until April 2018.
SYNTHESIS
Twenty randomized controlled trials (RCTs) were reviewed. In 12 RCTs, PT for FOG was assessed, which was the primary outcome measure in nine of these RCTs. In eight RCTs, PT for gait impairment (not targeting specifically FOG) in PD was assessed. The following PT interventions reduce FOG with a good category A recommendation: cueing strategies (P < .05) (visual and auditory); treadmill walking (P < .05); aquatic obstacle training (P < .01); supervised slackline training (P < .05). These interventions can be combined and maintain their efficacy when being applied concurrently: though there is a lack of long-term follow-up studies. The following PT interventions show possible benefit and need further investigations: balance and coordination training; aquatic gait training; sensory (tactile) cues. The treadmill training and auditory and visual cues are effective also for other gait disturbances in PD and improve gait kinematics.
CONCLUSIONS
Visual and auditory cueing and the treadmill training are effective interventions for FOG and gait impairments in PD patients (evidence level A- according to the European Federation of Neurological Societies). Tactile cues and other specific therapies targeting FOG are probably effective but need further studies.
Topics: Gait; Gait Disorders, Neurologic; Humans; Parkinson Disease; Physical Therapy Modalities; Walking
PubMed: 31994842
DOI: 10.1002/pmrj.12337 -
BMC Women's Health Jul 2023Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it.
OBJECTIVES
The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia.
DESIGN
A systematic review and meta-analysis was conducted.
METHOD
Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I index.
RESULTS
Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function.
CONCLUSIONS
Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity.
PROSPERO REGISTRATION
CRD42021236155.
Topics: Humans; Female; Dyspareunia; Quality of Life; Physical Therapy Modalities; Pain; Transcutaneous Electric Nerve Stimulation
PubMed: 37482613
DOI: 10.1186/s12905-023-02532-8 -
Journal of Manipulative and... Jun 2018The aim of this literature review was to examine the effect of physical therapy in bruxism treatment. (Review)
Review
OBJECTIVE
The aim of this literature review was to examine the effect of physical therapy in bruxism treatment.
METHODS
The data sources used were Medline, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database, SPORTDiscus, Scientific Electronic Library Online, Web of Science, Cochrane Library, Scopus, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. We included randomized and nonrandomized and controlled and noncontrolled clinical trials and interventions focused on physical therapy as treatment for sleep bruxism or awake bruxism. Two reviewers independently screened the records, examined full-text reports for compliance with the eligibility criteria, and extracted data.
RESULTS
The present review found 1296 articles. We excluded 766 duplicated articles and 461 irrelevant articles and selected 69 titles to read. Forty-five of these were excluded, leading to a total of 24 that met the eligibility criteria and were included in our analysis. The articles were grouped into 7 treatment methods used in physical therapy. The treatment methods were electrotherapeutic (14 articles), cognitive-behavioral therapy (3 articles), therapeutic exercises (2 articles), acupuncture (2 articles), postural awareness (1 article), muscular relaxation (1 article), and massage (1 article). Results and conclusions, methodological quality, and quality of evidence of each study were reported.
CONCLUSIONS
These results suggest very low-quality evidence that diverse methods used in physical therapy improve muscle pain and activity, mouth opening, oral health, anxiety, stress, depression, temporomandibular disorder, and head posture in individuals with bruxism. This finding is mainly a result of the poor methodological quality of most of the studies.
Topics: Bruxism; Humans; Massage; Muscle Stretching Exercises; Sleep Bruxism; Treatment Outcome
PubMed: 30041736
DOI: 10.1016/j.jmpt.2017.10.014