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Medicina (Kaunas, Lithuania) Sep 2023Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared... (Review)
Review
Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared to be just as effective in dysphonia. This review aimed at clarifying whether TENS can be an effective practice in dysphonia therapy and/or management on its own or combined with other types of interventions and, hence, whether its practice can be a useful, more widespread establishment to speech and language therapy intervention methods. A search was conducted on the PubMed database using specific terms based on the PICO search strategy. Eventually, four randomized controlled studies and four clinical trials were included. The methodological quality of the included studies was evaluated using the physiotherapy evidence-based database (PEDro) assessment tool, and this indicated high-quality research with an average score of 8.43. The studies utilized various TENS devices, predominantly the Dualpex 961 device (frequency of 10 Hz, phase of 200 ms). The assessment methods varied, including auditory perception, vocal therapy, electrostimulation, audio and video perceptual assessments, and laryngeal evaluations. The clinical outcomes of TENS showed a reduction in musculoskeletal pain in various areas, while the acoustic analysis results were significant in only one study. TENS was compared to manual laryngeal therapy (LMT), placebo TENS, and vocal therapy in different studies with mixed results. This review supports the idea that a multidimensional approach, incorporating various therapeutic modalities (TENS, LMT, speech therapy, and vocal training) can yield positive outcomes for patients with voice disorders. Further research is needed to explore the specific mechanisms of action and optimal treatment protocols for TENS in voice therapy.
Topics: Humans; Transcutaneous Electric Nerve Stimulation; Dysphonia; Musculoskeletal Pain; Treatment Outcome
PubMed: 37893455
DOI: 10.3390/medicina59101737 -
Journal of Neuroradiology = Journal de... Sep 2023First-episode psychosis (FEP) is defined as the first occurrence of delusions, hallucinations, or psychic disorganization of significant magnitude, lasting more than 7... (Review)
Review
First-episode psychosis (FEP) is defined as the first occurrence of delusions, hallucinations, or psychic disorganization of significant magnitude, lasting more than 7 days. Evolution is difficult to predict since the first episode remains isolated in one third of cases, while recurrence occurs in another third, and the last third progresses to a schizo-affective disorder. It has been suggested that the longer psychosis goes unnoticed and untreated, the more severe the probability of relapse and recovery. MRI has become the gold standard for imaging psychiatric disorders, especially first episode psychosis. Besides ruling out some neurological conditions that may have psychiatric manifestations, advanced imaging techniques allow for identifying imaging biomarkers of psychiatric disorders. We performed a systematic review of the literature to determine how advanced imaging in FEP may have high diagnostic specificity and predictive value regarding the evolution of disease.
Topics: Humans; Psychotic Disorders; Hallucinations; Magnetic Resonance Imaging
PubMed: 37028754
DOI: 10.1016/j.neurad.2023.04.001 -
Pain Practice : the Official Journal of... Nov 2023Limb amputation can cause residual limb pain (RLP) and/or phantom limb pain (PLP). Although targeted muscle reinnervation (TMR) was initially introduced to facilitate... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Limb amputation can cause residual limb pain (RLP) and/or phantom limb pain (PLP). Although targeted muscle reinnervation (TMR) was initially introduced to facilitate the control of prosthetic limbs, it has been noted that these patients experience less pain and improved prosthetic functional outcomes. As a result, the use of TMR in managing neuroma-related RLP is increasing. The aim of this review is to assess the quality and strength of the evidence supporting the effectiveness of TMR in managing amputation-related pain.
METHODS
Five different databases, including MEDLINE (PubMed), Scopus, Web of Science, Cochrane Library, and Embase, were searched from inception to March 2022. The protocol for this systematic review has been registered in the PROSPERO database (CRD42020218242). To be included, studies needed to compare pre- and postoperative pain outcomes or different techniques for adult patients who underwent TMR following amputation. Eligible studies also needed to use patient-reported outcome measures (PROMS) and be clinical trials or observational studies published in English. Excluded studies were case reports, case series, reviews, proof of concept studies, and conference proceedings. A meta-analysis was performed on studies that had similar intervention and control groups to examine treatment effects using a random-effects model. Studies were weighted using the inverse variance method, and a statistically significant p-value was considered to be less than or equal to 0.05.
RESULTS
This review included five studies for qualitative analysis and four studies for quantitative analysis. Reviewed studies enrolled a total of 127 patients. The TMR group was compared with standard treatment at 12 months follow-up. The TMR group showed significantly better PLP as assessed by the numerical rating score RLP, and PLP assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) also showed significantly lower pain intensity in the TMR group.
CONCLUSION
There is limited evidence of good quality favoring TMR in reducing postamputation PLP and RLP pain compared with standard care. Randomized clinical trials are encouraged to compare the efficacy of different surgical techniques.
Topics: Adult; Humans; Amputation, Surgical; Phantom Limb; Neurosurgical Procedures; Extremities; Muscles
PubMed: 37357830
DOI: 10.1111/papr.13262 -
Hand (New York, N.Y.) Jun 2024Upper and lower limb amputations are frequently associated with phantom limb pain (PLP). Recently, virtual reality (VR) and augmented reality (AR) have been reported as... (Review)
Review
Upper and lower limb amputations are frequently associated with phantom limb pain (PLP). Recently, virtual reality (VR) and augmented reality (AR) have been reported as a potential therapy of PLP. We have conducted a systematic review of literature to evaluate the efficacy of VR and AR in managing PLP. Four databases were searched: PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Web of Science. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for our organization. The initial search resulted in 164 results. After title, abstract, and full-text screening, 9 studies were included. One study was of good quality and 8 studies were of fair to poor quality. Seven studies utilized VR and 2 studies utilized AR. The number of treatment sessions ranged from 1 to 28 and the duration ranged from 10 minutes to 2 hours. Several pain scales were used to evaluate PLP pre- and postintervention including Numeric Rating Scale, Pain Rating Index, McGill Pain Questionnaire, and Visual Analog Scale. All the studies reported improvement of PLP on one or more of pain scales after one or more sessions of VR or AR. Despite the promising results reported by literature, we cannot recommend using VR or AR for PLP. Most of the studies are of poor design and have limited sample size with high bias levels. Therefore, no substantial evidence can be derived from them. However, we do believe further research with high-quality randomized controlled trials should take place to increase the knowledge of the potential advantages.
Topics: Humans; Phantom Limb; Augmented Reality; Pain Measurement; Virtual Reality; Pain Management; Amputation, Surgical; Virtual Reality Exposure Therapy
PubMed: 36341580
DOI: 10.1177/15589447221130093 -
Frontiers in Psychology 2023This systematic review synthesized the outcomes of previous intervention studies published from January 2000-October 2022 to evaluate the effectiveness of Dalcroze-based... (Review)
Review
This systematic review synthesized the outcomes of previous intervention studies published from January 2000-October 2022 to evaluate the effectiveness of Dalcroze-based or similar music-movement integration among groups of individuals considered vulnerable (in relation to their abilities and health/wellbeing). The target groups addressed in previous intervention studies included individuals with special educational needs (such as disorders, disabilities, or impairments) or with a (risk of) decline in health and/or physical strength. Twenty articles met the review inclusion criteria. All studies showed beneficial outcomes for music-movement intervention except one that suffered from low adherence rates. In older adults, the benefits were cognitive, physical, social, and/or emotional, including improved postural stability, balance, gait safety, confidence in mobility, metamemory skills, dual-task performance, social and physical pleasure, autotelic/flow experience, enjoyment, health, and quality of life. In individuals with special educational needs, improvement was seen in relation to inclusion, reductions in compulsive and other problematic behaviors, self-regulation, perceptual and cognitive abilities and functions, linguistic and learning skills, auditory attention and phonological awareness, social interaction, engagement, and agency.
PubMed: 37744587
DOI: 10.3389/fpsyg.2023.1127654 -
Vascular and Endovascular Surgery Feb 2024Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA.
METHODS
Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed.
RESULTS
Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%.
CONCLUSIONS
This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation.
Topics: Humans; Phantom Limb; Retrospective Studies; Cross-Sectional Studies; Quality of Life; Prospective Studies; Treatment Outcome; Amputation, Surgical; Neuroma; Extremities; Lower Extremity
PubMed: 37616476
DOI: 10.1177/15385744231197097 -
Neurological Sciences : Official... Oct 2023Parkinson's disease (PD) is one of the common causes of disability in the elderly. This study aims to estimate the prevalence of hallucinations in Parkinson's patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Parkinson's disease (PD) is one of the common causes of disability in the elderly. This study aims to estimate the prevalence of hallucinations in Parkinson's patients in the world.
METHODS
A systematic review of PubMed/Medline, ISI Web of Knowledge, and Google Scholar was conducted from 2017 to 2022. This study investigated the prevalence of hallucinations in Parkinson's patients. Point prevalence was analyzed with a 95% confidence interval. The variances of each study were calculated using the binomial distribution formula The researcher used Cochrane Q-test with a significance level of less than 0.1 to check the heterogeneity between studies and the change index assigned to heterogeneity I. Due to the heterogeneity between the studies, the random effects model was used to combine the results of the studies. All statistical analyses were performed by STATA version 14 software using meta-analysis commands.
RESULTS
Reports indicated that the prevalence of hallucinations in Parkinson's patients in 32 studies was 28% (0.22-0.34 = 95%CI). The highest prevalence was 34% and 95% CI = 0.07- 0.61 in developing countries and 27% with CI = 0.33-0.21 in developed countries. Reports showed the prevalence in men was 30% (CI = 0.22-0.38) and in women 23% (95% CI = 0.14-0.31).
CONCLUSIONS
Considering the relatively high prevalence of hallucinations in these patients, checking up for the presence of hallucinations on every visit of Parkinson's patients is recommended, and providing appropriate treatment for that is necessary.
Topics: Male; Humans; Female; Aged; Parkinson Disease; Prevalence; Hallucinations
PubMed: 37140832
DOI: 10.1007/s10072-023-06831-8 -
European Journal of Neurology Feb 2024This review aims to characterize the pattern of post-COVID-19 cognitive impairment, allowing better prediction of impact on daily function to inform clinical management... (Review)
Review
BACKGROUND AND PURPOSE
This review aims to characterize the pattern of post-COVID-19 cognitive impairment, allowing better prediction of impact on daily function to inform clinical management and rehabilitation.
METHODS
A systematic review and meta-analysis of neurocognitive sequelae following COVID-19 was conducted, following PRISMA-S guidelines. Studies were included if they reported domain-specific cognitive assessment in patients with COVID-19 at >4 weeks post-infection. Studies were deemed high-quality if they had >40 participants, utilized healthy controls, had low attrition rates and mitigated for confounders.
RESULTS
Five of the seven primary Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cognitive domains were assessed by enough high-quality studies to facilitate meta-analysis. Medium effect sizes indicating impairment in patients post-COVID-19 versus controls were seen across executive function (standardised mean difference (SMD) -0.45), learning and memory (SMD -0.55), complex attention (SMD -0.54) and language (SMD -0.54), with perceptual motor function appearing to be impacted to a greater degree (SMD -0.70). A narrative synthesis of the 56 low-quality studies also suggested no obvious pattern of impairment.
CONCLUSIONS
This review found moderate impairments across multiple domains of cognition in patients post-COVID-19, with no specific pattern. The reported literature was significantly heterogeneous, with a wide variety of cognitive tasks, small sample sizes and disparate initial disease severities limiting interpretability. The finding of consistent impairment across a range of cognitive tasks suggests broad, as opposed to domain-specific, brain dysfunction. Future studies should utilize a harmonized test battery to facilitate inter-study comparisons, whilst also accounting for the interactions between COVID-19, neurological sequelae and mental health, the interplay between which might explain cognitive impairment.
PubMed: 38375608
DOI: 10.1111/ene.16181 -
Journal of Neurology Apr 2024Visual auras in migraine have been extensively studied, but less is known about multisensory hallucinations or other unusual sensory experiences, including whether these... (Review)
Review
OBJECTIVE AND BACKGROUND
Visual auras in migraine have been extensively studied, but less is known about multisensory hallucinations or other unusual sensory experiences, including whether these should be diagnostically considered as part of aura symptoms. The current study aimed to conduct a systematic review and synthesis to bring together existing empirical evidence on these non-visual perceptual experiences, focusing on their phenomenological descriptions and clinical correlates.
METHODS
Forty-eight relevant studies were included based on a systematic search across PsycINFO APA and Web of Science, for peer-reviewed publications in the English language, from 1980 to the present. These comprised a mix of case reports/series (n = 19) and group design studies (n = 29).
RESULTS
Reports of complex multisensory hallucinations, beyond typical established aura symptoms, were numerous and varied in nature. Yet there were limited data on how this related to patient distress and functional interference. Other sensory distortions or hypersensitivities across non-visual domains were also evident, and generally more common in those with established aura symptoms.
CONCLUSION
Our findings provide preliminary evidence that multisensory hallucinations and other unusual perceptual experiences in migraine are likely more common than previously believed. Further investigations are needed to appropriately account for these symptoms within current nosological systems. Increased clinician-patient awareness is important for managing distress (where necessary), and potentially for offering a holistic therapeutic approach to migraine management.
Topics: Humans; Migraine with Aura; Migraine Disorders; Hallucinations; Epilepsy
PubMed: 38236395
DOI: 10.1007/s00415-023-12144-9 -
Journal of Voice : Official Journal of... Mar 2024The Coronavirus Disease 2019 (COVID-19) is an ongoing global pandemic and wearing face mask is recommended across the globe to break the transmission chain of infection.... (Review)
Review
OBJECTIVE
The Coronavirus Disease 2019 (COVID-19) is an ongoing global pandemic and wearing face mask is recommended across the globe to break the transmission chain of infection. The masks available in the market are of different types and materials and tend to alter the voice characteristics of the speaker. This can therefore impair optimal communication and the present study is a systematic review exploring the effect of various masks on voice production parameters.
STUDY DESIGN
Systematic review.
MATERIALS AND METHODS
The titles and abstracts screening was carried out for the inclusion of articles using eight electronic databases spanning the period from 1st January 2020 to 30th April 2021. 10 articles (8 published & 2 in pre-print) that met the inclusion criteria were considered for this systematic review and the pooled age range was 18 -69 years.
RESULTS
Three primary studies from the USA, 2 each from Australia & Italy, one each from Brazil, China, and Germany were found to have investigated the influence of wearing N95, KN95, surgical and fabric masks on voice related measures. The users significantly reported vocal fatigue, discomfort, and also perceived voice problems. Attenuation of speech sound amplitude was highest for the transparent mask followed by cloth mask, N95, KN95, and surgical mask.
CONCLUSION
The World Health Organization (WHO) has been repeatedly endorsing the need to use a face mask in the current COVID-19 pandemic. However, for an unintruded voice production, the surgical mask is recommended for everyone, including healthcare professionals when they are not in close contact with patients, and not involved in aerosol-generating procedures. For teachers, doing direct teaching (offline classes), 'surgical mask' can reduce the vocal load of teachers, smoothen the teacher-student interaction and thereby facilitate better learning by the students. Additionally, it would be useful to protect oneself from the risk of developing voice problems by following standard vocal healthcare tips.
Topics: Humans; Adolescent; Young Adult; Adult; Middle Aged; Aged; Pandemics; Masks; COVID-19; Voice; Voice Disorders
PubMed: 34802856
DOI: 10.1016/j.jvoice.2021.09.027