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International Journal of Gynaecology... Jun 2024
Letter to the Editor: Efficacy and safety of fezolinetant for vasomotor symptoms in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials.
PubMed: 38881190
DOI: 10.1002/ijgo.15740 -
Journal of Foot and Ankle Research Jun 2024The objective of this systematic review is to determine the benefits and harms of heel lifts to any comparator for lower limb musculoskeletal conditions. (Review)
Review
INTRODUCTION
The objective of this systematic review is to determine the benefits and harms of heel lifts to any comparator for lower limb musculoskeletal conditions.
METHODS
Ovid MEDLINE, Ovid AMED, Ovid EMCARE, CINAHL Plus and SPORTDiscus were searched from inception to the end of May 2024. Randomised, quasi-randomised or non-randomised trials comparing heel lifts to any other intervention or no-treatment were eligible for inclusion. Data was extracted for the outcomes of pain, disability/function, participation, participant rating of overall condition, quality of life, composite measures and adverse events. Two authors independently assessed risk of bias and certainty of evidence using the GRADE approach at the primary time point 12 weeks (or next closest).
RESULTS
Eight trials (n = 903), investigating mid-portion Achilles tendinopathy, calcaneal apophysitis and plantar heel pain were included. Heel lifts were compared to exercise, ultrasound, cryotherapy orthotics, stretching, footwear, activity modification, felt pads and analgesic medication. No outcome was at low risk of bias and few effects (2 out of 47) were clinically important. Low-certainty evidence (1 trial, n = 199) indicates improved pain relief (55.7 points [95% CI: 50.3-61.1], on a 100 mm visual analogue scale) with custom orthotics compared to heel lifts at 12 weeks for calcaneal apophysitis. Very low-certainty evidence (1 trial, n = 62) indicates improved pain and function with heel lifts over indomethacin (35.5 points [95% CI: 21.1-49.9], Foot Function Index) at 12 months for plantar heel pain.
CONCLUSIONS
Few trials have assessed the benefits and harms of heel lifts for lower limb musculoskeletal conditions. Only two outcomes out of 47 showed clinically meaningful between group differences. However, due to very low to low certainty evidence we are unable to be confident in the results and the true effect may be substantially different.
REGISTRATION
PROSPERO registration number CRD42022309644.
Topics: Humans; Heel; Treatment Outcome; Musculoskeletal Diseases; Male; Female; Lower Extremity; Randomized Controlled Trials as Topic; Pain Measurement; Tendinopathy; Adult
PubMed: 38878299
DOI: 10.1002/jfa2.12031 -
Journal of Bodywork and Movement... Jul 2024The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function,... (Review)
Review
INTRODUCTION
The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.
OBJECTIVES
This systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.
METHODS
Web of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.
RESULTS
Age, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.
CONCLUSION
This is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk.
Topics: Humans; Upper Extremity; Postural Balance; Male; Age Factors; Sex Factors; Female; Athletic Injuries; Adult; Athletes; Muscle Strength; Fatigue; Sports
PubMed: 38876624
DOI: 10.1016/j.jbmt.2024.02.043 -
Environmental Research Jun 2024Nature-based interventions (NBIs) are activities, strategies, or programs taking place in natural settings, such as exercising in greenspaces, to improve the health and... (Review)
Review
Nature-based interventions (NBIs) are activities, strategies, or programs taking place in natural settings, such as exercising in greenspaces, to improve the health and well-being of people by integrating the benefits of nature exposure with healthy behaviours. Current reviews on NBIs do not report the effects on different groups of physical health conditions. The purpose of this systematic review and meta-analysis was to identify and synthesize the evidence of the effect of NBIs on physical health outcomes and biomarkers of physical health conditions. Overall, 20,201 studies were identified through searching MEDLINE, Embase, CINAHL, SPORTDiscus, and CENTRAL databases up to June 7, 2024. Inclusion criteria were: 1) randomized controlled intervention studies; 2) population with a physical health condition; 3) NBIs vs. different intervention or no intervention; and 4) measuring physical health outcomes and/or biomarkers. Twenty-six studies were included in the review, 15 of which contributed to the meta-analysis. Compared to control groups, NBIs groups showed significant improvements in: diastolic blood pressure (MD -3.73 mmHg [-7.46 to -0.00], I = 62%) and heart rate (MD -7.44 bpm [-14.81 to -0.06], I = 0%) for cardiovascular conditions, fatigue (SMD -0.50 [-0.82 to -0.18], I = 16%) for central nervous system conditions, and body fat percentage (MD -3.61% [-5.05 to -2.17], I = 0%) for endocrine conditions. High effect heterogeneity was found in several analyses and the included studies had moderate-to-high risk of bias (RoB). The non-significant outcomes showed a direction of effect in favour of NBI groups for cardiovascular, central nervous system, endocrine, musculoskeletal, and respiratory conditions. This review found some beneficial effects in favour of NBIs for health outcomes in at least three condition groups though RoB and inconsistent effects limited some interpretations. NBIs are promising therapies that healthcare professionals can consider integrating into clinical practice.
PubMed: 38876421
DOI: 10.1016/j.envres.2024.119421 -
European Journal of Sport Science Jun 2024We aimed to assess the effects of muscle disuse on muscle strength (MS), muscle mass (MM) and cardiovascular fitness. Databases were scrutinized to identify human... (Meta-Analysis)
Meta-Analysis Review
We aimed to assess the effects of muscle disuse on muscle strength (MS), muscle mass (MM) and cardiovascular fitness. Databases were scrutinized to identify human studies assessing the effects of muscle disuse on both (1) MM and (2) maximal oxygen uptake (VO) and/or MS. Random-effects meta-analysis and meta-regression with initial physical fitness and length of the protocol as a priori determined moderators were performed. We quantitatively analyzed 51 different studies, and the level of significance was set at p < 0.05. Data from the participants in 14 studies showed a decline in both VO (SMD: -0.93; 95% CI: -1.27 to -0.58) and MM (SMD: -0.34; 95% CI: -0.57 to -0.10). Data from 47 studies showed a decline in strength (-0.88; 95% CI: -1.04 to -0.73) and mass (SMD: -0.47; 95% CI: -0.58 to -0.36). MS loss was twice as high as MM loss, but differences existed between anatomical regions. Notably, meta-regression analysis revealed that initial MS was inversely associated with MS decline. VO and MS decline to a higher extent than MM during muscle disuse. We reported a more profound strength loss in subjects with high muscular strength. This is physiologically relevant for athletes because their required muscular strength can profoundly decline during a period of muscle disuse. It should however be noted that a period of muscle disuse can have devastating consequences in old subjects with low muscular strength.
Topics: Humans; Muscle, Skeletal; Muscle Strength; Oxygen Consumption; Cardiorespiratory Fitness
PubMed: 38874988
DOI: 10.1002/ejsc.12093 -
Chiropractic & Manual Therapies Jun 2024To assess the concurrent validity and inter-rater agreement of the diagnosis of musculoskeletal (MSK) conditions using synchronous telehealth compared to standard... (Review)
Review
OBJECTIVES
To assess the concurrent validity and inter-rater agreement of the diagnosis of musculoskeletal (MSK) conditions using synchronous telehealth compared to standard in-person clinical diagnosis.
METHODS
We searched five electronic databases for cross-sectional studies published in English in peer-reviewed journals from inception to 28 September 2023. We included studies of participants presenting to a healthcare provider with an undiagnosed MSK complaint. Eligible studies were critically appraised using the QUADAS-2 and QAREL criteria. Studies rated as overall low risk of bias were synthesized descriptively following best-evidence synthesis principles.
RESULTS
We retrieved 6835 records and 16 full-text articles. Nine studies and 321 patients were included. Participants had MSK conditions involving the shoulder, elbow, low back, knee, lower limb, ankle, and multiple conditions. Comparing telehealth versus in-person clinical assessments, inter-rater agreement ranged from 40.7% agreement for people with shoulder pain to 100% agreement for people with lower limb MSK disorders. Concurrent validity ranged from 36% agreement for people with elbow pain to 95.1% agreement for people with lower limb MSK conditions.
DISCUSSION
In cases when access to in-person care is constrained, our study implies that telehealth might be a feasible approach for the diagnosis of MSK conditions. These conclusions are based on small cross-sectional studies carried out by similar research teams with similar participant demographics. Additional research is required to improve the diagnostic precision of telehealth evaluations across a larger range of patient groups, MSK conditions, and diagnostic accuracy statistics.
Topics: Humans; Musculoskeletal Diseases; Telemedicine; Reproducibility of Results; Cross-Sectional Studies
PubMed: 38872176
DOI: 10.1186/s12998-024-00542-3 -
International Journal of Paediatric... Jun 2024Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients. (Review)
Review
BACKGROUND
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients.
AIM
The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA.
DESIGN
PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome.
RESULTS
Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra-articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis.
CONCLUSION
Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted.
PubMed: 38863137
DOI: 10.1111/ipd.13225 -
The Surgeon : Journal of the Royal... Jun 2024Surgeons are expected to work long hours in operating theatres. A high prevalence of work-related musculoskeletal (WRMSK) injuries and pain in healthcare professions... (Review)
Review
INTRODUCTION
Surgeons are expected to work long hours in operating theatres. A high prevalence of work-related musculoskeletal (WRMSK) injuries and pain in healthcare professions exists. We aimed to study WRMSK pain and injuries in general surgeons and study their risk in different surgical techniques comprising open, laparoscopic and robotic-assisted surgery.
METHODS
A systematic search was performed in compliance with The PRISMA checklist. Search was performed in PubMed and Cochrane library databases for 6 years to 2024. The search terms used were "disability and surgeon", "occupational injuries and surgeon", and "musculoskeletal pain and surgeons", in addition to MESH terms in PubMed database. Risk of bias was calculated among studies.
RESULTS
The search revealed 3648 citations from which a final list of 24 citations were included after application of inclusion and exclusion criteria. The citations comprised over 1900 surgeons including consultants and surgical trainees from different subspecialities. Incorporated citations consisted of 21 cross-sectional 3 observational studies. Most common pain sites, risks and preventative measure for MSK injuries were revealed.
CONCLUSION
There is high prevalence of WRMSK pain among general surgeons. Surgeons were primarily affected at physical body parts ranging from the neck, shoulders, upper back and lower back to upper extremity. Robotic-assisted surgery led to lower post-operative discomfort and decreased demanding muscle activity in upper extremities but enhanced static neck position resulting in subjective back stiffness compared with laparoscopic surgery.
PubMed: 38862375
DOI: 10.1016/j.surge.2024.05.001 -
Musculoskeletal Care Jun 2024The use of diagnostic imaging in low back pain (LBP) management is often inappropriate, despite recommendations from clinical practice guidelines. There is a limited... (Review)
Review
BACKGROUND
The use of diagnostic imaging in low back pain (LBP) management is often inappropriate, despite recommendations from clinical practice guidelines. There is a limited understanding of factors that influence the imaging clinical decision-making (CDM) process.
AIM
Explore the literature on factors influencing imaging CDM for people with LBP and consider how these findings could be used to reduce inappropriate use of imaging in LBP management.
DESIGN
Scoping review.
METHOD
This review followed the Preferred Reporting Items for Systematic Review extension for scoping reviews. A digital search was conducted in Medline, the Cumulative Index of Nursing and Allied Health Literature, Scopus, and the Cochrane Central Register of Controlled Trials for eligible studies published between January 2010-2023. Data reporting influences on imaging CDM were extracted. Data were then analysed through an inductive process to group the influencing factors into categories.
RESULTS
After screening, 35 studies (5 qualitative and 30 quantitative) were included in the review, which reported factors influencing imaging CDM. Three categories were developed: clinical features (such as red flags, pain, and neurological deficit), non-modifiable factors (such as age, sex, and ethnicity) and modifiable factors (such as beliefs about consequences and clinical practice). Most studies reported non-modifiable factors.
CONCLUSIONS
The results of this scoping review challenge the perception that imaging CDM is purely based on clinical history and objective findings. There is a complex interplay between clinical features, patient and clinician characteristics, beliefs, and environment. These findings should be considered when designing strategies to address inappropriate imaging behaviour.
Topics: Humans; Low Back Pain; Clinical Decision-Making; Diagnostic Imaging
PubMed: 38862275
DOI: 10.1002/msc.1898 -
Neuroscience and Biobehavioral Reviews Jun 2024The aim of this study was to assess the moderator effect of the target concepts covered in the Pain science education (PSE) sessions, including both the total amount of... (Review)
Review
How do the target concepts of pain science education combined with exercise contribute to the effect on pain intensity and disability in patients with chronic spinal pain? A systematic review and meta-analysis with moderator analysis.
The aim of this study was to assess the moderator effect of the target concepts covered in the Pain science education (PSE) sessions, including both the total amount of target concepts and each individual target concept, on changes in pain intensity and disability in patients with chronic spinal pain (CSP). A systematic search of PubMed, Scopus, Embase, Web of Science and CENTRAL was conducted from inception to March 10, 2024. A random effects model was used for meta-regression analysis. A total of 11 studies were included. The total amount of target concepts of PSE showed a significant correlation with changes in pain intensity (k=11; F=4.45; p=0.04; R=26.07 %). In terms of each target content, only a significant effect on pain intensity was obtained for 'transfer knowledge about pain to an adaptive behavioural change' (z=-2.35, P =0.019, 95 %CI -3.42 to -0.31) and 'reconceptualization of pain' (z=-2.43, P =0.015, 95 %CI -3.70 to -0.39). No significant effect on disability was found. These results may be useful for optimising the effectiveness of PSE programmes.
PubMed: 38852291
DOI: 10.1016/j.neubiorev.2024.105740