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International Orthopaedics Feb 2022Systematic review and meta-analysis to assess the effectiveness of manual therapy in improving carpal tunnel syndrome (CTS) symptoms, physical function, and nerve... (Meta-Analysis)
Meta-Analysis Review
AIM OF THE STUDY
Systematic review and meta-analysis to assess the effectiveness of manual therapy in improving carpal tunnel syndrome (CTS) symptoms, physical function, and nerve conduction studies.
METHOD
MEDLINE, Web of Science, SCOPUS, Cochrane Library, TRIP database, and PEDro databases were searched from the inception to September 2021. PICO search strategy was used to identify randomized controlled trials applying manual therapy on patients with CTS. Eligible studies and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by PEDro scale. Outcomes assessed were pain intensity, physical function, and nerve conduction studies.
RESULTS
Eighty-one potential studies were identified and six studies involving 401 patients were finally included. Pain intensity immediately after treatment showed a pooled standard mean difference (SMD) of - 2.13 with 95% confidence interval (CI) (- 2.39, - 1.86). Physical function with Boston Carpal Tunnel Syndrome Questionnaire (BCTS-Q) showed a pooled SMD of - 1.67 with 95% CI (- 1.92, - 1.43) on symptoms severity, and a SMD of - 0.89 with 95% CI (- 1.08, - 0.70) on functional status. Nerve conduction studies showed a SMD of - 0.19 with 95% CI (- 0.40, - 0.02) on motor conduction and a SMD of - 1.15 with 95% CI (- 1.36, - 0.93) on sensory conduction.
CONCLUSIONS
This study highlights the effectiveness of manual therapy techniques based on soft tissue and neurodynamic mobilizations, in isolation, on pain, physical function, and nerve conduction studies in patients with CTS.
Topics: Carpal Tunnel Syndrome; Humans; Musculoskeletal Manipulations; Neural Conduction; Pain; Pain Measurement; Treatment Outcome
PubMed: 34862562
DOI: 10.1007/s00264-021-05272-2 -
The Journal of Head Trauma... 2019To characterize the indications, timing, barriers, and perceived value of rehabilitation currently provided for individuals with moderate or severe traumatic brain...
OBJECTIVE
To characterize the indications, timing, barriers, and perceived value of rehabilitation currently provided for individuals with moderate or severe traumatic brain injury (TBI) admitted to the intensive care unit (ICU) based on the perspectives of providers who work in the ICU setting.
PARTICIPANTS
Members (n = 66) of the Neurocritical Care Society and the American Congress of Rehabilitation Medicine.
DESIGN
An anonymous electronic survey of the timing of rehabilitation for patients with TBI in the ICU.
MAIN MEASURES
Questions asked about type and timing of rehabilitation in the ICU, extent of family involvement, participation of physiatrists in patient care, and barriers to early rehabilitation.
RESULTS
Sixty-six respondents who reported caring for patients with TBI in the ICU completed the survey; 98% recommended rehabilitative care while patients were in the ICU. Common reasons to wait for the initiation of physical therapy and occupational therapy were normalization of intracranial pressure (86% and 89%) and hemodynamic stability (66% and 69%).
CONCLUSIONS
The majority of providers caring for patients with TBI in the ICU support rehabilitation efforts, typically after a patient is extubated, intracranial pressure has normalized, and the patient is hemodynamically stable. Our findings describe current practice; future studies can be designed to determine optimal timing, intensity, and patient selection for early rehabilitation.
Topics: Brain Injuries, Traumatic; Clinical Decision-Making; Hemodynamics; Hospitalization; Humans; Intensive Care Units; Intracranial Pressure; Occupational Therapy; Patient Care Team; Physical Therapy Modalities; Speech Therapy; Surveys and Questionnaires; Time-to-Treatment
PubMed: 30829824
DOI: 10.1097/HTR.0000000000000477 -
Lancet (London, England) Feb 2022
Review
Topics: Analgesics, Opioid; COVID-19; Female; Global Health; Health Policy; Humans; Male; North America; Opioid Epidemic; Opioid-Related Disorders; Pain; Practice Guidelines as Topic
PubMed: 35122753
DOI: 10.1016/S0140-6736(21)02252-2 -
International Journal of Environmental... Feb 2021We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in Spain due to the COVID-19 pandemic.
METHODS
A single-blind randomized controlled trial was designed. Thirty-four women with FM were randomized into two groups: TP group and Control group. The intervention lasted 15 weeks, with 2 sessions per week. The TP based on aerobic exercise was guided by video and the intensity of each session was monitored using the Borg scale. Pain intensity (Visual Analogue Scale), mechanical pain sensitivity (algometer), number of tender points, FM impact (Revised Fibromyalgia Impact Questionnaire), pain catastrophizing (Pain Catastrophizing Scale), physiological distress (Hospital Anxiety and Depression Scale), upper (Arm Curl Test) and lower-limb physical function (6-min Walk Test) were measured at baseline and after the intervention.
RESULTS
The TP group improved pain intensity ( = 0.022), mechanical pain sensitivity ( < 0.05), and psychological distress ( = 0.005), compared to the Control group. The Control group showed no statistically significant changes in any variable ( > 0.05).
CONCLUSIONS
A TP based on aerobic exercise achieved improvements on pain intensity, mechanical pain sensitivity, and psychological distress compared to a Control group during the lockdown declared in Spain due to COVID-19 pandemic.
Topics: Adult; COVID-19; Exercise Therapy; Female; Fibromyalgia; Humans; Middle Aged; Pandemics; Single-Blind Method; Spain; Telerehabilitation; Treatment Outcome
PubMed: 33672691
DOI: 10.3390/ijerph18042075