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Clinical Biomechanics (Bristol, Avon) Aug 2023Although impairments in dorso-lumbar spine mobility have been previously reported in patients with low back pain, its exact mechanism is not yet clear. Therefore, the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although impairments in dorso-lumbar spine mobility have been previously reported in patients with low back pain, its exact mechanism is not yet clear. Therefore, the purpose of this systematic review and meta-analysis is to investigate and compare spinal kinematics between subjects with and without low back pain and identify appropriate tools to evaluate it.
METHODS
The PubMed, Scopus and Web of Science databases were searched for relevant literature. The search strategy was mainly focused on studies investigating lumbar kinematics in subjects with and without low back pain during clinical functional tests, gait, sports and daily functional activities. Papers were selected if at least one of these outputs was reported: lumbar range of motion, lumbar velocity, lumbar acceleration and deceleration, lordosis angle or lumbar excursion.
FINDINGS
Among 804 papers, 48 met the review eligibility criteria and 29 were eligible to perform a meta-analysis. Lumbar range of motion was the primary outcome measured. A statistically significant limitation of the lumbar mobility was found in low back pain group in all planes, and in the frontal and transverse planes for thoracic range of motion, but there is no significant limitation for pelvic mobility. The amount of limitation was found to be more important in the lumbar sagittal plane and during challenging functional activities in comparison with simple activities.
INTERPRETATION
The findings of this review provide insight into the impact of low back pain on spinal kinematics during specific movements, contributing to our understanding of this relationship and suggesting potential clinical implications.
Topics: Humans; Biomechanical Phenomena; Low Back Pain; Spine
PubMed: 37595368
DOI: 10.1016/j.clinbiomech.2023.106070 -
Journal of Oral Rehabilitation Oct 2023Orthognathic surgery is done to treat a variety of dentofacial abnormalities, but a wide gap still remains on how it can result in temporomandibular joint dysfunction... (Review)
Review
Prevalence of Temporomandibular Disorders in Orthognathic Surgery patients: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.
BACKGROUND
Orthognathic surgery is done to treat a variety of dentofacial abnormalities, but a wide gap still remains on how it can result in temporomandibular joint dysfunction (TMD). The primary goal of this review was to assess the effects of various orthognathic surgical techniques on the emergence or exacerbation of TMJ dysfunction.
METHODS
A comprehensive search was conducted across several databases using Boolean operators and MeSH keywords related to temporomandibular joint disorders (TMDs) and orthognathic surgical interventions, with no limitation on the year of publication. Two independent reviewers screened the identified studies based on predetermined inclusion and exclusion criteria, followed by a risk of bias assessment using a standardised tool.
RESULTS
Five articles were considered for inclusion in this review. A greater number of females opted for surgical options than their male cohorts. Three studies were of prospective design, 1 of retrospective and 1 of observational type. Mobility on lateral excursion, tenderness on palpation, arthralgia and popping sounds were the TMD characteristics that showed significant differences. Overall, orthognathic surgical intervention did not show an increase in TMD signs and symptoms as compared to nonsurgical counterparts.
CONCLUSION
Though orthognathic surgery reported greater cases of some TMD symptoms and signs as compared to the nonsurgical cohorts in four studies, the conclusive evidence is debatable. Further studies are recommended with a longer follow-up period and greater sample size to determine the impact of orthognathic surgery on TMJ.
Topics: Female; Humans; Male; Orthognathic Surgery; Retrospective Studies; Prevalence; Temporomandibular Joint Disorders; Orthognathic Surgical Procedures; Temporomandibular Joint Dysfunction Syndrome
PubMed: 37309105
DOI: 10.1111/joor.13534 -
BMJ Open Jun 2023The aim of this review was to identify the potential intrinsic and extrinsic risk factors (RFs), associated factors (AFs) and consequences of developing calcaneal...
OBJECTIVES
The aim of this review was to identify the potential intrinsic and extrinsic risk factors (RFs), associated factors (AFs) and consequences of developing calcaneal apophysitis (CA).
DESIGN
Systematic review.
DATA SOURCES
Cochrane Library, Embase, Medline Ovid, PubMed, Web of Science and Evidence, searched from inception to April 2021.
ELIGIBILITY CRITERIA
We included cohort, case-control and cross-sectional studies that were conducted in patients younger than 18 years who were exposed to RFs or who presented with factors associated with developing CA. Studies in languages other than English or Spanish were excluded.
DATA EXTRACTION AND SYNTHESIS
Two reviewers worked independently to evaluate the risk of bias of included studies. The Newcastle-Ottawa Scale (adapted version) was used.
RESULTS
A total of 736 studies were identified and 11 observational studies fully met the inclusion criteria, including 1265 participants with a mean age of 10.72 years. Four studies identified extrinsic factors, 10 identified intrinsic factors and three identified both. The extrinsic and intrinsic RFs, AFs and consequences of CA include limitation of ankle dorsiflexion, foot alignment, stiffness and mobility of the midfoot, plantar pressures and ground reaction force, body mass index, age, gender, presence of other osteochondroses and practice of sport. The risk of bias varied, being either moderate or low.
CONCLUSIONS
Regarding the factors and consequences associated with CA (Sever's disease), ankle dorsiflexion limitation is the most frequent intrinsic factor studied, followed by peak plantar pressures and foot malalignment. However, disagreements between the investigators of the included studies were found; in some cases, there is a lack of unanimity between different studies as to which factors are considered to be RFs, AFs and consequences.
PROSPERO REGISTRATION NUMBER
CRD42021246366.
Topics: Humans; Child; Calcaneus; Cross-Sectional Studies; Foot; Foot Diseases; Risk Factors; Osteitis
PubMed: 37280033
DOI: 10.1136/bmjopen-2022-064903 -
Neuroscience and Biobehavioral Reviews Jul 2023The difficulty in assessing FOG and the variety of existing cues, hamper to determine which cueing modality should be applied and which FOG-related aspect should be... (Meta-Analysis)
Meta-Analysis Review
The difficulty in assessing FOG and the variety of existing cues, hamper to determine which cueing modality should be applied and which FOG-related aspect should be targeted to reach personalized treatments for FOG. This systematic review aimed to highlight: i) whether cues could reduce FOG and improve FOG-related gait parameters, ii) which cues are the most effective, iii) whether medication state (ON-OFF) affects cues-related results. Thirty-three repeated measure design studies assessing cueing effectiveness were included and subdivided according to gait tasks (gait initiation, walking, turning) and to the medication state. Main results reveal that: preparatory phase of gait initiation benefit from visual and auditory cues; spatio-temporal parameters (e.g., step and stride length) are improved by visual cues during walking; turning time and step time variability are reduced by applying auditory and visual cues. Some findings on the potential benefits of cueing on FOG and FOG gait-related parameters were found. Questions remain about which are the best behavioral strategies according to FOG features and PD clinical characteristics.
Topics: Humans; Parkinson Disease; Cues; Gait Disorders, Neurologic; Gait; Walking
PubMed: 37086934
DOI: 10.1016/j.neubiorev.2023.105189 -
Innovation in Aging 2023This review aimed to summarize the association between cognitive frailty (presence of frailty and cognitive impairment) and the risk of disabilities in activities of... (Review)
Review
BACKGROUND AND OBJECTIVES
This review aimed to summarize the association between cognitive frailty (presence of frailty and cognitive impairment) and the risk of disabilities in activities of daily living (ADL), instrumental ADL (IADL), mobility, or other functional disabilities among older adults.
RESEARCH DESIGN AND METHODS
PubMed, Embase, CINAHL Plus, and PsycINFO were searched from January 2001 to May 14, 2022, for observational studies that reported cognitive frailty among community-dwelling individuals aged 60 years and above. Results were narratively synthesized.
RESULTS
Eleven studies encompassing 44 798 participants were included, with a prevalence of cognitive frailty ranging from 1.4% to 39.3%. Individuals with cognitive frailty were more likely to develop disabilities in ADL and IADL compared to robust (absence of frailty and cognitive impairment) individuals. Significant disability burden and elevated risk of combined ADL/IADL disability or physical limitation among participants with cognitive frailty were reported. There was limited evidence on the association between cognitive frailty and mobility disability.
DISCUSSION AND IMPLICATIONS
Individuals with cognitive frailty were likely at higher risk of developing functional disability and incurring higher disability burden than robust individuals, but evidence remains limited for those with prefrailty with cognitive impairment. Further research on this gap and standardization of cognitive frailty assessments would facilitate comparisons across populations.
PROSPERO REGISTRATION
CRD42021232222.
PubMed: 36908650
DOI: 10.1093/geroni/igad005 -
Clinical Rheumatology Jul 2023The objective of this systematic review and meta-analysis is to clarify the effect of exercise therapy on the first peak knee adduction moment (KAM), as well as other... (Meta-Analysis)
Meta-Analysis Review
The objective of this systematic review and meta-analysis is to clarify the effect of exercise therapy on the first peak knee adduction moment (KAM), as well as other biomechanical loads in patients with knee osteoarthritis (OA), and identify physical characteristics that influence differences in biomechanical load after exercise therapy. The data sources are PubMed, PEDro, and CINAHL, from study inception to May 2021. The eligibility criteria include studies evaluating the first peak (KAM), peak knee flexion moment (KFM), maximal knee joint compression force (KCF), or co-contraction during walking before and after exercise therapy in patients with knee OA. The risk of bias was independently assessed by two reviewers using PEDro and NIH scales. Among 11 RCTs and nine non-RCTs, 1119 patients with knee OA were included (average age: 63.7 years). As the results of meta-analysis, exercise therapy tended to increase the first peak KAM (SMD 0.11; 95% CI: -0.03-0.24), peak KFM (SMD 0.13; 95% CI: -0.03-0.29), and maximal KCF (SMD 0.09; 95% CI -0.05-0.22). An increased first peak KAM was significantly associated with a larger improvement in knee muscle strength and WOMAC pain. However, the quality of evidence regarding the biomechanical loads was low-to-moderate according to the GRADE approach. The improvement in pain and knee muscle strength may mediate the increase in first peak KAM, suggesting difficulty in balancing symptom relief and biomechanical load reduction. Therefore, exercise therapy may satisfy both aspects simultaneously when combined with biomechanical interventions, such as a valgus knee brace or insoles. Registration: PROSPERO (CRD42021230966).
Topics: Humans; Middle Aged; Osteoarthritis, Knee; Knee Joint; Walking; Exercise Therapy; Pain; Biomechanical Phenomena; Gait
PubMed: 36879173
DOI: 10.1007/s10067-023-06553-4 -
Journal of Back and Musculoskeletal... 2023Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain.
OBJECTIVE
This study aimed to evaluate the effects of ischemic compression on the myofascial trigger points for improving neck pain-related symptoms (mainly pain, joint mobility limitation and function limitation) and to compare ischemic compression with other therapies.
METHODS
Electronic searches were conducted in PubMed, OVID, Web of Science, EBSCO, SCOUPS, Cochrane Library, PEDro, Wanfang, CNKI and Chinese VIP Database in June 2021. Only randomised controlled trials on the effects of ischemic compression on neck pain were included. The major outcomes were pain intensity, pressure pain threshold, pain-related disability and range of motion.
RESULTS
Fifteen studies involving 725 participants were included. Significant differences were observed between ischemic compression and sham/no treatment group in pain intensity, pressure pain threshold and range of motion immediately and in the short term. Significant effect sizes of dry needling were observed over ischemic compression in terms of improving pain intensity (SMD = 0.62; 95% CI: 0.08 to 1.16; P= 0.02), pain-related disability (SMD = 0.68; 95% CI: 0.19 to 1.17; P= 0.007) and range of motion (MD =-2.12; 95% CI: -2.59 to -1.65; P< 0.001) immediately after treatment. Dry needling also showed a significant small effect size for the short-term reduction of pain (SMD = 0.44; 95% CI: 0.04 to 0.85; P= 0.03).
CONCLUSION
Ischemic compression can be recommended in the immediate and short-term pain relief and increase in the pressure pain threshold and range of motion. Dry needling is superior to ischemic compression in relieving pain and improving pain-related disability and range of motion immediately after treatment.
Topics: Humans; Trigger Points; Neck Pain; Myofascial Pain Syndromes; Dry Needling; Pain Threshold
PubMed: 36872769
DOI: 10.3233/BMR-220045 -
Journal of Clinical Medicine Feb 2023This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more... (Review)
Review
This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12-20% lower Helkimo index, and 5-17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction.
PubMed: 36836198
DOI: 10.3390/jcm12041664 -
Gait & Posture Feb 2023Trips and slips increase fall risk for young and older adults. To examine recovery responses, studies utilized treadmill and/or over-ground methods to simulate... (Review)
Review
BACKGROUND
Trips and slips increase fall risk for young and older adults. To examine recovery responses, studies utilized treadmill and/or over-ground methods to simulate real-world perturbations. However, differences in the recovery response between treadmill and over-ground perturbations remain unexamined.
RESEARCH QUESTION
To assess the current literature on the reactive recovery responses between over-ground- and split-belt treadmill trips and slips as well as the effect of aging on these responses.
METHODS
PubMed, Medline, Web of Science, SCOPUS, and Cochrane databases were searched for publications examining trips and slips in healthy young, healthy older adults, and older adults who fall. Included articles were in English, full-text accessible, and biomechanically quantified the reactive recovery responses for slips and trips during either over-ground or split-belt treadmill protocols. The initial database search yielded 1075 articles and 31 articles were included after title, abstract, and full-text screening.
RESULTS
For slips, 7 articles utilized lubricated surfaces while 5 articles used treadmills. Further, 3 studies examined differences between older and younger adults. For trips, 9 articles utilized obstacles and 7 used treadmills. Further, 4 articles examined differences between older and young adults and 1 article only examined older adults during over-ground trips. For both perturbations, treadmill and over-ground protocols demonstrated similar anteroposterior destabilization on the center of mass. In the mediolateral direction, over-ground slips consistently found a lateral destabilization while treadmill articles did not examine this direction. Foot placement recovery responses varied less for both perturbation directions on a treadmill compared to over-ground.
SIGNIFICANCE
Although treadmill and over-ground perturbations destabilize the center of mass similarly, the recovery response to these perturbations were different on treadmills. Specifically, recovery responses were more consistent for both slips and trips on treadmills. As older adults have difficulty in perturbation recovery scaling, treadmills may be limited in their ability to investigate the variety of aging impairments on perturbation recovery responses.
Topics: Young Adult; Humans; Aged; Postural Balance; Aging; Foot; Exercise Test; Walking; Gait
PubMed: 36603326
DOI: 10.1016/j.gaitpost.2022.12.015 -
Journal of Clinical Neuroscience :... Jan 2023Understanding gait alterations immediately post-concussion can improve identification, management and prognosis of concussion. (Review)
Review
BACKGROUND
Understanding gait alterations immediately post-concussion can improve identification, management and prognosis of concussion.
OBJECTIVE
To identify and define gait characteristics immediately post-concussion.
METHOD
A review of electronic databases was conducted using terms gait alteration AND mTBI OR concussion. 172 reports were identified. After restricting to English and human studies, 158 remained. Reports were screened to include studies assessing quantifiable gait change post-concussion. 12 studies were included.
DISCUSSION
Multiple gait features are altered post-impact: stability, step length, walking speed and postural control. There is evidence that postural measures in gait initiation and termination may identify more subtle deficits. There is paucity of data evaluating the impact of concussion on gait function acutely and the authors identified no studies examining immediate changes.
CONCLUSION
Acutely post-concussion, various gait alterations are seen and correlate with degree of deficit and prognosis. Slowed gait, instability and postural control are several features. Dynamic gait and postural assessments identify more subtle gait alterations. Given the absence in literature, high quality prospective studies examining immediate gait alterations post-concussion would contribute to improved assessment, management and prognostication. Given difficulty in participant recruitment, technological and standardised gait assessments should be used to assess force of impact and immediate gait alteration.
Topics: Humans; Prospective Studies; Brain Concussion; Gait; Prognosis; Postural Balance; Post-Concussion Syndrome
PubMed: 36462967
DOI: 10.1016/j.jocn.2022.11.005