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Cureus Jul 2023Musculoskeletal shoulder pain (MSP) is a common orthopedic condition frequently treated by orthopedic surgeons and physical therapists in an interdisciplinary manner.... (Review)
Review
The Impact of Dry Needling With Electrical Stimulation on Pain and Disability in Patients With Musculoskeletal Shoulder Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Musculoskeletal shoulder pain (MSP) is a common orthopedic condition frequently treated by orthopedic surgeons and physical therapists in an interdisciplinary manner. Dry needling with electrical stimulation (DNES) is an increasingly popular intervention used for the conservative treatment of MSP during physical therapy. To date, no systematic review and meta-analysis have examined the impact of DNES on outcomes in patients with MSP. This study aims to explore the effectiveness and safety of DNES in patients with MSP to improve patient outcomes. A systematic review and meta-analysis were conducted using PubMed, MEDLINE, CINAHL, and Web of Science from database inception to March 10, 2023. Inclusion criteria were studies with DNES as an intervention, recorded patient outcomes, and randomized controlled trials (RCTs) only. DNES with or without conventional physical therapy (CPT) was compared to CPT alone, which included interventions such as exercise, manual therapy, dry needling without electrical stimulation, and/or interferential current. A total of five RCTs were analyzed from 144 articles retrieved on the initial search. Included patients (n=342) had an average age of 48.75 ± 5.92 years, an average follow-up time of 3.40 ± 1.42 months, and 184 patients receiving DNES with or without CPT. Patients treated with DNES with or without CPT (n=163) had a frequency-weighted mean decrease in pain of 4.8 ± 1.4 points, whereas patients treated with CPT alone (n=158) had a frequency-weighted mean decrease in pain of 3.3 ± 2.2 points. For meta-analysis of pain outcomes (n=321 total patients), DNES with or without CPT improved pain by 1.40/10 points as compared to CPT alone with no significant difference between groups (p=0.203; Cohen's d effect size (ES): 4.352; 95% CI: -2.343, 11.048). Patients treated with DNES with or without CPT (n=118) had a frequency-weighted mean decrease in disability of 34.7 ± 9.1 points. In contrast, patients treated with CPT alone (n=115) had a frequency-weighted decrease in disability of 20.1 ± 5.0 points. For meta-analysis of disability outcomes (n=233 total patients), DNES with or without CPT did not have a significant improvement in disability as compared to CPT alone (p=0.282; Cohen's d ES: 0.543; 95% CI: -0.446, 1.532). No serious adverse effects were reported for patients treated with DNES with or without CPT or CPT alone. DNES with or without CPT may significantly improve pain and disability in patients with MSP. However, DNES with or without CPT does not provide statistically significant improvements in pain or disability compared to CPT alone. Furthermore, DNES appears to be a safe intervention for MSP.
PubMed: 37546088
DOI: 10.7759/cureus.41404 -
Brazilian Journal of Physical Therapy 2023There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain.
OBJECTIVE
To investigate the effectiveness of IC in patients with chronic non-specific low back pain.
METHODS
The databases PUBMED, EMBASE, PEDro, Cochrane Library, CINAHL, and SCIELO were searched. Randomized controlled trials reporting pain intensity and disability in patients with chronic non-specific low back pain, in which IC was applied were included. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence.
RESULTS
Thirteen RCTs were considered eligible for this systematic review (pooled n = 1367). Main results showed moderate-quality evidence and moderate effect sizes that IC probably reduces pain intensity and disability compared to placebo immediately post-treatment (Pain: MD = -1.57 points; 95% CI -2.17, -0.98; Disability: MD = -1.51 points; 95% CI -2.57, -0.46), but not at intermediate-term follow-up. Low-quality evidence with small effect size showed that IC may reduce pain intensity (SMD = -0.32; 95% CI -0.61, -0.03, p = 0.03) compared to TENS immediately post-treatment, but not for disability. There is very low-quality evidence that IC combined with other interventions (massage or exercises) may not further reduce pain intensity and disability compared to the other interventions provided in isolation immediately post-treatment.
CONCLUSION
Moderate-quality evidence shows that IC is probably better than placebo for reducing pain intensity and disability immediately post-treatment in patients with chronic non-specific low back pain.
Topics: Humans; Low Back Pain; Exercise Therapy; Pain Measurement; Disabled Persons; Chronic Pain
PubMed: 37801776
DOI: 10.1016/j.bjpt.2023.100549 -
Archives of Physical Medicine and... Dec 2023To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC).
DATA SOURCES
The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases in February 2023.
STUDY SELECTION
Prospective studies comparing the outcomes of PRP with other intervention in patients with AC.
DATA EXTRACTION
The quality of included randomized trials was assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool. The Risk of Bias in Non-Randomized Studies of Interventions tool was applied to assess the quality of nonrandomized trials. The mean difference (MD) or standardized mean difference (SMD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs).
DATA SYNTHESIS
Fourteen studies involving 1139 patients were included. Our meta-analysis revealed that PRP injection can significantly improve passive abduction (MD=3.91; 95% CI, 0.84-6.98), passive flexion (MD=3.90; 95% CI, 0.15-7.84), and disability (SMD=-0.50; 95% CI, -1.29 to -0.74) within 1 month after intervention. Moreover, PRP injection can significantly improve passive abduction (MD=17.19; 95% CI, 12.38-22.01), passive flexion (MD=17.74; 95% CI, 9.89-25.59), passive external rotation (MD=12.95; 95% CI, 10.04-15.87), pain (MD=-8.40; 95% CI, -16.73 to -0.06), and disability (SMD=-1.02; 95% CI, -1.29 to -0.74) 3 months after intervention. PRP injection can also significantly improve pain (MD=-18.98; 95% CI, -24.71 to -13.26), and disability (SMD=-2.01; 95% CI, -3.02 to -1.00) 6 months after intervention. In addition, no adverse effects of PRP injection were reported.
CONCLUSIONS
PRP injection may serve as an effective and safe treatment for patients with AC.
Topics: Humans; Prospective Studies; Bursitis; Shoulder Pain; Platelet-Rich Plasma; Range of Motion, Articular; Treatment Outcome
PubMed: 37119955
DOI: 10.1016/j.apmr.2023.03.032 -
Life (Basel, Switzerland) Nov 2023Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the... (Review)
Review
Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would reduce pain and improve disability in the lumbar radiculopathy population, leveraging the statistical power of multiple studies. Electronic databases from their inception up to October 2023 were searched for randomized controlled trials (RCTs) that explored the impact of NM on lumbar radiculopathy. Our primary outcome measure was the alteration in pain intensity, while the secondary one was the improvement of disability, standardized using Hedges' . To combine the data, we employed a random-effects model. A total of 20 RCTs comprising 877 participants were included. NM yielded a significant reduction in pain intensity (Hedges' = -1.097, 95% CI = -1.482 to -0.712, < 0.001, I2 = 85.338%). Subgroup analyses indicated that NM effectively reduced pain, whether employed alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, with a notable effect size (Hedges' = -0.964, 95% CI = -1.475 to -0.453, < 0.001, I2 = 88.550%), particularly in chronic cases. The findings provide valuable insights for clinicians seeking evidence-based interventions for this patient population. This study has limitations, including heterogeneity, potential publication bias, varied causal factors in lumbar radiculopathy, overall study quality, and the inability to explore the impact of neural pathology on NM treatment effectiveness, suggesting opportunities for future research improvements.
PubMed: 38137856
DOI: 10.3390/life13122255 -
Cureus Nov 2023Subacromial pain syndrome (SAPS) is the most frequent diagnosis in patients with shoulder pain presenting with persistent pain and significant functional decline.... (Review)
Review
Manual Therapy and Exercise Have Similar Outcomes to Corticosteroid Injections in the Management of Patients With Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis.
Subacromial pain syndrome (SAPS) is the most frequent diagnosis in patients with shoulder pain presenting with persistent pain and significant functional decline. Although exercise and manual therapy (EMT) and corticosteroid injections provide first-line treatment options, evidence for the best management of SAPS remains inconclusive. We aimed to evaluate the effectiveness of EMT compared with corticosteroid injections on disability, recovery rates, and pain in patients with SAPS through a systematic review and meta-analysis approach. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), ScienceDirect, the Cochrane Library, and grey literature databases were searched. Only randomized controlled trials evaluating the effectiveness of EMT alone or as an additive intervention compared to corticosteroid injections were included. Methodological quality was evaluated with the PEDro score and certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In total, 8 trials with 946 patients were included. EMT presented no difference in disability compared with corticosteroid injections at very short- (standardized mean difference {SMD}: 0.19; 95%CI: -0.20, 0.58), short- (SMD: -0.16; 95%CI: -0.58, 0.25), mid- (SMD: -0.14; 95%CI: -0.44, 0.16), and long-term (SMD: 0.00; 95%CI: -0.25, 0.25) follow-up. No difference was found between the comparators in self-perceived recovery at very short- (risk ratio: 0.93; 95%CI: 0.71, 1.21) and mid- (risk ratio: 0.98; 95%CI: 0.90, 1.07) follow-up and in pain rating at very short- (SMD: -0.18; 95%CI: -0.73, 0.38), short- (SMD: 0.05; 95%CI: -0.26, 0.37), and long-term (SMD: 0.04; 95%CI: -0.26, 0.34) follow-ups. The addition of corticosteroid injections to EMT provided no better results in shoulder disability compared with EMT (SMD: 0.45; 95%CI: -0.47, 1.37) or corticosteroid injections alone (MD: 2.70; 95%CI: -7.70, 13.10) in the mid-term. Based on very low to moderate certainty of evidence, EMT has similar effects to corticosteroid injections on improving all outcomes in patients with SAPS at all follow-up periods. Based on low certainty of evidence the combination of both interventions does not change the treatment outcome compared with each intervention alone.
PubMed: 38111394
DOI: 10.7759/cureus.48907 -
Sports (Basel, Switzerland) Sep 2023Low 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... (Review)
Review
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.
PubMed: 37755844
DOI: 10.3390/sports11090167 -
Disability and Rehabilitation Jan 2024To evaluate the data on the psychometric properties of the Neck Disability Index (NDI). (Review)
Review
PURPOSE
To evaluate the data on the psychometric properties of the Neck Disability Index (NDI).
MATERIALS AND METHODS
Medline, Embase, PsychINFO, Web of Science, and Scopus were searched in April 2023. The random effects meta-analysis was conducted when possible.
RESULTS
Of 492 identified records, 79 were included. 70 studies were considered to be of low risk of systematic bias. Alpha was >0.81. Pooled test-retest intraclass correlation coefficient was 0.91 (95% CI 0.90-0.93). The NDI correlations with pain rating scales varied from 0.38 to 0.89. 13 studies found the NDI to be unidimensional and 15 - two- or three-dimensional. The minimal detectable change varied from 3% to 27% and minimal clinically important difference from 5% to 33%. Pooled area under the curve was 0.74 (95% CI 0.68-0.80). Most studies have not detected floor or ceiling effect. Sex-related differential item functioning has been present in one study.
CONCLUSIONS
The NDI demonstrated good internal consistency and test-retest reliability without floor or ceiling effect. In most situations, the NDI could be considered a unidimensional scale. The NDI well correlated with the common scales of pain and disability. The minimal clinically important difference and minimal detectable change were around 15% (7.5/50 points).
PubMed: 38240027
DOI: 10.1080/09638288.2024.2304644 -
Healthcare (Basel, Switzerland) Jul 2023This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and... (Review)
Review
This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and structuring aspects for the prescription of CT. This systematic review was carried out through four databases (Pubmed, Web of Science, Scopus, and SPORTDiscus), considering data from the period between 2013 and 2022. From 257 studies, 12 studies were included in this systematic review. Three studies used interval CT, while seven used continuous CT. Seven were carried out in the population with Down syndrome, while only three were carried out with participants with ID. The CT programs had the following characteristics: duration of 8 to 12 weeks, weekly frequency of three sessions, for 20 to 60 min, the intensity of 50% to 80% of maximal heart rate or 70% to 80% of peak oxygen consumption, using an ergometer cycle or an outdoor walking. The studies reported improvements in cardiorespiratory function, lipid, hemodynamic and metabolic profile, body composition, and neuromuscular and cognitive capacity. This review presents characteristics and recommendations that technicians can follow when structuring, prescribing, and implementing CT programs to individuals with ID.
PubMed: 37510547
DOI: 10.3390/healthcare11142106 -
Applied Ergonomics May 2024Exercise is recommended for office workers with neck pain. However, recent reviews evaluated the effectiveness of workplace interventions only. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exercise is recommended for office workers with neck pain. However, recent reviews evaluated the effectiveness of workplace interventions only.
OBJECTIVES
To evaluate the effect of exercise on pain, disability, and quality of life (QoL) in office workers with chronic neck pain.
DESIGN
Systematic review with meta-analysis.
METHODS
Electronic databases were searched from inception to April 30, 2022, to identify studies in which participants were adults aged ≥18 years undergoing any form of neck exercises (e.g., strengthening, motor control) or physical activity (e.g., aerobic exercise) performed for a minimum of two-weeks without any other additional treatment besides advice or education. Two reviewers independently screened papers and determined the certainty of the evidence.
RESULTS
Eight randomised controlled trials met the eligibility criteria. Seven studies reported a significant decrease in Visual Analogue Scale (VAS) scores for neck pain intensity and five studies reported a significant decrease in Neck Disability Index (NDI) scores following strengthening exercises. Only one study assessed the effect of strengthening exercises on QoL and reported no significant effect. All eight included studies had a high risk of bias and the overall certainty of evidence was low. Meta-analyses demonstrated a significant decrease of neck pain intensity and disability for strengthening exercises compared to a control (p < 0.01).
CONCLUSION
There is low certainty of evidence that strengthening of the neck, shoulder and scapular musculature is effective at reducing neck pain and disability in office workers. Further research evaluating the effect of exercise on QoL is required.
Topics: Adult; Humans; Chronic Pain; Exercise; Neck; Neck Pain; Quality of Life; Occupational Health; Randomized Controlled Trials as Topic
PubMed: 38219373
DOI: 10.1016/j.apergo.2023.104216 -
Child: Care, Health and Development Mar 2024Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures,... (Review)
Review
BACKGROUND
Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures, the reliability and validity of the translated versions remain uncertain. To address this gap in knowledge, this study aims to identify tools for assessing the participation of children aged 5-18 years and to appraise the psychometric properties of their translated versions.
METHODS
Four electronic databases were searched for peer-reviewed studies published in English. Preferred Reporting Items for Systematic Reviews guidelines was followed. Study titles and abstracts were screened by four independent reviewers. Data were extracted for both original and translated versions of eligible tools. Instrument quality assessments were performed using the Outcome Measures Rating Form Guidelines. Any discrepancies were resolved by consensus.
RESULTS
Out of the 31 measurement tools examined, 18 tools had at least one translated version available, and among those original measurement tools, a total of 58 translated versions were identified. The most widely translated tool was the Physical Activity Questionnaire for Children (12 languages), and the most frequently translated language was Chinese (7 tools). Most translated versions verified internal consistency and content validity. Only three translated versions were verified inter-rater reliability, and seven translated versions were tested criterion validity with the gold standard tools assessing participation of children (e.g., accelerometer, Pediatric Evaluation of Disability Inventory and four 24-h recalls). None of the translated versions were tested for intra-rater reliability and responsiveness.
CONCLUSIONS
These findings can support the selection of psychometrically sound tools for children with disabilities, given their culture and language, and tool quality.
Topics: Humans; Child; Adolescent; Quality of Life; Surveys and Questionnaires; Reproducibility of Results; Translations; Psychometrics
PubMed: 38494984
DOI: 10.1111/cch.13248