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British Journal of Sports Medicine Sep 2020To systematically review risk factors for hamstring strain injury (HSI). (Meta-Analysis)
Meta-Analysis
Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport.
OBJECTIVE
To systematically review risk factors for hamstring strain injury (HSI).
DESIGN
Systematic review update.
DATA SOURCES
Database searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.
METHOD
Search result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.
RESULTS
The 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.
SUMMARY/CONCLUSION
Older age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.
Topics: Age Factors; Anterior Cruciate Ligament Injuries; Athletic Injuries; Electromyography; Hamstring Muscles; Humans; Muscle Strength; Muscle Tonus; Muscle, Skeletal; Risk Factors; Running; Sprains and Strains
PubMed: 32299793
DOI: 10.1136/bjsports-2019-100983 -
The Journal of Sexual Medicine Aug 2023The association between pelvic pain and pelvic floor muscle (PFM) tone in women with persistent noncancer pelvic pain (PNCPP) is unclear. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The association between pelvic pain and pelvic floor muscle (PFM) tone in women with persistent noncancer pelvic pain (PNCPP) is unclear.
AIM
To synthesize the evidence of the association between pelvic pain and PFM tone in women with PNCPP.
METHODS
A systematic review was conducted via MEDLINE, Emcare, Embase, CINAHL, PsycINFO, and Scopus to identify relevant studies. Studies were eligible if pelvic pain and PFM tone outcome measures were reported among women aged >18 years. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality. Studies were pooled by assessment of PFM tone via a random effects model. Associations between the presence of pelvic pain and PFM tone were assessed with odds ratio (OR), while linear associations were assessed with Pearson or Spearman correlation.
OUTCOMES
Pelvic pain measures (intensity, threshold, and frequency) and resting PFM tone in women with PNCPP, as evaluated by any clinical assessment method or tool.
RESULTS
Twenty-four studies were included in this review. The presence of pelvic pain was significantly associated with increased PFM tone as assessed by digital palpation (OR, 2.85; 95% CI, 1.66-4.89). Pelvic pain intensity was inversely but weakly associated with PFM flexibility when evaluated through dynamometry (r = -0.29; 95% CI, -0.42 to -0.17). However, no significant associations were found between pelvic pain and PFM tone when measured with other objective assessment methods.
CLINICAL IMPLICATIONS
Pelvic pain and increased PFM tone may not be directly associated; alternatively, a nonlinear association may exist. A range of biopsychosocial factors may mediate or moderate the association, and clinicians may need to consider these factors when assessing women with PNCPP.
STRENGTHS AND LIMITATIONS
This review was reported according to the PRISMA guidelines. All possible findings from relevant theses and conference abstracts were considered in our search. However, nonlinear associations between pelvic pain and increased PFM tone were not assessed as part of this review.
CONCLUSION
Pelvic pain may be linearly associated with increased PFM tone and decreased PFM flexibility when measured with digital palpation or dynamometry; however, this association was not observed when other aspects of PFM tone were assessed through objective methods. Future studies are required using robust assessment methods to measure PFM tone and analyses that account for other biopsychosocial factors that may influence the association.
Topics: Female; Humans; Pelvic Floor; Muscle Tonus; Cross-Sectional Studies; Pelvic Pain; Pelvic Floor Disorders; Muscle Contraction
PubMed: 37507352
DOI: 10.1093/jsxmed/qdad089 -
The Journal of Sexual Medicine Jan 2023Alterations in pelvic floor muscle (PFM) function have been observed in women with persistent noncancer pelvic pain (PNCPP) as compared with women without PNCPP;... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Alterations in pelvic floor muscle (PFM) function have been observed in women with persistent noncancer pelvic pain (PNCPP) as compared with women without PNCPP; however, the literature presents conflicting findings regarding differences in PFM tone between women with and without PNCPP.
AIM
To systematically review the literature comparing PFM tone in women with and without PNCPP.
METHODS
MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Scopus were searched from inception to June 2021 for relevant studies. Studies were included that reported PFM tone data in women aged ≥18 years with and without PNCPP. The risk of bias was assessed with the National Heart, Lung, and Blood Institute Quality Assessment Tool. Standardized mean differences (SMDs) for PFM tone measures were calculated via random effects models.
OUTCOMES
Resting PFM tone parameters, including myoelectrical activity, resistance, morphometry, stiffness, flexibility, relaxation, and intravaginal pressure, measured by any clinical examination method or tool.
RESULTS
Twenty-one studies met the inclusion criteria. Seven PFM tone parameters were measured. Meta-analyses were conducted for myoelectrical activity, resistance, and anterior-posterior diameter of the levator hiatus. Myoelectrical activity and resistance were higher in women with PNCPP than in women without (SMD = 1.32 [95% CI, 0.36-2.29] and SMD = 2.05 [95% CI, 1.03-3.06], respectively). Women with PNCPP also had a smaller anterior-posterior diameter of the levator hiatus as compared with women without (SMD = -0.34 [95% CI, -0.51 to -0.16]). Meta-analyses were not performed for the remaining PFM tone parameters due to an insufficient number of studies; however, results of these studies suggested greater PFM stiffness and reduced PFM flexibility in women with PNCPP than in women without.
CLINICAL IMPLICATIONS
Available evidence suggests that women with PNCPP have increased PFM tone, which could be targeted by treatments.
STRENGTHS AND LIMITATIONS
A comprehensive search strategy was used with no restriction on language or date to review studies evaluating PFM tone parameters between women with and without PNCPP. However, meta-analyses were not undertaken for all parameters because few included studies measured the same PFM tone properties. There was variability in the methods used to assess PFM tone, all of which have some limitations.
CONCLUSION
Women with PNCPP have higher PFM tone than women without PNCPP; therefore, future research is required to understand the strength of the relationship between pelvic pain and PFM tone and to investigate the effect of treatment modalities to reduce PFM tone on pelvic pain in this population.
Topics: Female; Humans; Adolescent; Adult; Pelvic Floor; Muscle Tonus; Pelvic Pain; Pelvic Floor Disorders; Muscle Contraction
PubMed: 36897234
DOI: 10.1093/jsxmed/qdac002 -
Journal of Clinical Ultrasound : JCU May 2024We explore the use of shear wave elastography (SWE) for assessing muscle stiffness and treatment response in cerebral palsy (CP) children by way of a systematic review.... (Review)
Review
We explore the use of shear wave elastography (SWE) for assessing muscle stiffness and treatment response in cerebral palsy (CP) children by way of a systematic review. SWE offers real-time muscle stiffness measurements, showing significant differences between CP patients and controls. Studies suggest that SWE can be used to follow muscle stiffness post-botulinum toxin treatment, correlating with clinical improvement. However, methodological variations and small sample sizes prevent comparison between different studies. Standardized protocols could enhance SWE's clinical utility. In conclusion, SWE holds promise for CP management, though standardized methodologies and larger studies are needed to validate its efficacy and integration into clinical practice.
PubMed: 38708803
DOI: 10.1002/jcu.23706 -
The Laryngoscope Jan 2024Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front-line treatment for MTD, and laryngeal manual therapy... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front-line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics-to-noise ratio) and vocal function (fundamental frequency) through a systematic review with meta-analysis.
DATA SOURCES
Four databases were searched from inception to December 2022, and a manual search was performed.
REVIEW METHODS
The PRISMA extension statement for reporting systematic reviews incorporating a meta-analysis of health care interventions was applied, and a random effects model was used for the meta-analyses.
RESULTS
We identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of -.58; 95% CI -1.00 to 0.16), shimmer in percent (mean difference of -5.66; 95% CI -8.16 to 3.17), and harmonics-to-noise ratio in dB (mean difference of 4.65; 95% CI 1.90-7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered.
CONCLUSION
The efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics-to-noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high-quality randomized control trials are needed to support evidence-based practice in laryngology. Laryngoscope, 134:18-26, 2024.
Topics: Humans; Dysphonia; Muscle Tonus; Treatment Outcome; Voice Quality; Speech Acoustics; Musculoskeletal Manipulations
PubMed: 37366280
DOI: 10.1002/lary.30850 -
Sensors (Basel, Switzerland) Feb 2022Spasticity is a disabling characteristic of neurological disorders, described by a velocity-dependent increase in muscle tone during passive stretch. During the last few... (Review)
Review
Spasticity is a disabling characteristic of neurological disorders, described by a velocity-dependent increase in muscle tone during passive stretch. During the last few years, many studies have been carried out to assess spasticity using wearable IMU (inertial measurements unit) sensors. This review aims to provide an updated framework of the current research on IMUs wearable sensors in people living with spasticity in recent studies published between 2017 and 2021. A total of 322 articles were screened, then finally 10 articles were selected. Results show the lack of homogenization of study procedures and missing apparatus information in some studies. Still, most studies performed adequately on measures of reporting and found that IMUs wearable data was successful in their respective purposes and goals. As IMUs estimate translational and rotational body motions, we believe there is a strong potential for these applications to estimate velocity-dependent exaggeration of stretch reflexes and spasticity-related characteristics in spasticity. This review also proposes new directions of research that should be challenged by larger study groups and could be of interest to both researchers as well as clinicians. The use of IMUs to evaluate spasticity is a promising avenue to provide an objective measurement as compared to non-instrumented traditional assessments.
Topics: Humans; Motion; Muscle Spasticity; Muscle Tonus; Reflex, Stretch; Wearable Electronic Devices
PubMed: 35270937
DOI: 10.3390/s22051791 -
Progres En Urologie : Journal de... Sep 2020The anal tone allows the maintenance of anorectal continence. Its regulation depends on spinal segmental mechanisms under supra-sacral control.
INTRODUCTION
The anal tone allows the maintenance of anorectal continence. Its regulation depends on spinal segmental mechanisms under supra-sacral control.
MATERIAL AND METHODS
A systematic review was performed using Medline database, according to PRISMA methodology, using following keywords anal tone ; anal sphincter ; anorectal function ; reflex ; digital rectal examination.
RESULTS
Anal hypertonia is an increase in the muscle's resistance to passive stretching. Muscular hypotonia is a decrease in muscle tone. It is associated with a decrease in resistance to passive mobilization. It is not possible to quantify the prevalence of anal tone alterations in the general population and in specific pathological conditions (urinary disorders, neurogenic or non-neurogenic anorectal disorders). In case of hypotonia, most often due to a lower motor neuron lesion, fecal incontinence may occur. Hypertonia (anal sphincter overactivity) is not always due to perineal spasticity. Indeed, in the majority of the cases, the cause of this anal hypertonia in a neurologic context, can be secondary to an upper motor neuron disease due to spinal or encephalic lesion, leading to recto-anal dyssynergia, giving distal constipation. In another way, this anal hypertonia can be purely behavioral, with no direct pathological significance. The evaluation of anal tone is clinical with validated scores but whose sensitivity is not absolute, and instrumental with, on the one hand, the measurement of anal pressure in manometry and, on the other hand, electrophysiological testing which still require validation in this indication.
CONCLUSION
Anal tone assessment is of interest in clinical practice because it gives diagnostic arguments for the neurological lesion and its level, in the presence of urinary or anorectal symptoms.
Topics: Anal Canal; Humans; Muscle Tonus
PubMed: 32636059
DOI: 10.1016/j.purol.2020.06.004 -
Advances in Mind-body MedicineMassage is a widely used alternative therapy among health professionals and parents for children with cerebral palsy (CP).
CONTEXT
Massage is a widely used alternative therapy among health professionals and parents for children with cerebral palsy (CP).
OBJECTIVE
The review intended to determine the effects of massage on the rehabilitation of children with CP.
DESIGN
The research team conducted a literature review that examined the use of massage for children with various types of CP, such as ataxia, using relevant keywords. It included articles published up to December 2019. The research team searched the electronic databases PubMed, MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials.
SETTING
The study took place at Eastern Mediterranean University in Famagusta, Cyprus.
PARTICIPANTS
Participants in the reviewed studies were children with CP.
OUTCOME MEASURES
The strength of the research designs was rated using Sackett's Levels of Evidence. The Physiotherapy Evidence Database (PEDro) scale was used to assess the studies' methodological quality. The outcome measures were classified according to the International Classification of Functioning, Disability, and Health (ICF).
RESULTS
Eleven studies that included 297 CP children were reviewed. According to the PEDro scores, 5 studies had high methodological quality; 5 studies had fair quality; and one study had poor quality. No study investigated the effects of massage for all classifications of the ICF. Muscle tone was decreased significantly in the reviewed studies, either between the groups or within the massage group (P < .05). No consensus existed about the other effects of massage due to the limited research.
CONCLUSIONS
This study is a first review in this area and can be an important guide for professionals and caregivers who want properly use massage for children with CP. Massage as an adjunct to traditional therapies should be used to reduce muscle tone in spastic-type CP. More clear methods and relevant outcome measures should be used in future studies. Further studies with randomized controlled trials are required to determine massage type, massage applier, and oil for this population and to investigate immediate and long-term effects of massage on all ICF's domains.
Topics: Cerebral Palsy; Child; Cyprus; Humans; Massage; Muscle Tonus; Physical Therapy Modalities
PubMed: 32822329
DOI: No ID Found -
Clinical Rehabilitation Nov 2020To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke survivors.
DATA SOURCES
Ten electronic databases were searched from inception to February 2020.
REVIEW METHODS
Inclusion criteria were: subacute stroke survivors (<6 months since stroke), an experimental group performing any type of cycling training with electrical stimulation, alone or in addition to usual care, and a control group performing usual care alone. Two reviewers assessed eligibility, extracted data and analyzed the risks of bias. Standardized Mean Difference (SMD) or Mean Difference (MD) with 95% Confidence Intervals (CI) were estimated using fixed- or random-effects models to evaluate the training effect.
RESULTS
Seven randomized controlled trials recruiting a total of 273 stroke survivors were included in the meta-analyses. There was a statistically significant, but not clinically relevant, effect of cycling with electrical stimulation compared to usual care on walking (six studies, SMD [95% CI] = 0.40 [0.13, 0.67]; = 0.004), capability to maintain a sitting position (three studies, MD [95% CI] = 7.92 [1.01, 14.82]; = 0.02) and work produced by the paretic leg during pedaling (2 studies, MD [95% CI] = 8.13 [1.03, 15.25]; = 0.02). No significant between-group differences were found for muscular power, tone, standing balance, and activities of daily living.
CONCLUSIONS
Cycling training with functional electrical stimulation cannot be recommended in terms of being better than usual care in subacute stroke survivors. Further investigations are required to confirm these results, to determine the optimal training parameters and to evaluate long-term effects.
Topics: Activities of Daily Living; Bicycling; Electric Stimulation; Humans; Muscle Strength; Muscle Tonus; Postural Balance; Stroke Rehabilitation
PubMed: 32613859
DOI: 10.1177/0269215520938423 -
Rehabilitacion 2020To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence.
OBJECTIVE
To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence.
MATERIALS AND METHODS
A systematic literature review was carried out; this method forms part of secondary studies under investigation and describes a phenomenon in detail based on primary sources of information.
RESULTS
The literature search in the databases consulted yielded 7,228 articles; of these, 15 more were identified through "snowball" search strategies. At the start of the screening process, 63 eligible records were chosen based on their title and summary, and 14 were excluded because they were duplicates. A total of 49 articles were selected for a full text revision and, of these, 37 were excluded because they did not meet all the inclusion criteria. Finally, 12 articles were selected to prepare the qualitative synthesis of the present research work.
CONCLUSIONS
In comparison with neonates born at term, premature infants demonstrate a particular motor repertoire, due to the immaturity of their systems; their motor behaviour follows a line of development mainly characterised by deficits in muscle tone, postural control, muscle balance, and antigravity muscle activation.
Topics: Humans; Infant; Infant, Newborn; Infant, Premature; Motor Activity; Muscle Tonus; Muscle, Skeletal; Postural Balance
PubMed: 32007181
DOI: 10.1016/j.rh.2019.09.004