-
The Journal of Orthopaedic and Sports... Mar 2017Study Design Systematic review and meta-analysis. Background An increasing number of physical therapists in the United States and throughout the world are using dry... (Meta-Analysis)
Meta-Analysis Review
Study Design Systematic review and meta-analysis. Background An increasing number of physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain. Objective To examine the short- and long-term effectiveness of dry needling delivered by a physical therapist for any musculoskeletal pain condition. Methods Electronic databases were searched. Eligible randomized controlled trials included those with human subjects who had musculoskeletal conditions that were treated with dry needling performed by a physical therapist, compared with a control or other intervention. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. Results The initial search returned 218 articles. After screening, 13 were included. Physiotherapy Evidence Database quality scale scores ranged from 4 to 9 (out of a maximum score of 10), with a median score of 7. Eight meta-analyses were performed. In the immediate to 12-week follow-up period, studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment. At 6 to 12 months, dry needling was favored for decreasing pain, but the treatment effect was not statistically significant. Dry needling, when compared to control/sham treatment, provides a statistically significant effect on functional outcomes, but not when compared to other treatments. Conclusion Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Evidence of long-term benefit of dry needling is currently lacking. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2017;47(3):133-149. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7096.
Topics: Acupuncture Therapy; Humans; Musculoskeletal Pain; Needles; Outcome Assessment, Health Care; Pain Management; Pain Measurement; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Trigger Points
PubMed: 28158962
DOI: 10.2519/jospt.2017.7096 -
Work (Reading, Mass.) 2023There is an increasing concern about musculoskeletal disorders (MSD), resulting from occupational health hazards among dentists. Dentists who are susceptible to... (Review)
Review
BACKGROUND
There is an increasing concern about musculoskeletal disorders (MSD), resulting from occupational health hazards among dentists. Dentists who are susceptible to occupational health hazards could develop cumulative trauma disorders, lead to absenteeism from work, loss of productivity and performance or even long-term disability.
OBJECTIVE
This study aims to determine the prevalence of musculoskeletal disorders among dentists, explore the risk factors and identify the ergonomic preventive measures for dental professionals.
METHODS
Articles published between 2008-2020 were searched in scientific databases (MEDLINE, PubMed, Scopus and Cochrane Library). The Critical Appraisal Skills Programme Systematic Review Checklist was used to assess the quality of the studies.
RESULTS
Eighteen studies were found to be suitable in the final review. Relevant data was extracted and summarized from the included studies. The annual prevalence of musculoskeletal disorders in any body site ranged between 68% and 100%. The most predominant regions for musculoskeletal disorders among dental professionals were identified to be the lower back (29% to 94.6%), shoulder (25% to 92.7%), and neck (26% to 92%). The most frequently reported risk factors of MSDs were the individual characteristic female gender (57.1%), followed by awkward working postures (50%), long working experience (50%) and being dental specialists (42.9%). Several preventive measures were identified as the most effective ways in preventing MSDs, the use of magnification (40%) and regular physical activity (40%).
CONCLUSIONS
This review reported a high prevalence of musculoskeletal disorders (MSD) among dentists. It critically updates and adds the latest evidence on occupational ergonomics among dentists.
Topics: Humans; Female; Dentists; Musculoskeletal Diseases; Ergonomics; Posture; Risk Factors; Occupational Diseases; Prevalence
PubMed: 36278379
DOI: 10.3233/WOR-211094 -
Journal of Pain and Symptom Management Aug 2004Skeletal muscle relaxants are a heterogeneous group of medications used to treat two different types of underlying conditions: spasticity from upper motor neuron... (Comparative Study)
Comparative Study Meta-Analysis Review
Skeletal muscle relaxants are a heterogeneous group of medications used to treat two different types of underlying conditions: spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions. Although widely used for these indications, there appear to be gaps in our understanding of the comparative efficacy and safety of different skeletal muscle relaxants. This systematic review summarizes and assesses the evidence for the comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions. Randomized trials (for comparative efficacy and adverse events) and observational studies (for adverse events only) that included oral medications classified as skeletal muscle relaxants by the FDA were sought using electronic databases, reference lists, and pharmaceutical company submissions. Searches were performed through January 2003. The validity of each included study was assessed using a data abstraction form and predefined criteria. An overall grade was allocated for the body of evidence for each key question. A total of 101 randomized trials were included in this review. No randomized trial was rated good quality, and there was little evidence of rigorous adverse event assessment in included trials or observational studies. There is fair evidence that baclofen, tizanidine, and dantrolene are effective compared to placebo in patients with spasticity (primarily multiple sclerosis). There is fair evidence that baclofen and tizanidine are roughly equivalent for efficacy in patients with spasticity, but insufficient evidence to determine the efficacy of dantrolene compared to baclofen or tizanidine. There is fair evidence that although the overall rate of adverse effects between tizanidine and baclofen is similar, tizanidine is associated with more dry mouth and baclofen with more weakness. There is fair evidence that cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine are effective compared to placebo in patients with musculoskeletal conditions (primarily acute back or neck pain). Cyclobenzaprine has been evaluated in the most clinical trials and has consistently been found to be effective. There is very limited or inconsistent data regarding the effectiveness of metaxalone, methocarbamol, chlorzoxazone, baclofen, or dantrolene compared to placebo in patients with musculoskeletal conditions. There is insufficient evidence to determine the relative efficacy or safety of cyclobenzaprine, carisoprodol, orphenadrine, tizanidine, metaxalone, methocarbamol, and chlorzoxazone. Dantrolene, and to a lesser degree chlorzoxazone, have been associated with rare serious hepatotoxicity.
Topics: Clinical Trials as Topic; Comorbidity; Evidence-Based Medicine; Humans; Motor Neuron Disease; Muscle Spasticity; Musculoskeletal Diseases; Neuromuscular Agents; Peripheral Nervous System Diseases; Treatment Outcome
PubMed: 15276195
DOI: 10.1016/j.jpainsymman.2004.05.002 -
Hong Kong Physiotherapy Journal :... Dec 2018The number of smartphone users is growing dramatically. Using the smartphone frequently forces the users to adopt an awkward posture leading to an increased risk of... (Review)
Review
The number of smartphone users is growing dramatically. Using the smartphone frequently forces the users to adopt an awkward posture leading to an increased risk of musculoskeletal disorders and pain. The objective of this study is to conduct a systematic review of studies that assess the effect of smartphone use on musculoskeletal disorders and pain. A systematic literature search of AMED, CINAHL, PubMed, Proquest, ScienceDirect using specific keywords relating to smartphone, musculoskeletal disorders and pain was conducted. Reference lists of related papers were searched for additional studies. Methodological quality was assessed by two independent reviewers using the modified Downs and Black checklist. From 639 reports identified from electronic databases, 11 were eligible to include in the review. One paper was found from the list of references and added to the review. The quality scores were rated as moderate. The results show that muscle activity of upper trapezius, erector spinae and the neck extensor muscles are increased as well as head flexion angle, head tilt angle and forward head shifting which increased during the smartphone use. Also, smartphone use in a sitting position seems to cause more shift in head-neck angle than in a standing position. Smartphone usage may contribute to musculoskeletal disorders. The findings of the included papers should be interpreted carefully in light of the issues highlighted by the moderate-quality assessment scores.
PubMed: 30930581
DOI: 10.1142/S1013702518300010 -
Physiotherapy Theory and Practice Jul 2016Systematic review of randomized control trials (RCTs) for the effectiveness of pain neuroscience education (PNE) on pain, function, disability, psychosocial factors,... (Review)
Review
OBJECTIVE
Systematic review of randomized control trials (RCTs) for the effectiveness of pain neuroscience education (PNE) on pain, function, disability, psychosocial factors, movement, and healthcare utilization in individuals with chronic musculoskeletal (MSK) pain.
DATA SOURCES
Systematic searches were conducted on 11 databases. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search.
STUDY SELECTION
All experimental RCTs evaluating the effect of PNE on chronic MSK pain were considered for inclusion. Additional Limitations: Studies published in English, published within the last 20 years, and patients older than 18 years. No limitations were set on specific outcome measures.
DATA EXTRACTION
Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach.
DATA SYNTHESIS
Study quality of the 13 RCTs used in this review was assessed by 2 reviewers using the PEDro scale. Narrative summary of results is provided for each study in relation to outcomes measurements and effectiveness.
CONCLUSIONS
Current evidence supports the use of PNE for chronic MSK disorders in reducing pain and improving patient knowledge of pain, improving function and lowering disability, reducing psychosocial factors, enhancing movement, and minimizing healthcare utilization.
Topics: Adolescent; Adult; Disability Evaluation; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Musculoskeletal Pain; Pain Management; Pain Measurement; Patient Education as Topic; Physical Therapy Modalities; Treatment Outcome; Young Adult
PubMed: 27351541
DOI: 10.1080/09593985.2016.1194646 -
Journal of Back and Musculoskeletal... 2023Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence... (Review)
Review
BACKGROUND
Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown.
OBJECTIVE
To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions.
METHODS
2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis.
RESULTS
The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low.
CONCLUSION
This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.
Topics: Humans; Acetaminophen; Cupping Therapy; Low Back Pain; Physical Therapy Modalities; Sports
PubMed: 35848010
DOI: 10.3233/BMR-210242 -
International Journal of Dental Hygiene Nov 2018Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk... (Review)
Review
OBJECTIVES
Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk factors. Proper seat selection and use of magnification loupes are promoted for their ergonomic benefits. The aim of this review was to evaluate the existing empirical evidence on the effect of the above interventions on (i) correction of poor posture and (ii) reduction in musculoskeletal pain.
METHODS
The review was conducted according to the PRISMA guidelines. The review protocol was registered with PROSPERO (CRD42017058580). The Medline via Ovid, CINHAL via EBSCO, Web of Science, OpenGrey and EThOS electronic databases were searched. Prospective experimental studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies.
RESULTS
Eight studies were included in the review. Four investigated the effect of loupes on posture and musculoskeletal pain, 4 the effect of the saddle seats on posture and one of the latter explored the combined effect of magnification and use of saddle seats on posture.
CONCLUSIONS
Based on a limited number of studies, the use of ergonomic saddle seats and dental loupes leads to improved working postures. The use of loupes appears to relieve shoulder, arm and hand pain. However, their effect on neck pain is scarce. None of the studies reported on the effect of the saddle seats on musculoskeletal pain. Future well-powered prospective longitudinal studies are deemed necessary to confirm the conclusions of this review.
Topics: Dental Hygienists; Dentists; Ergonomics; Humans; Lenses; Musculoskeletal Diseases; Occupational Diseases; Posture; Risk Factors; Sitting Position
PubMed: 29318741
DOI: 10.1111/idh.12327 -
British Journal of Sports Medicine Dec 2017Chronic musculoskeletal disorders are a prevalent and costly global health issue. A new form of exercise therapy focused on loading and resistance programmes that... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic musculoskeletal disorders are a prevalent and costly global health issue. A new form of exercise therapy focused on loading and resistance programmes that temporarily aggravates a patient's pain has been proposed. The object of this review was to compare the effect of exercises where pain is allowed/encouraged compared with non-painful exercises on pain, function or disability in patients with chronic musculoskeletal pain within randomised controlled trials.
METHODS
Two authors independently selected studies and appraised risk of bias. Methodological quality was evaluated using the Cochrane risk of bias tool, and the Grading of Recommendations Assessment system was used to evaluate the quality of evidence.
RESULTS
The literature search identified 9081 potentially eligible studies. Nine papers (from seven trials) with 385 participants met the inclusion criteria. There was short- term significant difference in pain, with moderate quality evidence for a small effect size of -0.27 (-0.54 to -0.05) in favour of painful exercises. For pain in the medium and long term, and function and disability in the short, medium and long term, there was no significant difference.
CONCLUSION
Protocols using painful exercises offer a small but significant benefit over pain-free exercises in the short term, with moderate quality of evidence. In the medium and long term there is no clear superiority of one treatment over another. Pain during therapeutic exercise for chronic musculoskeletal pain need not be a barrier to successful outcomes. Further research is warranted to fully evaluate the effectiveness of loading and resistance programmes into pain for chronic musculoskeletal disorders.
PROSPERO REGISTRATION
CRD42016038882.
Topics: Chronic Pain; Exercise Therapy; Humans; Musculoskeletal Pain; Randomized Controlled Trials as Topic
PubMed: 28596288
DOI: 10.1136/bjsports-2016-097383 -
International Journal of Dental Hygiene Aug 2009Musculoskeletal problems have become a significant issue for the profession of dentistry and dental hygiene. This review provides a detailed examination and discussion... (Review)
Review
Musculoskeletal problems have become a significant issue for the profession of dentistry and dental hygiene. This review provides a detailed examination and discussion regarding the prevalence of musculoskeletal disorders (MSD) in dental personnel and possible causative factors. All research studies or literature reviews, which have reported on the prevalence of musculoskeletal symptoms and/or potential risk factors for this problem in dentists, dental hygienists and dental students, were selected for inclusion. Our literature suggests that the prevalence of general musculoskeletal pain ranges between 64% and 93%. The most prevalent regions for pain in dentists have been shown to be the back (36.3-60.1%) and neck (19.8-85%), while the hand and wrist regions were the most prevalent regions for dental hygienists (60-69.5%). Interestingly, we found that studies on MSDs among dental and dental hygiene students are quite limited. Many risk factors have been identified, including static and awkward posture and work practices. Overall, the review suggests that musculoskeletal problems represent a significant burden for the dental profession. More research in the form of larger studies is urgently required, to help more clearly elucidate the development of this important issue for dental hygienists and dental hygiene students.
Topics: Arthralgia; Back Pain; Dental Hygienists; Dentists; Hand; Humans; Musculoskeletal Diseases; Neck Pain; Occupational Diseases; Pain; Prevalence; Risk Factors; Students, Dental; Wrist Joint
PubMed: 19659711
DOI: 10.1111/j.1601-5037.2009.00395.x -
International Journal of Environmental... May 2020Musculoskeletal diseases and pain (MSDs) are prevalent among dental professionals. They cause a growing inability to work and premature leaving of the occupation. Thus,...
Musculoskeletal diseases and pain (MSDs) are prevalent among dental professionals. They cause a growing inability to work and premature leaving of the occupation. Thus, the objective of this review was to summarize the evidence of ergonomic interventions for the prevention of MSDs among dental professionals. This review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was carried out in May 2018, with an update in April 2019. Scientific databases such as MEDLINE, CINAHL, PubMed and Web of Science as well as reference lists of the included studies were used. Relevant data were extracted from the studies and summarized. The quality assessment was performed using a validated standardized instrument. Eleven studies were included in this review, of which four are of high quality. Eight studies focused on setting prevention strategies. Of those, in five studies, magnification loupes or prismatic spectacles were the subject of ergonomic interventions. Further subjects were the dental chair ( = 2) and dental instruments ( = 1). Three studies evaluated ergonomic training. In all studies, the ergonomic interventions had positive effects on the study outcome. Several ergonomic interventions to prevent MSDs among dental professionals were found to exert a positive effect on the prevalence of MSDs or working posture. This systematic review adds current evidence for the use of prismatic spectacles in order to prevent MSDs among dental professionals. Further intervention studies about the role of ergonomics for the prevention of MSDs among dental professionals are warranted.
Topics: Dentists; Ergonomics; Humans; Musculoskeletal Diseases; Occupational Diseases; Pain; Posture
PubMed: 32429439
DOI: 10.3390/ijerph17103482