-
Systematic Reviews Mar 2024Manual therapy (MT) is frequently used in combination with management of osteoarthritis of the knee, but there is no consensus on the exact efficacy of this treatment... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Manual therapy (MT) is frequently used in combination with management of osteoarthritis of the knee, but there is no consensus on the exact efficacy of this treatment strategy. The purpose of this systematic review and meta-analysis was to evaluate the pain relief and safety of MT for treatment of knee osteoarthritis (KOA).
METHODS
Randomized controlled trials evaluating MT in patients with KOA in major English and Chinese journals were searched in the following databases: Wanfang, China Science and Technology Journal Database (VIP database), China National Knowledge Infrastructure (CNKI), PubMed, Embase, Web of Science, and the Cochrane Library databases through June 2023. The methodological quality and quality of evidence of the included studies were assessed using Cochrane's risk-of-bias 2 (ROB 2) tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Data analysis was performed using Stata version 15.0 software. After use of Galbraith plots to exclude studies that could lead to heterogeneity, random effects models were used to analyze the remaining data and test the consistency of the findings. We used meta-regression to assess the effect of treatment period, patient age, and sex ratio on outcomes. Funnel plots and Egger's test were used to evaluate publication bias. Sensitivity analyses were used to determine the reliability of the results.
RESULTS
A total of 25 studies, with 2376 participants, were included in this review. The overall methodological quality of the included studies was limited. Our findings suggest that MT has a positive impact on pain relief outcomes in KOA patients. The meta-analysis showed that MT was superior to usual care (SMD = 2.04, 95% CI 0.94, 3.14, I = 96.3%; low evidence quality) and exercise (SMD = 1.56, 95% CI 0.41, 2.71, I = 96.3%; low evidence quality) for reducing pain. In terms of improvement in visual analogue scale (VAS) scores, MT treatment beyond 4 weeks (SMD = 1.56, 95% CI 0.41, 2.71, I = 96.3%) may be superior to treatments less than or equal to 4 weeks (SMD = 1.24, 95% CI 0.56, 1.95, I = 94.7%). No serious adverse events associated with MT were reported.
CONCLUSIONS
MT may be effective at reducing pain in patients with KOA and may be more effective after a 4-week treatment period. Compared with usual care and exercise therapy, MT may be superior at reducing KOA pain in the short term (9 weeks), but its long-term efficacy requires careful consideration of evidence-based outcomes. MT appears to be safe for KOA patients, though clinicians should inform patients of the potential risk of MT-related adverse events.
Topics: Humans; Osteoarthritis, Knee; Reproducibility of Results; Pain; Pain Management; Musculoskeletal Manipulations
PubMed: 38504373
DOI: 10.1186/s13643-024-02467-7 -
The Journal of Manual & Manipulative... Jun 2024Risks and benefits of spinal manipulations and mobilization in pediatric populations are a concern to the public, policymakers, and international physiotherapy governing... (Review)
Review
Psychometric properties of clinician-reported and performance-based outcomes cited in a scoping review on spinal manipulation and mobilization for pediatric populations with diverse medical conditions: a systematic review.
INTRODUCTION
Risks and benefits of spinal manipulations and mobilization in pediatric populations are a concern to the public, policymakers, and international physiotherapy governing organizations. Clinical Outcome Assessments (COA) used in the literature on these topics are contentious. The aim of this systematic review was to establish the quality of clinician-reported and performance-based COAs identified by a scoping review on spinal manipulation and mobilization for pediatric populations across diverse medical conditions.
METHOD AND ANALYSIS
Electronic databases, clinicaltrials.gov and Ebsco Open Dissertations were searched up to 21 October 2022. Qualitative synthesis was performed using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines to select studies, perform data extraction, and assess risk of bias. Data synthesis used Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to determine the certainty of the evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), or indeterminate (?).
RESULTS
Four of 17 identified COAs (77 studies, 9653 participants) with supporting psychometric research were classified as:Performance-based outcome measures: AIMS - Alberta Infant Motor Scale ( = 51); or:Clinician-reported outcome measures: LATCH - Latch, Audible swallowing, Type of nipple, Comfort, Hold ( = 10),Cobb Angle ( = 15),Postural Assessment ( = 1).AIMS had an overall sufficient (+) rating with high certainty evidence, and LATCH had an overall sufficient (+) rating with moderate certainty of evidence. For the Cobb Angle and Postural Assessment, the overall rating was indeterminate (?) with low or very low certainty of evidence, respectively.
CONCLUSION
The AIMS and LATCH had sufficient evidence to evaluate the efficacy of spinal manipulation and mobilization for certain pediatric medical conditions. Further validation studies are needed for other COAs.
Topics: Humans; Manipulation, Spinal; Psychometrics; Child; Outcome Assessment, Health Care
PubMed: 38070150
DOI: 10.1080/10669817.2023.2269038 -
Sensors (Basel, Switzerland) Apr 2024Reinforcement learning (RL) has emerged as a dynamic and transformative paradigm in artificial intelligence, offering the promise of intelligent decision-making in... (Review)
Review
Reinforcement learning (RL) has emerged as a dynamic and transformative paradigm in artificial intelligence, offering the promise of intelligent decision-making in complex and dynamic environments. This unique feature enables RL to address sequential decision-making problems with simultaneous sampling, evaluation, and feedback. As a result, RL techniques have become suitable candidates for developing powerful solutions in various domains. In this study, we present a comprehensive and systematic review of RL algorithms and applications. This review commences with an exploration of the foundations of RL and proceeds to examine each algorithm in detail, concluding with a comparative analysis of RL algorithms based on several criteria. This review then extends to two key applications of RL: robotics and healthcare. In robotics manipulation, RL enhances precision and adaptability in tasks such as object grasping and autonomous learning. In healthcare, this review turns its focus to the realm of cell growth problems, clarifying how RL has provided a data-driven approach for optimizing the growth of cell cultures and the development of therapeutic solutions. This review offers a comprehensive overview, shedding light on the evolving landscape of RL and its potential in two diverse yet interconnected fields.
Topics: Robotics; Humans; Algorithms; Artificial Intelligence; Delivery of Health Care; Machine Learning
PubMed: 38676080
DOI: 10.3390/s24082461 -
Sports Medicine (Auckland, N.Z.) Aug 2023Repeated-sprint training (RST) involves maximal-effort, short-duration sprints (≤ 10 s) interspersed with brief recovery periods (≤ 60 s). Knowledge about the... (Meta-Analysis)
Meta-Analysis
The Acute Demands of Repeated-Sprint Training on Physiological, Neuromuscular, Perceptual and Performance Outcomes in Team Sport Athletes: A Systematic Review and Meta-analysis.
BACKGROUND
Repeated-sprint training (RST) involves maximal-effort, short-duration sprints (≤ 10 s) interspersed with brief recovery periods (≤ 60 s). Knowledge about the acute demands of RST and the influence of programming variables has implications for training prescription.
OBJECTIVES
To investigate the physiological, neuromuscular, perceptual and performance demands of RST, while also examining the moderating effects of programming variables (sprint modality, number of repetitions per set, sprint repetition distance, inter-repetition rest modality and inter-repetition rest duration) on these outcomes.
METHODS
The databases Pubmed, SPORTDiscus, MEDLINE and Scopus were searched for original research articles investigating overground running RST in team sport athletes ≥ 16 years. Eligible data were analysed using multi-level mixed effects meta-analysis, with meta-regression performed on outcomes with ~ 50 samples (10 per moderator) to examine the influence of programming factors. Effects were evaluated based on coverage of their confidence (compatibility) limits (CL) against elected thresholds of practical importance.
RESULTS
From 908 data samples nested within 176 studies eligible for meta-analysis, the pooled effects (± 90% CL) of RST were as follows: average heart rate (HR) of 163 ± 9 bpm, peak heart rate (HR) of 182 ± 3 bpm, average oxygen consumption of 42.4 ± 10.1 mL·kg·min, end-set blood lactate concentration (B[La]) of 10.7 ± 0.6 mmol·L, deciMax session ratings of perceived exertion (sRPE) of 6.5 ± 0.5 au, average sprint time (S) of 5.57 ± 0.26 s, best sprint time (S) of 5.52 ± 0.27 s and percentage sprint decrement (S) of 5.0 ± 0.3%. When compared with a reference protocol of 6 × 30 m straight-line sprints with 20 s passive inter-repetition rest, shuttle-based sprints were associated with a substantial increase in repetition time (S: 1.42 ± 0.11 s, S: 1.55 ± 0.13 s), whereas the effect on sRPE was trivial (0.6 ± 0.9 au). Performing two more repetitions per set had a trivial effect on HR (0.8 ± 1.0 bpm), B[La] (0.3 ± 0.2 mmol·L), sRPE (0.2 ± 0.2 au), S (0.01 ± 0.03) and S (0.4; ± 0.2%). Sprinting 10 m further per repetition was associated with a substantial increase in B[La] (2.7; ± 0.7 mmol·L) and S (1.7 ± 0.4%), whereas the effect on sRPE was trivial (0.7 ± 0.6). Resting for 10 s longer between repetitions was associated with a substantial reduction in B[La] (-1.1 ± 0.5 mmol·L), S (-0.09 ± 0.06 s) and S (-1.4 ± 0.4%), while the effects on HR (-0.7 ± 1.8 bpm) and sRPE (-0.5 ± 0.5 au) were trivial. All other moderating effects were compatible with both trivial and substantial effects [i.e. equal coverage of the confidence interval (CI) across a trivial and a substantial region in only one direction], or inconclusive (i.e. the CI spanned across substantial and trivial regions in both positive and negative directions).
CONCLUSIONS
The physiological, neuromuscular, perceptual and performance demands of RST are substantial, with some of these outcomes moderated by the manipulation of programming variables. To amplify physiological demands and performance decrement, longer sprint distances (> 30 m) and shorter, inter-repetition rest (≤ 20 s) are recommended. Alternatively, to mitigate fatigue and enhance acute sprint performance, shorter sprint distances (e.g. 15-25 m) with longer, passive inter-repetition rest (≥ 30 s) are recommended.
Topics: Humans; Team Sports; Running; Fatigue; Athletes; Lactic Acid; Athletic Performance
PubMed: 37222864
DOI: 10.1007/s40279-023-01853-w -
Journal of Orthopaedic Surgery and... Sep 2023Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and safety of outpatient versus home-based rehabilitation persists.
METHODS
A thorough literature review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across four databases. Two researchers independently identified eligible studies centering on knee arthroplasty patients undergoing either outpatient or home-based rehabilitation. Study quality was assessed using the Cochrane Collaboration's risk of bias tool, while continuous outcomes were subject to meta-analyses using Stata 17 software.
RESULTS
Our analysis identified no significant differences in primary outcomes, including Range of Motion, Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, and the Knee Society Score, between home-based and outpatient rehabilitation across different follow-up points. Adverse reactions, readmission rates, the need for manipulation under anesthesia, reoperation rate, and post-surgery complications were also similar between both groups. Home-based rehabilitation demonstrated cost-effectiveness, resulting in substantial annual savings. Furthermore, quality of life and patient satisfaction were found to be comparable in both rehabilitation methods.
CONCLUSIONS
Home-based rehabilitation post-knee arthroplasty appears as an effective, safe, and cost-efficient alternative to outpatient rehabilitation. Despite these findings, further multicenter, long-term randomized controlled trials are required to validate these findings and provide robust evidence to inform early rehabilitation choices post-knee arthroplasty.
Topics: Humans; Outpatients; Arthroplasty, Replacement, Knee; Quality of Life; Knee Joint; Anesthesia; Multicenter Studies as Topic
PubMed: 37726800
DOI: 10.1186/s13018-023-04160-2 -
BMC Complementary Medicine and Therapies Jan 2024There is a continuing interest in finding effective methods for scar treatment. Dry needling is gaining popularity in physiotherapy and is defined by Western medicine as...
BACKGROUND
There is a continuing interest in finding effective methods for scar treatment. Dry needling is gaining popularity in physiotherapy and is defined by Western medicine as a type of acupuncture. The terms acupuncture and dry needling have been used interchangeably so we have focused on the efficacy of dry needling or acupuncture in scar treatment.
OBJECTIVE
The aim of this systematic review was to determine the usefulness of dry needling or local acupuncture for scar treatment. In our search process, we used the terms 'acupuncture,' 'needling,' or 'dry needling' to identify all relevant scientific papers. We have focused on the practical aspects of local management of different scar types with dry needling or acupuncture.
SEARCH STRATEGY
The search strategy included different combinations of the following keywords: 'scar', 'keloid', 'dry needling', 'needling', 'acupuncture', 'treatment', 'physical therapy'. This systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (PubMed, EBSCOHost and Ovid), EMBASE (Elsevier), and Web of Science databases were searched for relevant publications from inception through October 2023.
INCLUSION CRITERIA
The studies that investigated the effectiveness of dry needling or acupuncture for scar treatment were included.
DATA EXTRACTION AND ANALYSIS
The main extraction data items were: the needling technique; needle: diameter, length; needling locations; manual needling manipulation; number of sessions; settings; outcomes and results.
RESULTS
As a result of a comprehensive search, 11 manuscripts were included in the systematic review, of which eight were case reports, two were randomized trials and one study concerned case series. Two case reports scored 2-4 out of 8 points on the JBI checklist, five studies scored 5-7, and one study scored 8 points. The methodological quality of the two clinical trials was rated as good or fair on the PEDro scale. The case series study scored 7 of 10 points on the JBI checklist. A meta-analysis was not possible as only two randomized trials, eight case reports, and one case series were eligible for review; also, scar assessment scales and pain severity scales were highly heterogeneous.
CONCLUSIONS
The studies differed regarding the delivery of dry needling or local acupuncture for scar treatment. Differences included treatment frequency, duration, number of treatments, selection of needle insertion sites, number of needles used, angle of needle placement, and use of manual needling manipulation.
SYSTEMATIC REVIEW REGISTRATION
INPLASY no. 202310058.
Topics: Humans; Acupuncture Therapy; Cicatrix; Dry Needling; Percutaneous Collagen Induction; Physical Therapy Modalities; Case Reports as Topic
PubMed: 38167051
DOI: 10.1186/s12906-023-04301-4 -
The Journal of Manual & Manipulative... Jun 2024Reliable, valid, and responsive outcomes is foundational to address concerns about the risks and benefits of performing spinal manipulation and mobilization in pediatric... (Review)
Review
Psychometric measurement properties of patient-reported and observer-reported outcome measures for spinal mobilisations and manipulation on paediatric subjects with diverse medical conditions: A systematic review.
INTRODUCTION
Reliable, valid, and responsive outcomes is foundational to address concerns about the risks and benefits of performing spinal manipulation and mobilization in pediatric populations. The aim of this systematic review was to synthesize evidence on measurement properties from cohort/case-control/cross-sectional/randomized studies on patient-reported (SQLI - Scoliosis Quality of Life Index; VAS-Visual Analog Scale; PAQLQ - Pediatric Asthma Quality of Life Questionnaire), observer-reported (Crying Diaries; ATEC - Autism Treatment Evaluation Checklist) and mixed (PedsQL - Pediatric Quality of Life Inventory) outcome measurements identified through a scoping review on manipulation and mobilization for pediatric populations with diverse medical conditions.
METHOD AND ANALYSIS
Electronic databases, clinicaltrial.gov and Ebsco Open Dissertations were searched up to 21 October 202221 October 2022. Two independent reviewers selected studies, extracted data, and assessed risk of bias. Qualitative synthesis was performed using COSMIN and Cochrane GRADE methodology to establish the certainty of evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), indeterminate (?).
RESULTS
Eighteen studies (2 SQLI for scoliosis; 1 VAS - perceived influence of exertion or movement/position on low back problems; 1 PAQLQ for asthma; 1 Crying Diaries for infantile colic; 8 ATEC for autism; 5 PedsQL for cerebral palsy/scoliosis/healthy) with 9653 participants were selected. ATEC and PedsQL had overall sufficient (+) measurement properties with moderate certainty evidence. PAQLQ had indeterminate measurement properties with moderate certainty evidence. Very low certainty of evidence identified measurement properties to be indeterminate (?) for SQLI, Crying Diaries, and VAS- perceived influence of exertion or movement/position on low back problems.
CONCLUSION
ATEC for autism and PedsQL for asthma may be a suitable clinical outcome assessment (COA); additional validation studies on responsiveness and the minimal important difference are needed. Other COA require further validation.
Topics: Humans; Child; Patient Reported Outcome Measures; Psychometrics; Manipulation, Spinal; Scoliosis; Quality of Life; Adolescent; Asthma; Male
PubMed: 38146749
DOI: 10.1080/10669817.2023.2281650 -
International Wound Journal Aug 2023This systematic review and meta-analysis aimed to examine the effects of massage therapy on pain and anxiety intensity in patients with burns. A comprehensive,... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to examine the effects of massage therapy on pain and anxiety intensity in patients with burns. A comprehensive, systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Massage therapy', 'Musculoskeletal manipulations', 'Acute pains', 'Burning pain', and 'Burn' from the earliest to October 17, 2022. Cochran's tool is used to check the risk of bias for randomised clinical trial (RCT) articles. The methodological index for non-randomised studies was used to assess the risk of bias in quasi-experimental studies. STATA version 14 software was used to perform the meta-analysis. A 95% confidence interval (CI) was used to determine statistical significance. Heterogeneity was investigated with I . A P-value less than .1 was considered statistically significant for publication bias value. A total of 733 patients with burns were included in seven studies. Five studies had an RCT design and two studies had a quasi-experimental design. The duration of the study was reported in five studies, with a mean of 42.40 weeks. The duration of the intervention was reported in seven studies with a mean of 22.86 minutes. The results of the meta-analysis showed using various types of massage therapy interventions significantly reduced pain intensity in the intervention group compared with the control group (weighted mean difference: -2.08, 95% CI: -2.55 to -1.62, Z = 8.77, I : 67.1%, P < .001). Massage therapy intervention significantly reduced the intensity of anxiety in burn patients (standard mean difference: -7.07, 95% CI: -10.13 to -4.01, Z = 4.53, I : 98.2, P < .001). Overall, the present systematic review and meta-analysis showed that massage therapy can reduce the intensity of pain and anxiety in burn patients. Therefore, it is recommended that health managers and policymakers pay special attention to massage therapy as a simple, low-cost, and efficient non-pharmacological treatment to relieve pain and anxiety in burn patients.
Topics: Humans; Pain; Anxiety; Anxiety Disorders; Massage; Burns
PubMed: 36680488
DOI: 10.1111/iwj.14089 -
Frontiers in Human Neuroscience 2023Mood disorders are very common among adolescents and include mainly bipolar disorder (BD) and major depressive disorder (MDD), with overlapping depressive symptoms that...
BACKGROUND
Mood disorders are very common among adolescents and include mainly bipolar disorder (BD) and major depressive disorder (MDD), with overlapping depressive symptoms that pose a significant challenge to realizing a rapid and accurate differential diagnosis in clinical practice. Misdiagnosis of BD as MDD can lead to inappropriate treatment and detrimental outcomes, including a poorer ultimate clinical and functional prognosis and even an increased risk of suicide. Therefore, it is of great significance for clinical management to identify clinical symptoms or features and biological markers that can accurately distinguish BD from MDD. With the aid of bibliometric analysis, we explore, visualize, and conclude the important directions of differential diagnostic studies of BD and MDD in adolescents.
MATERIALS AND METHODS
A literature search was performed for studies on differential diagnostic studies of BD and MDD among adolescents in the Web of Science Core Collection database. All studies considered for this article were published between 2004 and 2023. Bibliometric analysis and visualization were performed using the VOSviewer and CiteSpace software.
RESULTS
In total, 148 publications were retrieved. The number of publications on differential diagnostic studies of BD and MDD among adolescents has been generally increasing since 2012, with the United States being an emerging hub with a growing influence in the field. Boris Birmaher is the top author in terms of the number of publications, and the is the most published journal in the field. Co-occurrence analysis of keywords showed that clinical characteristics, genetic factors, and neuroimaging are current research hotspots. Ultimately, we comprehensively sorted out the current state of research in this area and proposed possible research directions in future.
CONCLUSION
This is the first-ever study of bibliometric and visual analyses of differential diagnostic studies of BD and MDD in adolescents to reveal the current research status and important directions in the field. Our research and analysis results might provide some practical sources for academic scholars and clinical practice.
PubMed: 37780961
DOI: 10.3389/fnhum.2023.1192544 -
International Journal of Environmental... Nov 2023Among several vector control methods commonly used, environmental management is one of the control measures to mitigate dengue in such vulnerable communities. Since... (Review)
Review
Among several vector control methods commonly used, environmental management is one of the control measures to mitigate dengue in such vulnerable communities. Since there is no curative treatment for dengue yet, targeted environmental and ecosystem management is increasingly relevant. Hence, this review was conducted to identify the effectiveness of environmental management intervention strategy to reduce dengue cases. We searched PUBMED, CENTRAL, SCOPUS, Web of Science, CIJE, WHO ICTRP, and ClinicalTrials.gov up to January 2021. A total of 521 articles were screened. Only 16 studies were included in this review. There were 6 studies that applied all three types of environmental management interventions (manipulation, modification and behavior), 8 studies applied two types of interventions (manipulation and behavior) and 2 studies applied one type of intervention (manipulation or behavior). All included studies reported reduction of entomological indices. The studies showed reduction in dengue cases and density of population through environmental interventions. It is recommended for the health authority to incorporate environmental management intervention in dengue control activities and enhanced the community involvement to ensure sustainability with high impact on dengue reduction.
Topics: Animals; Humans; Mosquito Control; Dengue; Ecosystem; Conservation of Natural Resources; Mosquito Vectors; Aedes
PubMed: 35642722
DOI: 10.1080/09603123.2022.2076815