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Journal of Orthopaedic Surgery and... Jun 2023Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and improve lumbar function is still unclear. Therefore, we conducted a meta-analysis of relevant studies to comprehensively analyse and determine the efficacy and safety of ESWT for chronic low back pain.
METHODS
Four databases were systematically searched for randomized controlled trials (RCTs) on ESWT for CLBP. The quality of the included studies was evaluated according to Cochrane systematic review criteria, relevant data were extracted, and meta-analysis was performed using RevMan 5.4 software. The primary outcomes were pain intensity, disability status, and mental health. The data were expressed as standardized mean differences (SMD) or weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed using the I statistic. If I ≥ 50%, a random effects model was applied; otherwise, a fixed effects model was used.
RESULTS
Twelve RCTs involving 632 patients were included in this meta-analysis. The ESWT group reported significantly more pain relief than the control group at 4 weeks (WMD = - 1.04; 95% CI = - 1.44 to - 0.65; P < 0.001) and 12 weeks (WMD = - 0.85; 95% CI = - 1.30 to - 0.41; P < 0.001). Regarding the dysfunction index, ESWT led to significant improvement in lumbar dysfunction compared with the control group at 4 weeks (WMD = - 4.22; 95% CI = - 7.55 to - 0.89; P < 0.001) and 12 weeks (WMD = - 4.51; 95% CI = - 8.58 to - 0.44; P = 0.03). For mental health, there was no significant difference between the ESWT group and the control group after 4 weeks of intervention (SMD = 1.17; 95% CI = - 0.10 to 2.45; P = 0.07).
CONCLUSION
This systematic review and meta-analysis found that ESWT provided better pain relief and improved lumbar dysfunction compared with the other interventions included, and no serious adverse effects were found. There was no significant effect of ESWT on the mental health of patients, but we hope to obtain more RCTs for further analysis in the future. Based on the pooled results, we suggest that ESWT is effective and safe for treating chronic low back pain.
Topics: Humans; Extracorporeal Shockwave Therapy; Low Back Pain; Pain Management; Pain Measurement; Musculoskeletal Diseases; Treatment Outcome; Chronic Pain
PubMed: 37355623
DOI: 10.1186/s13018-023-03943-x -
International Journal of Public Health 2022This study aimed to critically review the results of recent studies that investigated the epidemiology of noncombat-related musculoskeletal injuries (MSIs) in the Navy.... (Review)
Review
This study aimed to critically review the results of recent studies that investigated the epidemiology of noncombat-related musculoskeletal injuries (MSIs) in the Navy. A systematic search was conducted of three major databases (Pubmed, Embase, and Cochrane) to identify epidemiological studies on MSIs in the Navy. Study selection and risk of bias assessment were conducted. The overall prevalence of MSIs ranged from 12.69% to 48.81%. And the prevalence of head and face injuries, upper extremity injuries, spine injuries, chest injuries, and lower extremity injuries were 0.11%-0.66%, 0.53%-11.47%, 0.75%-12.09%, 0.43%-0.95%, and 0.4%-21.17%, respectively. For the specific MSIs, the incidence ranged from 0.03/1000 person-years to 32.3/1000 person-years in the Navy and Marines. The ankle-foot, lumbopelvic, knee and lower leg, and shoulder were identified as the most frequent location for MSIs. This systematic review summarized that the Navy population had a high prevalence of MSIs. And different risk factors for MSIs varied from different anatomic locations. This systematic review also provided valuable information on MSIs for sports medicine specialists.
Topics: Humans; Incidence; Military Personnel; Prevalence; Risk Factors; Occupational Injuries; Musculoskeletal System
PubMed: 36531604
DOI: 10.3389/ijph.2022.1605435 -
Journal of Medical Internet Research Sep 2022Digital health solutions can provide populations with musculoskeletal pain with high-reach, low-cost, easily accessible, and scalable patient education and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Digital health solutions can provide populations with musculoskeletal pain with high-reach, low-cost, easily accessible, and scalable patient education and self-management interventions that meet the time and resource restrictions.
OBJECTIVE
The main objective of this study was to determine the effectiveness of digital health interventions for people with musculoskeletal pain conditions (ie, low back pain, neck pain, shoulder pain, knee pain, elbow pain, ankle pain, and whiplash).
METHODS
A systematic review and meta-analysis was conducted. We searched PubMed and Cochrane Central Register of Controlled Trials (from 1974 to August 2021) and selected randomized controlled trials of digital health interventions in the target population of patients with musculoskeletal pain with a minimum follow-up of 1 month. A total of 2 researchers independently screened and extracted the data.
RESULTS
A total of 56 eligible studies were included covering 9359 participants, with a mean follow-up of 25 (SD 15.48) weeks. In moderate-quality evidence, digital health interventions had a small effect on pain (standardized mean difference [SMD] 0.19, 95% CI 0.06-0.32), disability (SMD 0.14, 95% CI 0.03-0.25), quality of life (SMD 0.22, 95% CI 0.07-0.36), emotional functioning (SMD 0.24, 95% CI 0.12-0.35), and self-management (SMD 0.14, 95% CI 0.05-0.24).
CONCLUSIONS
Moderate-quality evidence supports the conclusion that digital health interventions are effective in reducing pain and improving functioning and self-management of musculoskeletal pain conditions. Low-quality evidence indicates that digital health interventions can improve the quality of life and global treatment. Little research has been conducted on the influence of digital health on expenses, knowledge, overall improvement, range of motion, muscle strength, and implementation fidelity.
TRIAL REGISTRATION
PROSPERO CRD42022307504; https://tinyurl.com/2cd25hus.
Topics: Disabled Persons; Humans; Low Back Pain; Musculoskeletal Pain; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 36066943
DOI: 10.2196/37869 -
Biomedicines Dec 2022Producing tremendous amounts of stress and financial burden on the global patient population and healthcare systems around the world, most current modalities of... (Review)
Review
Producing tremendous amounts of stress and financial burden on the global patient population and healthcare systems around the world, most current modalities of treatment for musculoskeletal ailments often do not address the etiopathogenetic causes of these disorders. Regenerative medicine for musculoskeletal disorders relies on orthobiologics derived from either allogenic or autologous sources. Multiple drawbacks are associated with autologous sources, including donor-site morbidity, a dearth of studies, and variability in both patient reported and clinical/functional outcomes. On the other hand, allogenic sources address several of these concerns, and continue to be a suitable source of mesenchymal stem cells (MSCs). This review qualitatively reports both the preclinical and clinical outcomes of publications studying the applications of umbilical cord (-derived Wharton's jelly), amniotic suspension allograft, amniotic membrane, and amniotic fluid in musculoskeletal medicine. A systematic review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines on studies published between January 2010 and October 2022 that used allogeneic perinatal tissues. Further randomized controlled clinical studies are necessary to properly evaluate the safety and efficacy of these tissues in orthopedic surgery.
PubMed: 36551929
DOI: 10.3390/biomedicines10123173 -
Iranian Journal of Public Health Apr 2021Musculoskeletal disorders are responsible for significant problem for workers' health. The present study aimed to investigate the prevalence of musculoskeletal disorders... (Review)
Review
BACKGROUND
Musculoskeletal disorders are responsible for significant problem for workers' health. The present study aimed to investigate the prevalence of musculoskeletal disorders among mining workers.
METHODS
This systematic review and meta-analysis study were designed in 2020 (from Jan to Mar). The researchers searched five international databases Medline/PubMed, ProQuest, Scopus, Embase and Web of Science. All analyzes were performed using STATA statistical software.
RESULTS
The search results were 447 articles and after screening stage finally 50 studies were included in review. The highest number of studies (26 studies) reported the prevalence of musculoskeletal disorders of upper back and 4 studies reported the prevalence of musculoskeletal disorders of the arms and ankles & feet. The results of meta-analysis based on prevalence in different organs showed that the highest prevalence of musculoskeletal disorders was in the upper back and the lowest in the knees with a prevalence of 50.39% (CI 95%: 31.23-54.73%) and 16.03% (CI 95%: 11.78-20.28%), respectively.
CONCLUSION
The prevalence of musculoskeletal disorders among miners is relatively high. Therefore, supervisors and mine managers should pay more attention to reducing musculoskeletal disorders and increasing the ergonomic level of mines in order to increase workers' health.
PubMed: 34183917
DOI: 10.18502/ijph.v50i4.5992 -
Acta Neurochirurgica Sep 2020Work-related musculoskeletal disorders (WMSDs) are a growing and probably undervalued concern for neurosurgeons and spine surgeons, as they can impact their quality of...
BACKGROUND
Work-related musculoskeletal disorders (WMSDs) are a growing and probably undervalued concern for neurosurgeons and spine surgeons, as they can impact their quality of life and career length. This systematic review aims to ascertain this association and to search for preventive measures.
METHODS
We conducted a PRISMA-P-based review on ergonomics and WMSDs in neurosurgery over the last 15 years. Twelve original articles were included, of which 6 focused on spine surgery ergonomics, 5 cranio-facial surgery (mainly endoscopic), and one on both domains.
RESULTS
We found a huge methodological and content diversity among studies with 5 surveys, 3 cross-sectional studies, 2 retrospective cohorts, and 2 technical notes. Spine surgeons have sustained neck flexion and neglect their posture during surgery. In a survey, low back pain was found in 62% of surgeons, 31% of them with a diagnosed lumbar disc herniation, and 23% of surgery rate. Pain in the neck (59%), shoulder (49%), finger (31%), and wrist (25%) are more frequent than in the general population. Carpal tunnel syndrome showed a linear relationship with increasing cumulative hours of spine surgery practice. Among cranial procedures, endoscopy was also significantly related to shoulder pain while pineal region surgery received some attempts to optimize ergonomics.
CONCLUSIONS
Ergonomics in neurosurgery remains underreported and lack attention from surgeons and authorities. Improvements shall target postural ergonomics, equipment design, weekly schedule adaptation, and exercise.
Topics: Carpal Tunnel Syndrome; Ergonomics; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Low Back Pain; Neurosurgeons; Occupational Diseases; Posture
PubMed: 32705353
DOI: 10.1007/s00701-020-04494-4 -
Healthcare (Basel, Switzerland) Jun 2023Biomechanical methods are frequently used to provide information about the kinematics and kinetics of posture and movement during musical performance. The aim of this... (Review)
Review
Biomechanical methods are frequently used to provide information about the kinematics and kinetics of posture and movement during musical performance. The aim of this review was to identify and analyze the biomechanical methods performed on woodwind musicians to understand their musculoskeletal demands. A systemic review was carried out following the guidelines of the document Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It was registered in PROSPERO (code 430304).The databases PubMed, Cochrane, CINAHL, Scopus, and Web of Science were consulted between January 2000 and March 2022. The search in the databases identified 1625 articles, and 16 different studies were finally included in the review, with a sample size of 390 participants. Pressure sensors, surface electromyography, infrared thermography, goniometry in two dimensions, and ultrasound topometry in three dimensions were biomechanical methods useful to broaden the knowledge of musculoskeletal demands during musical practice. Piezoresistive pressure sensors were the most widely used method. The great heterogeneity of the studies limited the comparability of the results. The findings raised the need to increase both the quantity and the quality of studies in future research.
PubMed: 37297764
DOI: 10.3390/healthcare11111621 -
Journal of Medical Internet Research Jul 2023Musculoskeletal disorders (MSDs) are widespread in many countries and their huge burden on the society has necessitated innovative approaches such as digital health... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Musculoskeletal disorders (MSDs) are widespread in many countries and their huge burden on the society has necessitated innovative approaches such as digital health interventions. However, no study has evaluated the findings of cost-effectiveness of these interventions.
OBJECTIVE
This study aims to synthesize the cost-effectiveness of digital health interventions for people with MSDs.
METHODS
Electronic databases including MEDLINE, AMED, CIHAHL, PsycINFO, Scopus, Web of Science, and Centre for Review and Dissemination were searched for cost-effectiveness of digital health published between inception and June 2022 following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. References of all retrieved articles were checked for relevant studies. Quality appraisal of the included studies was performed using the Quality of Health Economic Studies (QHES) instrument. Results were presented using a narrative synthesis and random effects meta-analysis.
RESULTS
A total of 10 studies from 6 countries met the inclusion criteria. Using the QHES instrument, we found that the mean score of the overall quality of the included studies was 82.5. Included studies were on nonspecific chronic low back pain (n=4), chronic pain (n=2), knee and hip osteoarthritis (n=3), and fibromyalgia (n=1). The economic perspectives adopted in the included studies were societal (n=4), societal and health care (n=3), and health care (n=3). Of the 10 included studies, 5 (50%) used quality-adjusted life-years as the outcome measures. Except 1 study, all the included studies reported that digital health interventions were cost-effective compared with the control group. In a random effects meta-analysis (n=2), the pooled disability and quality-adjusted life-years were -0.176 (95% CI -0.317 to -0.035; P=.01) and 3.855 (95% CI 2.023 to 5.687; P<.001), respectively. The meta-analysis (n=2) for the costs was in favor of the digital health intervention compared with control: US $417.52 (95% CI -522.01 to -313.03).
CONCLUSIONS
Studies indicate that digital health interventions are cost-effective for people with MSDs. Our findings suggest that digital health intervention could help improve access to treatment for patients with MSDs and as a result improve their health outcomes. Clinicians and policy makers should consider the use of these interventions for patients with MSDs.
TRIAL REGISTRATION
PROSPERO CRD42021253221; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=253221.
Topics: Humans; Cost-Benefit Analysis; Musculoskeletal Diseases; Outcome Assessment, Health Care; Qualitative Research; Fibromyalgia
PubMed: 37410542
DOI: 10.2196/41113 -
JMIR Rehabilitation and Assistive... Sep 2022Real-time telerehabilitation (TR) is a new strategy for delivering rehabilitation interventions to older adults with musculoskeletal conditions, to provide continuity to... (Review)
Review
BACKGROUND
Real-time telerehabilitation (TR) is a new strategy for delivering rehabilitation interventions to older adults with musculoskeletal conditions, to provide continuity to conventional services and mitigate travel-related barriers.
OBJECTIVE
We aimed to examine the effectiveness of treatment delivered via real-time TR services compared to conventional services among older adults with musculoskeletal conditions, in terms of physical performance, treatment adherence, and cost-effectiveness.
METHODS
A literature search of randomized controlled trials (RCTs) published from January 2000 to April 2022 was conducted in six online databases: Cochrane Library, PubMed (ie, MEDLINE), PEDro, ClinicalKey, EBSCO, and ProQuest. The main eligibility criterion for articles was the use of real-time TR among older adults with musculoskeletal conditions to improve physical performance. Two reviewers screened 2108 abstracts and found 10 studies (n=851) that met the eligibility criteria. Quality assessment was based on version 2 of Cochrane's risk-of-bias tool for RCTs, in order to assess the methodological quality of the selected articles. Results were pooled for meta-analyses, based on the primary outcome measures, and were reported as standardized mean differences (SMDs) with 95% CIs. A fixed model was used, and subgroup analysis was performed to check for possible factors influencing TR's effectiveness based on different treatments, controls, and outcome measures.
RESULTS
The search and screening process identified 10 papers that collectively reported on three musculoskeletal conditions in older adults and three types of TR programs. Aggregate results suggested that real-time TR, compared to conventional treatment, was more effective at improving physical performance regarding balance (SMD 0.63, 95% CI 0.36-0.9; I=58.5%). TR was slightly better than usual care at improving range of motion (SMD 0.28, 95% CI 0.1-0.46; I=0%) and muscle strength (SMD 0.76, 95% CI 0.32-1.2; I=59.60%), with moderate to large effects. Subgroup analyses suggested that real-time TR had medium to large effects favoring the use of smartphones or tablets (SMD 0.92, 95% CI 0.56-1.29; I=45.8%), whereas the use of personal computers (SMD 0.25, 95% CI -0.16 to 0.66; I=0%) had no effect on improving balance and was comparable to conventional treatment.
CONCLUSIONS
We found that real-time TR improved physical performance in older adults with musculoskeletal conditions, with an effectiveness level equal to that of conventional face-to-face treatment. Therefore, real-time TR services may constitute an alternative strategy for the delivery of rehabilitation services to older adults with musculoskeletal conditions to improve their physical performance. We also observed that the ideal device for delivering TR is the smartphone. Results suggested that the use of smartphones for TR is driven by ease of use among older adults. We encourage future studies in areas related to rehabilitation in older adults, in addition to examination of physical performance outcomes, to gain additional knowledge about comprehensive care.
TRIAL REGISTRATION
PROSPERO CRD42021287289; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287289.
PubMed: 36048520
DOI: 10.2196/36028 -
International Journal of Environmental... Sep 2022Shoulder dysfunctions represent the third musculoskeletal disorder by frequency. However, monitoring the movement of the shoulder is particularly challenging due to the... (Review)
Review
Shoulder dysfunctions represent the third musculoskeletal disorder by frequency. However, monitoring the movement of the shoulder is particularly challenging due to the complexity of the joint kinematics. The 3D kinematic analysis with optical motion capture systems (OMCs) makes it possible to overcome clinical tests' shortcomings and obtain objective data on the characteristics and quality of movement. This systematic review aims to retrieve the current knowledge about using OMCs for 3D shoulder kinematic analysis in patients with musculoskeletal shoulder disorders and their corresponding clinical relevance. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. Studies employing OMCs for 3D kinematic analysis in patients with musculoskeletal shoulder disorders were retrieved. Eleven articles were considered eligible for this study. OMCs can be considered a powerful tool in orthopedic clinical research. The high costs and organizing complexities of experimental setups are likely outweighed by the impact of these systems in guiding clinical practice and patient follow-up. However, additional high-quality studies on using OMCs in clinical practice are required, with standardized protocols and methodologies to make comparing clinical trials easier.
Topics: Biomechanical Phenomena; Humans; Motion; Movement; Range of Motion, Articular; Shoulder; Shoulder Joint; Upper Extremity
PubMed: 36231336
DOI: 10.3390/ijerph191912033