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Nutrients Apr 2024Hip fracture is a common condition in older adults, leading to disability and mortality. Several studies have demonstrated the association between nutritional status and... (Meta-Analysis)
Meta-Analysis Review
Hip fracture is a common condition in older adults, leading to disability and mortality. Several studies have demonstrated the association between nutritional status and the risk of a negative health outcome after fractures. In this systematic review, we evaluated the association between malnutrition and mortality, changes in mobility/living arrangements, and postoperative complications, such as delirium, in older patients with hip fractures. A literature search on the PubMed, Web of Science, and Scopus databases, up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR, OR, and HR) extracted from the 14 eligible selected studies. Malnutrition significantly increased the risk of any analyzed adverse outcome by 70% at 1 month, and up to 250% at 1 year. Malnutrition significantly increased delirium risk by 275% (OR = 2.75; 95% CI 1.80-4.18; ≤ 0.05), mortality risk by 342% (OR = 3.42; 95% CI 2.14-5.48; ≤ 0.05), mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; ≤ 0.05) at 1 month, and transfer-to-more-supported-living-arrangements risk by 218% (OR = 2.18; 95% CI 1.58-3.01; ≤ 0.05), and declined mobility risk by 41% (OR = 1.41; 95% CI 1.14-1.75; ≤ 0.05), mortality risk by 368% (OR = 3.68; 95% CI 3.00-4.52; ≤ 0.05), and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; ≤ 0.05) at 1 year. Malnutrition of older patients increases the risk of death and worsens mobility and independence after hip fractures. The results of the present study highlight the importance of nutritional status evaluation of older subjects with hip fractures in order to prevent potential adverse outcomes (Registration No: CRD42023468751).
Topics: Humans; Aged; Hip Fractures; Malnutrition; Nutritional Status; Outcome Assessment, Health Care; Delirium
PubMed: 38613102
DOI: 10.3390/nu16071069 -
Journal of Clinical Medicine Dec 2023This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in... (Review)
Review
This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure.
PubMed: 38202113
DOI: 10.3390/jcm13010106 -
Gait & Posture Feb 2024Information on determinants of patient-reported functional mobility is lacking but would inform the planning of healthcare, resources and strategies to promote... (Review)
Review
BACKGROUND
Information on determinants of patient-reported functional mobility is lacking but would inform the planning of healthcare, resources and strategies to promote functional mobility in people with Parkinson's disease (PD).
RESEARCH QUESTION
To identify the determinants of patient-reported functional mobility of people with PD.
METHODS
Eligible: Randomized Controlled Trials, cohort, case-control, or cross-sectional analyses in people PD without date or setting restrictions, published in English, German, or French. Excluded: instruments with under 50 % of items measuring mobility. On August 9th 2023 we last searched Medline, CINAHL and PsychInfo. We assessed risk of bias using the mixed-methods appraisal tool. Results were synthesized by tabulating the determinants by outcomes and study designs.
RESULTS
Eleven studies published 2012-2023 were included (most in Swedish outpatient settings). Samples ranged from 9 to 255 participants. Follow-up varied from 1.5 to 36 months with attrition of 15-42 %. Heterogenic study designs complicated results synthesis. However, determinants related to environment seem to associate the strongest with patient-reported functional mobility, although determinants related to body structures and functions were most investigated. We identified disease duration, the ability to drive, caregiving, sex, age, cognitive impairment, postural instability and social participation as determinants of patient-reported functional mobility.
DISCUSSION
Methodological quality of the studies was limited. No study reported an a priori power calculation. Three studies controlled for confounders. The included studies lack representativeness of the population of people living with PD. Standardized sets of outcomes could enable more systematic research synthesis.
CONCLUSIONS
Future research should focus on activities, participation and environmental factors and improve methodological quality.
Topics: Humans; Parkinson Disease; Cross-Sectional Studies; Delivery of Health Care; Cognitive Dysfunction; Patient Reported Outcome Measures
PubMed: 38029483
DOI: 10.1016/j.gaitpost.2023.11.013 -
Systematic Reviews Sep 2023We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies...
We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies because walking surfaces are poorly defined and underspecified. We conducted a systematic review of 384 studies from 370 articles that tested how different surfaces influenced human walking and falling. For each study, we report which categories of surfaces were used (indoor, outdoor, treadmill, virtual reality and qualitative), the nature of each surface (stairs, slopes, slippery, compliant, rough or default) and how information about each surface was measured. We found that minimal information was provided for many surfaces, making it impossible to meaningfully compare results for different types of surfaces across studies. We conclude that most published studies of walking and falling provide insufficient data to describe the surfaces that they used and we provide recommendations about how to improve the reporting of walking surfaces.
Topics: Humans; Accidental Falls; Virtual Reality; Walking
PubMed: 37660050
DOI: 10.1186/s13643-023-02315-0 -
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 -
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 -
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 -
Age and Ageing Nov 2022regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults.
DESIGN
systematic review and meta-analysis.
PARTICIPANTS
community-dwelling older adults over 65 years.
INTERVENTION
exercises at home through DHI.
OUTCOMES MEASURES
physical function, HRQoL and falls.
RESULTS
twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, -0.56 s, 95% confidence interval, CI -1.00 to -0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD -0.23; 95% CI -0.45 to -0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004).
CONCLUSION
the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility.
Topics: Humans; Aged; Quality of Life; Exercise; Exercise Therapy; Independent Living
PubMed: 36346736
DOI: 10.1093/ageing/afac243 -
Pharmacological Research Dec 2022Widespread musculoskeletal pain characterizes fibromyalgia (FM), accompanied by sleep, fatigue, and mood problems. Chronic stress and depression play a crucial role in... (Review)
Review
Widespread musculoskeletal pain characterizes fibromyalgia (FM), accompanied by sleep, fatigue, and mood problems. Chronic stress and depression play a crucial role in the etiology and pathophysiology of FM. They may contribute to a dysregulation of the central pain mechanisms together with the neuroendocrine and immune systems. Pharmacological treatments are the first-line therapy to reduce the symptoms of FM. The US Food and Drug Administration (FDA) indicated gabapentinoid, pregabalin, duloxetine, and milnacipran for adult patients. An alternative approach is widely used, based on therapies including interventions in patient education, behavioral therapy, exercise, pain management, and a healthy diet. A systematic search was performed on PubMed, MEDLINE, EMBASE, and Web of Science databases. The authors established the selection, inclusion, and exclusion criteria. We found a total of 908 articles. This systematic review will include ten articles selected after excluding duplicates and reading the abstracts and full texts. All studies related the effect of drugs to various symptoms caused by fibromyalgia patients with depression, such as insomnia/sleepiness, depression, suicide, difficulty walking/working, pain, fatigue, and nervousness. Although, we concluded that antidepressant drugs are effective in treating depression and pain in fibromyalgia, further studies are needed to understand the etiology of this disease and to find a combination of therapies to increase tolerability and adherence of the patient to the drug, decreasing the adverse effects.
Topics: Adult; Humans; Fibromyalgia; Antidepressive Agents; Fatigue; Musculoskeletal Pain; Employment
PubMed: 36336218
DOI: 10.1016/j.phrs.2022.106547