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Cannabis and Cannabinoid Research Feb 2023Δ-Tetrahydrocannabinol (THC), the main intoxicating component of cannabis, can cause cognitive and psychomotor impairment. Whether this impairment is still present... (Review)
Review
Δ-Tetrahydrocannabinol (THC), the main intoxicating component of cannabis, can cause cognitive and psychomotor impairment. Whether this impairment is still present many hours or even days after THC use requires clarification. Possible "next day" effects are of major significance in safety-sensitive workplaces. We therefore conducted a systematic review of studies investigating the "next day" effects of THC. Studies that measured performance on safety-sensitive tasks (e.g., driving, flying) and/or neuropsychological tests >8 h after THC (or cannabis) use using interventional designs were identified by searching two online databases from inception until March 28, 2022. Risk of bias (RoB) was evaluated using the relevant Cochrane tools. Results were described in terms of whether THC had a significant effect on performance relative to the primary comparator (i.e., placebo or baseline, as appropriate). Twenty studies (=458) involving 345 performance tests were reviewed. Most studies administered a single dose of THC (median [interquartile range]: 16 [11-26] mg) and assessed performance between >12 and 24 h post-treatment. =209/345 tests conducted across 16 published studies showed no "next day" effects of THC. Nine of these 16 studies used randomized, double-blind, placebo-controlled designs. Half (=8) had "some" RoB, and half (=8) had a "high" RoB. Notably, =88 of these 209 tests failed to demonstrate "acute" (i.e., <8 h post-treatment) THC-induced impairment. =12/345 tests conducted across five published studies indicated negative (i.e., impairing) "next day" effects of THC. None of these five studies used randomized, double-blind, placebo-controlled designs and all were published >18 years ago (four, >30 years ago). Three had "some" RoB, and two had a "high" RoB. A further =121/345 tests indicated "unclear" "next day" effects of THC with insufficient information provided to assess outcomes. The remaining =3/345 tests indicated positive (i.e., enhancing) "next day" effects of THC. Some lower quality studies have reported "next day" effects of THC on cognitive function and safety-sensitive tasks. However, most studies, including some of higher quality, have found no such effect. Overall, it appears that there is limited scientific evidence to support the assertion that cannabis use impairs "next day" performance. Further studies involving improved methodologies are required to better address this issue.
Topics: Cannabis; Dronabinol; Hallucinogens; Cannabinoid Receptor Agonists; Automobile Driving; Randomized Controlled Trials as Topic
PubMed: 36475998
DOI: 10.1089/can.2022.0185 -
International Journal of Environmental... Nov 2022The patient perspective of dual-task (DT) impairment in real life is unclear. This review aimed (i) to identify patient-reported outcome measures (PROMs) on DT and... (Review)
Review
The patient perspective of dual-task (DT) impairment in real life is unclear. This review aimed (i) to identify patient-reported outcome measures (PROMs) on DT and evaluate their measurement properties and (ii) to investigate the usage of PROMs for the evaluation of DT difficulties. A systematic literature search was conducted using PubMed and Web of Science from inception to March 2022. Methodological quality was evaluated using the COSMIN checklist. Six studies examined the measurement properties of DT PROMs. Nine studies used DT PROMs as the outcome measure. Five PROMs were identified, including the Divided Attention Questionnaire (DAQ), Dual-Task-Impact on Daily-life Activities Questionnaire (DIDA-Q), a Questionnaire by Cock et al. (QOC), Dual-Tasking Questionnaire (DTQ), and Dual-Task Screening-List (DTSL). Fourteen measurement properties were documented: five (35.7%) rated quality as "sufficient", six (42.8%) "insufficient", and three (21.4%) "indeterminate". The quality of evidence for each measurement property ranged from very low to high. While DT performance is investigated in many populations, the use of PROMs is still limited, although five instruments are available. Currently, due to insufficient data, it is not possible to recommend a specific DT PROM in a specific population. An exception is DIDA-Q, which has the highest quality of measurement properties in people with multiple sclerosis.
Topics: Humans; Checklist; Patient Reported Outcome Measures; Quality of Life; Surveys and Questionnaires; Task Performance and Analysis
PubMed: 36429747
DOI: 10.3390/ijerph192215029 -
Journal of Robotic Surgery Aug 2023Due to its advantages over open surgery and conventional laparoscopy, uptake of robot-assisted surgery has rapidly increased. It is important to know whether the... (Review)
Review
Due to its advantages over open surgery and conventional laparoscopy, uptake of robot-assisted surgery has rapidly increased. It is important to know whether the existing open or laparoscopic skills of robotic novices shorten the robotic surgery learning curve, potentially reducing the amount of training required. This systematic review aims to assess psychomotor skill transfer to the robot in clinical and simulated settings. PubMed, EMBASE, Cochrane Library and Scopus databases were systematically searched in accordance with PRISMA guidelines from inception to August 2021 alongside website searching and citation chaining. Article screening, data extraction and quality assessment were undertaken by two independent reviewers. Outcomes included simulator performance metrics or in the case of clinical studies, peri- and post-operative metrics. Twenty-nine studies met the eligibility criteria. All studies were judged to be at high or moderate overall risk of bias. Results were narratively synthesised due to heterogeneity in study designs and outcome measures. Two of the three studies assessing open surgical skill transfer found evidence of successful skill transfer while nine of twenty-seven studies evaluating laparoscopic skill transfer found no evidence. Skill transfer from both modalities is most apparent when advanced robotic tasks are performed in the initial phase of the learning curve but quality and methodological limitations of the existing literature prevent definitive conclusions. The impact of incorporating laparoscopic simulation into robotic training curricula and on the cost effectiveness of training should be investigated.
Topics: Humans; Robotic Surgical Procedures; Clinical Competence; Robotics; Computer Simulation; Laparoscopy
PubMed: 36418717
DOI: 10.1007/s11701-022-01492-9 -
International Journal of Environmental... Oct 2022The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD.
METHODS
On 28 June 2021, a systematic review with meta-analysis was performed using the following databases: MEDLINE, SciELO, LILACS, PEDro, SPORTDiscus, CINAHL, SCOPUS, Web of Science, Cochrane, and Science Direct. We analyzed the methodological quality and risk of bias using the Jadad scale and Cochrane tool, respectively. Motor coordination results were meta-analyzed using the RevMan program. Two independent researchers used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool to assess the level of evidence from the meta-analysis.
RESULTS
We found four studies in the listed databases and five randomized clinical trials were included in the meta-analysis that included 109 children with ASD. Children with ASD who performed physical activity did not present significantly better motor coordination than control children ( = 0.12).
CONCLUSIONS
Considering the clinical importance of physical activity for children with ASD, this systematic review with meta-analysis showed that physical activity had no statistically significant effects on coordination in individuals with ASD.
Topics: Child; Humans; Autism Spectrum Disorder; Motor Skills; Exercise
PubMed: 36360956
DOI: 10.3390/ijerph192114081 -
Frontiers in Aging Neuroscience 2022A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim...
UNLABELLED
A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim of this systematic review was to (i) determine how studies evaluated napping behavior in older adults (frequency, duration and timing); (ii) explore how napping impacts perceptual measures, cognitive and psychomotor performance, night-time sleep and physiological parameters in the elderly (PROSPERO CRD42022299805). A total of 738 records were screened by two researchers using the PICOS criteria. Fifteen studies met our inclusion criteria with a mean age ranging from 60.8 to 78.3 years and a cumulative sample size of = 326. Daytime napping had an overall positive impact on subjective measures (i.e., sleepiness and fatigue), psychomotor performances (i.e., speed and accuracy) and learning abilities (i.e., declarative and motor learning). Additionally, studies showed (i) consistency between nap and control conditions regarding sleep duration, efficiency and latency, and proportion of sleep stages, and (ii) increase of 24 h sleep duration with nap compared to control condition. Based on the findings of the present review, there is minimal evidence to indicate that napping is detrimental for older adults' nighttime sleep. Future studies should consider involving repeated naps during a micro-cycle in order to investigate the chronic effect of napping on older adults.
SYSTEMATIC REVIEW REGISTRATION
identifier: CRD42022299805.
PubMed: 36337699
DOI: 10.3389/fnagi.2022.1000707 -
International Journal of Environmental... Sep 2022Nintendo Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nintendo Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy.
METHODS
A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI).
RESULTS
Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7).
CONCLUSIONS
Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.
Topics: Activities of Daily Living; Cerebral Palsy; Child; Humans; Motor Skills; Stroke Rehabilitation; Upper Extremity
PubMed: 36231643
DOI: 10.3390/ijerph191912343 -
International Journal of Environmental... Sep 2022: To evaluate how different physical activity (PA) interventions (traditional, exergaming, and teacher/parent education) impacted children's motor skills (object... (Meta-Analysis)
Meta-Analysis Review
: To evaluate how different physical activity (PA) interventions (traditional, exergaming, and teacher/parent education) impacted children's motor skills (object control, locomotor, and gross motor). : Systematic review and network meta-analysis. : PubMed, Medline, Scopus, Web of Science, EMBASE, and PsycINFO. : (1) Participants comprised 1708 children 3-12 years; (2) PA or exercise-based interventions were investigated; (3) only studies using a Test of Gross Motor Skills assessment were included; (4) RCT were chosen as the study design to assess the impact of PA interventions on children's motor skills; and (5) culture-based PA studies with English language only were included. Data were analyzed using a Bayesian network meta-analysis. : The results were reported as standardized mean differences (SMDs) with associated 95% credible intervals (CrIs). For object control, aerobic intervention (SMD 6.90, 95% Crl 1.39 to 13.50); for locomotor, exergaming intervention (SMD 12.50, 95% Crl 0.28 to 24.50); and for gross motor, aerobic intervention (SMD 7.49, 95% Crl 0.11 to 15.70) were the most effective treatments. : Children's FMSs have been improved through different PA interventions. Among them, aerobic interventions seem to be the most effective intervention in enhancing object control skills and overall gross motor skills.
Topics: Adolescent; Bayes Theorem; Child; Exercise; Humans; Motor Skills; Network Meta-Analysis
PubMed: 36231213
DOI: 10.3390/ijerph191911914 -
Frontiers in Psychiatry 2022Recreational use of Synthetic Cannabinoids (SCs), one of the largest groups of New Psychoactive Substances (NPS), has increased globally over the past few years. Driving...
Recreational use of Synthetic Cannabinoids (SCs), one of the largest groups of New Psychoactive Substances (NPS), has increased globally over the past few years. Driving is a structured process requiring the cooperation of several cognitive and psychomotor functions, organized in different levels of complexity. Each of these functions can be affected when Driving Under the Influence (DUI) of SCs. In order to reduce the likelihood of SC-related road accidents, it is essential to understand which areas of psychomotor performance are most affected by these substances, as well as the severity of impairment. For this purpose, a multiple database- literature review of recent experimental studies in humans and animals regarding the psychomotor effects of SCs has been performed. Despite the many limitations connected to experimental studies on humans, results showed a consistency between animal and human data. SCs appear to impair psychomotor performance in humans, affecting different domains related to safe driving even at low doses. Cases of DUI of SC have been repeatedly reported, although the exact prevalence is likely to be underestimated due to current analytical and interpretative issues. For this reason, an accurate physical examination performed by trained and experienced personnel has a primary role in recognizing signs of impairment in case of strong suspicion of SC consumption. The identification of a suspected case should be followed by reliable laboratory examination.
PubMed: 36226105
DOI: 10.3389/fpsyt.2022.998828 -
Revista de Neurologia Oct 2022Nearly 60% of those diagnosed with fragile X syndrome show comorbidity with autism. Thus, there are similarities and differences between both conditions that lead to...
INTRODUCTION
Nearly 60% of those diagnosed with fragile X syndrome show comorbidity with autism. Thus, there are similarities and differences between both conditions that lead to very different clinical manifestations. However, an early differential diagnosis may help professionals to detect deficits and enhance strengths to apply the best suitable intervention. The purpose of this scoping review was to provide a comprehensive overview of the relation and the differences between autism and fragile X syndrome to orientate diagnosis and intervention.
MATERIALS AND METHODS
The research for articles was carried out in PsycInfo, Medline, SCOPUS and Web of Science, including scientific articles published from 2010 to 2020 and children aged 0-6 years. The scoping review followed the PRISMA-ScR criteria.
RESULTS
22 studies were selected. Results were reviewed in terms of structural and morphological changes and cognitive, communicative, social-emotional and sensory-motor skills.
CONCLUSIONS
Different growing cerebral patterns are observed in both conditions. Besides, there are early signs from the different developmental areas studied that show comorbidity or allow early differentiation. However, attentional function or repetitive mannerisms, among others, need further research.
Topics: Autism Spectrum Disorder; Autistic Disorder; Child; Diagnosis, Differential; Fragile X Syndrome; Humans; Motor Skills
PubMed: 36218252
DOI: 10.33588/rn.7508.2022074 -
Age and Ageing Sep 2022Delirium is a common neurocognitive disorder in hospitalised older adults with vast negative consequences. The predominant method of subtyping delirium is by motor... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Delirium is a common neurocognitive disorder in hospitalised older adults with vast negative consequences. The predominant method of subtyping delirium is by motor activity profile into hypoactive, hyperactive and mixed groups.
OBJECTIVE
This systematic review and meta-analysis investigated how predisposing factors differ between delirium motor subtypes.
METHODS
Databases (Medline, PsycINFO, Embase) were systematically searched for studies reporting predisposing factors (prior to delirium) for delirium motor subtypes. A total of 61 studies met inclusion criteria (N = 14,407, mean age 73.63 years). Random-effects meta-analyses synthesised differences between delirium motor subtypes relative to 22 factors.
RESULTS
Hypoactive cases were older, had poorer cognition and higher physical risk scores than hyperactive cases and were more likely to be women, living in care homes, taking more medications, with worse functional performance and history of cerebrovascular disease than all remaining subtypes. Hyperactive cases were younger than hypoactive and mixed subtypes and were more likely to be men, with better cognition and lower physical risk scores than all other subtypes. Those with no motor subtype (unable to be classified) were more likely to be women and have better functional performance. Effect sizes were small.
CONCLUSIONS
Important differences in those who develop motor subtypes of delirium were shown prior to delirium occurrence. We provide robust quantitative evidence for a common clinical assumption that indices of frailty (institutional living, cognitive and functional impairment) are seen more in hypoactive patients. Motor subtypes should be measured across delirium research. Motor subtyping has great potential to improve the clinical risk assessment and management of delirium.
Topics: Aged; Delirium; Female; Humans; Male; Psychomotor Agitation; Risk Assessment; Risk Factors
PubMed: 36153750
DOI: 10.1093/ageing/afac200