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International Journal of Environmental... Oct 2022Assess the effectiveness of physical therapy, including supervised physical exercise for body mass index (BMI) restoration; improving muscle strength and the... (Review)
Review
OBJECTIVE
Assess the effectiveness of physical therapy, including supervised physical exercise for body mass index (BMI) restoration; improving muscle strength and the psychological, behavioural, cognitive symptoms and quality of life in patients with anorexia nervosa (AN).
METHODS
A Systematic Review (SR) was conducted in the following scientific databases: Medline, PubMed, PEDro, PsychInfo, Cochrane Library plus, Nursing and Allied Health database, Scopus and Web of Science databases, from inception until November 2021. An assessment of the risk of bias and the certainty of evidence across studies was conducted. Articles were eligible if they followed randomized and non-randomized control trial designs with treatments based on physical therapy or exercise or physical activity in AN patients.
RESULTS
496 records were screened, and after eligibility assessment, 6 studies from 8 articles were finally analysed. The studies, involving 176 AN patient (85.02% of patients), reported improvements in muscle strength, eating behaviour, eating attitude, mood and quality of life. Three studies included nutritional co-interventions and four studies included psychological therapy. None of the studies reported adverse effects.
CONCLUSIONS
In two of the RCTs included in this SR, strength training and high intensity resistance improved the muscle strength of patients with AN. In addition, in two RCTs, improvements were observed in patients' attitudes towards their bodies after basic body awareness therapy or after full body massage and instruction to relax. In addition, quality of life improved in two studies, with stretching, isometrics, endurance cardiovascular and muscular exercising.
Topics: Humans; Anorexia Nervosa; Quality of Life; Exercise; Muscle Strength; Physical Therapy Modalities
PubMed: 36360815
DOI: 10.3390/ijerph192113921 -
Auris, Nasus, Larynx Feb 2024This study aimed to reveal the efficacy of physical therapy for patients with peripheral facial palsy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to reveal the efficacy of physical therapy for patients with peripheral facial palsy.
METHODS
A literature search was conducted using PubMed, Ichushi-Web, and Cochrane Central Register of Controlled Trials. Published randomized controlled trials comparing the physical therapy versus placebo/non-treatment for peripheral facial palsy such as Bell's palsy, Ramsay Hunt syndrome, and traumatic facial palsy were included for meta-analysis. The primary outcome was non-recovery at the end of the follow-up. Non-recovery was defined according to the authors' definition. The secondary outcomes were the composite score of the Sunnybrook facial grading system and sequelae (presence of synkinesis or hemifacial spasm) at the end of the follow-up. Data was analyzed using Review Manager software and pooled risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI) were calculated.
RESULTS
Seven randomized controlled trials met the eligible criteria. The data on non-recovery from four studies was obtained and included 418 participants in the meta-analysis. Physical therapy might reduce non-recovery (RR = 0.51 [95% CI = 0.31-0.83], low quality). Pooling the data of composite score of the Sunnybrook facial grading system from three studies (166 participants) revealed that physical therapy might increase the composite scores (MD = 12.1 [95% CI = 3.11-21.0], low quality). Moreover, we obtained data on sequelae from two articles (179 participants). The evidence was very uncertain about the effect of physical therapy on reduction of sequelae (RR = 0.64 [95% CI = 0.07-5.95], very low quality).
CONCLUSION
The evidence suggested that physical therapy reduces non-recovery in patients with peripheral facial palsy and improves the composite score of the Sunnybrook facial grading system, whereas the efficacy of physical therapy in reducing sequelae remained uncertain. The included studies had high risk of bias, imprecision, or inconsistency; therefore, the certainty of evidence was low or very low. Further well-designed randomized controlled trials are needed to confirm its efficacy.
Topics: Humans; Anti-Inflammatory Agents; Facial Paralysis; Bell Palsy; Physical Therapy Modalities; Drug Therapy, Combination
PubMed: 37149416
DOI: 10.1016/j.anl.2023.04.007 -
The Journal of Manual & Manipulative... Oct 2023Adhesive capsulitis (AC) affects approximately 1% of the general population. Current research lacks clear guidance on the dosage of manual therapy and exercise... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adhesive capsulitis (AC) affects approximately 1% of the general population. Current research lacks clear guidance on the dosage of manual therapy and exercise interventions.
OBJECTIVE
The purpose of this systematic review was to assess the effectiveness of manual therapy and exercise in the management of AC, with a secondary aim of describing the available literature present on the dosage of interventions.
METHODS
Eligible studies were randomized clinical/quasi-experimental trials with complete data analysis and no limits on date of publication, published in English, recruited participants >18 years of age with primary adhesive capsulitis, that had at least two groups with one group receiving manual therapy (MT) alone, exercise alone, or MT and exercise, that included at least one outcome measure of pain, disability, or external rotation range of motion, and that had dosage of visits clearly defined. An electronic search was conducted using PubMed, Embase, Cochrane, Pedro, and clinicaltrials.gov. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 Tool. The Grading of Recommendations Assessment, Development, and Evaluation was used to provide an overall assessment of the quality of evidence. Meta-analyses were conducted when possible, and dosage was discussed in narrative form.
RESULTS
Sixteen studies were included. All meta-analyses revealed non-significant effects of pain, disability, and external rotation range of motion at short- and long-term follow-up, with an overall level of evidence ranging from very low to low.
CONCLUSION
Non-significant findings with low-to-very-low-quality of evidence were found across meta-analyses, preventing seamless transition of research evidence to clinical practice. Lack of consistency in study designs, manual therapy techniques, dosing parameters, and duration of care impedes the ability to make strong recommendations regarding optimal dosage of physical therapy for individuals with AC.
Topics: Humans; Exercise; Musculoskeletal Manipulations; Physical Therapy Modalities; Shoulder Pain; Bursitis; Randomized Controlled Trials as Topic
PubMed: 36861780
DOI: 10.1080/10669817.2023.2180702 -
Journal of Back and Musculoskeletal... 2021Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various...
BACKGROUND
Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various non-operative methods has been demonstrated to improve the pain, range of motion (ROM) and functional status of patients with adhesive capsulitis.
OBJECTIVE
This study aims to review recent evidence on the efficacy of physiotherapy interventions in the treatment of adhesive capsulitis.
METHODS
PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and Cochrane databases were searched for studies published since 2013. The search terms included: Frozen shoulder, adhesive capsulitis, physical therapy, rehabilitation, manual therapy, mobilization, exercise, education, and electrotherapy. The search was limited to studies published in English and studies that used human subjects.
RESULTS
Quality scores of 33 articles were reviewed according to the Sackett's critical appraisal criteria and the grades of recommendation were determined for physiotherapy interventions used in the studies.
CONCLUSION
The empirical evidence suggests that certain physical therapy techniques and modalities are strongly recommended for pain relief, improvement of ROM, and functional status in patients with adhesive capsulitis, while others are either moderately or mildly recommended. However, the efficacy of one treatment modality over another is uncertain. The poor methodological rigors demonstrated in most of the reviewed studies emphasize the urgent need of properly conducted, adequately sampled randomized controlled trials with adequate follow up to determine the superior combination of treatment.
Topics: Bursitis; Humans; Pain; Pain Management; Physical Therapy Modalities; Range of Motion, Articular; Shoulder Joint; Treatment Outcome
PubMed: 33185587
DOI: 10.3233/BMR-200186 -
Revista Espanola de Salud Publica Jan 2023Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical... (Review)
Review
OBJECTIVE
Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical intervention, caesarean section is not exempt from complications and these can be classified as short-term (acute pain) and long-term (adhesions in the scar, lumbar and pelvic pain, intestinal obstruction and ectopic pregnancies). Physiotherapy has different tools to address these complications. The aim of this study was to review the scientific bibliography to know the effects of physiotherapy on patients who have given birth by cesarean section.
METHODS
A search for articles was carried out during the month of December 2021 in the databases: PubMed, Medline, Cinahl, Scopus, PEDro and WOS using the search terms Cesarean Section, Physical Therapy Modalities and Physical therapy. As an inclusion criterion, it was established that the type of study was a Randomized Clinical Trial (RCT).
RESULTS
A total of 280 articles were obtained, of which 9 were selected after applying the eligibility criteria. In them, the most used physiotherapy intervention was electrotherapy, followed by massage therapy and therapeutic exercise. Studies show effects of these forms of physiotherapy, with a determined duration and frequency, with improvements in pain, activities of daily living, comfort level, joint ranges and reduction in the consumption of analgesics.
CONCLUSIONS
Physiotherapy has various modalities with which to attend complications after cesarean section, both in an immediate and a late phase, especially highlighting the reduction of pain.
Topics: Pregnancy; Female; Humans; Spain; Cesarean Section; Physical Therapy Modalities; Exercise Therapy; Pain; Randomized Controlled Trials as Topic
PubMed: 36636805
DOI: No ID Found -
Complementary Therapies in Medicine Jun 2021The purpose of this meta-analytic review was to quantitatively examine the effects of myofascial release technique (MFR) on pain intensity, back disability, lumbar range... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this meta-analytic review was to quantitatively examine the effects of myofascial release technique (MFR) on pain intensity, back disability, lumbar range of motion, and quality of life in patients with low back pain (LBP).
METHODS
Potential articles were retrieved using five electronic databases (Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang). The search period was from inception to January 27, 2021. Two researchers independently completed record retrieval and selection, data extraction, and methodological quality assessment. Randomized controlled trials (RCTs) assessing the effect of MFR on pain intensity, back disability, lumbar range of motion, and quality of life in LBP patients were included. Pooled effect sizes were calculated using random effects models and 95 % confidence interval (95 % CI).
RESULTS
Data from eight RCTs (386 patients with back pain) meeting the inclusion criteria were extracted for meta-analysis with methodological quality assessment scores ranging from 6 to 10. Compared to the control intervention, MFR induced significant decrease in back disability (SMD = -0.35, 95 % confidence interval [CI] = -0.68, -0.02, P = 0.04, I² = 46 %, n = 284). MFR induced non-significant decrease in the pain intensity (SMD = -0.12, 95 % confidence interval[CI] = -0.35, 0.11, P = 0.32, I² = 0%, n = 294), non-significant improvement in quality of life (SMD = -0.09, 95 % confidence interval [CI] = -0.46, 0.28, P = 0.62, I² = 0%, n = 114), and non-significant improvement in lumbar range of motion (Flexion SMD = 0.57,95 % confidence interval [CI] = -0.09, 1.24, P = 0.09, I² = 54 %, n = 80) (Extension SMD = 0.68, 95 % confidence interval[CI] = -0.72, 2.08, P = 0.34, I² = 89 %, n = 80) (Right flexion SMD = 0.05, 95 % confidence interval[CI] = -0.90, 0.99, P = 0.92, I² = 78 %, n = 80) (Left flexion SMD = 0.14, 95 % confidence interval[CI] = -0.59, 0.88, P = 0.70, I² = 64 %, n = 80).
CONCLUSION
The findings suggest that MFR can improve the effect of physical therapy alone and exercise therapy alone, and that MFR can be an effective adjuvant therapy. Meta-analysis showed that MFR has a significant effect on reducing back disability in patients with low back pain, but no significant effect on reducing pain intensity, improving quality of life, and improving lumbar range of motion.
Topics: Back Pain; Exercise Therapy; Humans; Low Back Pain; Manipulation, Osteopathic; Physical Therapy Modalities; Randomized Controlled Trials as Topic
PubMed: 33984499
DOI: 10.1016/j.ctim.2021.102737 -
Spine Mar 2021A systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis
STUDY DESIGN
A systematic review and meta-analysis.
OBJECTIVE
This study was performed to evaluate the effects of different rehabilitation interventions in spinal cord injury.
SUMMARY OF BACKGROUND DATA
Several activity-based interventions have been widely applied in spinal cord injury in the past, but the effects of these rehabilitation exercises are controversial.
METHODS
Publications were searched from databases (PubMed, Embase, Cochrane, the database of the U.S. National Institutes of Health and World Health Organization International Clinical Trials Registry Platform) using the searching terms like spinal cord injury, transcranial magnetic stimulation, functional electrical stimulation, activity-based therapy, and robotic-assisted locomotor training. Randomized controlled trials and controlled trials were included. The primary outcomes included functional upper/lower extremity independence, walking capacity, spasticity, and life quality of individuals with spinal cord injury. Meta-analysis was performed using Revman 5.0 software.
RESULTS
Thirty-one articles were included. Meta-analysis showed that transcranial magnetic stimulation improved walking speed (95% confidence interval [CI] 0.01, 0.16) and lower extremity function (95% CI 1.55, 7.27); functional electrical stimulation significantly increased upper extremity independence (95% CI 0.37, 5.48). Robotic-assisted treadmill training improved lower extremity function (95% CI 3.44, 6.56) compared with related controls.
CONCLUSION
Activity-based intervention like transcranial magnetic stimulation, functional electrical stimulation, and robotic-assisted treadmill training are effective in improving function in individuals with spinal cord injury.Level of Evidence: 1.
Topics: Exercise Test; Exercise Therapy; Female; Humans; Middle Aged; Physical Therapy Modalities; Quality of Life; Randomized Controlled Trials as Topic; Spinal Cord Injuries; Transcranial Magnetic Stimulation; Treatment Outcome; Walking; Young Adult
PubMed: 33620185
DOI: 10.1097/BRS.0000000000003789 -
The Journal of Sports Medicine and... Nov 2022Adhesive capsulitis is a disease of unknown etiology. Conservative therapy is based on the use of multimodal techniques (instrumental physical therapy, exercise,...
INTRODUCTION
Adhesive capsulitis is a disease of unknown etiology. Conservative therapy is based on the use of multimodal techniques (instrumental physical therapy, exercise, physiokinesitherapy and anti-inflammatory drug therapy). Yet, there is no consensus on which conservative therapy treatment is best for the management of the patient with adhesive capsulitis. The aim of this study is to define the state of the art and guide specialists in choosing effective treatments for adhesive capsulitis.
EVIDENCE ACQUISITION
We performed a search on PubMed; Web of Science, Scopus, Chochrane Library and PEDRo selecting 20 RCT studies published between 2010 and 2020 in any language of which the Full-Text was available with a PEDro Score greater than or equal to 6, and which compared any conservative treatment with no treatment or other conservative treatments.
EVIDENCE SYNTHESIS
For this study, 1089 subjects were taken into consideration and 19 out of the 20 studies compared multimodal therapies: 6 directly assessed the effectiveness of physical therapies (3 US; 1 WBC; 1 HILT and 1 rESWT), 3 studies evaluated the efficacy of manual glenohumeral mobilizations, 4 compared manual and mechanical stretching techniques, and 7 evaluated the effectiveness of different supervised group or home therapeutic exercises in multimodal rehabilitation programs. The characteristics of the selected studies were very heterogeneous, and sample were not uniform as regards stage of disease, level of ROM reduction and mean duration of complaints).
CONCLUSIONS
Ultrasound therapy did not prove effective on the pathology, unlike radial shockwaves and cryotherapy. The joint mobilizations, techniques adopting posterior glenohumeral approaches and high-end mobilizations would appear to be effective both manual and instrumental techniques. In general stretching is a mandatory implementation in rehabilitation programs. From the data in the literature, it does not emerge the possibility of identifying treatment guidelines execpt for individual or group exercises, that are possibly oriented to the performance of daily activities.
Topics: Humans; Shoulder Joint; Range of Motion, Articular; Bursitis; Physical Therapy Modalities; Treatment Outcome; Anti-Inflammatory Agents
PubMed: 35179326
DOI: 10.23736/S0022-4707.22.13054-9 -
Cerebellum (London, England) Oct 2019The effectiveness of exercise and physical therapy for children with ataxia is poorly understood. The aim of this systematic review was to critically evaluate the range,...
The effectiveness of exercise and physical therapy for children with ataxia is poorly understood. The aim of this systematic review was to critically evaluate the range, scope and methodological quality of studies investigating the effectiveness of exercise and physical therapy interventions for children with ataxia. The following databases were searched: AMED, CENTRAL, CDSR, CINAHL, ClinicalTrials.gov, EMBASE, Ovid MEDLINE, PEDro and Web of Science. No limits were placed on language, type of study or year of publication. Two reviewers independently determined whether the studies met the inclusion criteria, extracted all relevant outcomes, and conducted methodological quality assessments. A total of 1988 studies were identified, and 124 full texts were screened. Twenty studies were included in the review. A total of 40 children (aged 5-18 years) with ataxia as a primary impairment participated in the included studies. Data were able to be extracted from eleven studies with a total of 21 children (aged 5-18 years), with a range of cerebellar pathology. The studies reported promising results but were of low methodological quality (no RCTs), used small sample sizes and were heterogeneous in terms of interventions, participants and outcomes. No firm conclusions can be made about the effectiveness of exercise and physical therapy for children with ataxia. There is a need for further high-quality child-centred research.
Topics: Ataxia; Child; Exercise Therapy; Humans; Physical Therapy Modalities; Prospective Studies; Retrospective Studies
PubMed: 31392562
DOI: 10.1007/s12311-019-01063-z -
Neurology Feb 2020In the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD).
OBJECTIVE
In the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD).
METHODS
We performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice.
RESULTS
We recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD.
CONCLUSIONS
There is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.
Topics: Accidental Falls; Breathing Exercises; Caregivers; Exercise; Humans; Huntington Disease; Moving and Lifting Patients; Physical Therapy Modalities; Practice Guidelines as Topic; Resistance Training
PubMed: 31907286
DOI: 10.1212/WNL.0000000000008887