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Rehabilitacion 2020To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence.
OBJECTIVE
To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence.
MATERIALS AND METHODS
A systematic literature review was carried out; this method forms part of secondary studies under investigation and describes a phenomenon in detail based on primary sources of information.
RESULTS
The literature search in the databases consulted yielded 7,228 articles; of these, 15 more were identified through "snowball" search strategies. At the start of the screening process, 63 eligible records were chosen based on their title and summary, and 14 were excluded because they were duplicates. A total of 49 articles were selected for a full text revision and, of these, 37 were excluded because they did not meet all the inclusion criteria. Finally, 12 articles were selected to prepare the qualitative synthesis of the present research work.
CONCLUSIONS
In comparison with neonates born at term, premature infants demonstrate a particular motor repertoire, due to the immaturity of their systems; their motor behaviour follows a line of development mainly characterised by deficits in muscle tone, postural control, muscle balance, and antigravity muscle activation.
Topics: Humans; Infant; Infant, Newborn; Infant, Premature; Motor Activity; Muscle Tonus; Muscle, Skeletal; Postural Balance
PubMed: 32007181
DOI: 10.1016/j.rh.2019.09.004 -
Sports Medicine (Auckland, N.Z.) Feb 2020Foam rolling (FR) has been demonstrated to acutely enhance joint range of motion (ROM). However, data syntheses pooling the effect sizes across studies are scarce. It... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Foam rolling (FR) has been demonstrated to acutely enhance joint range of motion (ROM). However, data syntheses pooling the effect sizes across studies are scarce. It is, furthermore, unknown which moderators affect the treatment outcome.
OBJECTIVE
To quantify the immediate effects of FR on ROM in healthy adults.
METHODS
A multilevel meta-analysis with a robust random effects meta-regression model was used to pool the standardized mean differences (SMD) between FR and no-exercise (NEX) as well as FR and stretching. The influence of the possible effect modifiers treatment duration, speed, targeted muscle, testing mode (active/passive ROM), sex, BMI, and study design was examined in a moderator analysis.
RESULTS
Twenty-six trials with high methodological quality (PEDro scale) were identified. Compared to NEX, FR had a large positive effect on ROM (SMD: 0.74, 95% CI 0.42-1.01, p = 0.0002), but was not superior to stretching (SMD: - 0.02, 95% CI - 0.73 to 0.69, p = 0.95). Although the few individual study findings suggest that FR with vibration may be more effective than NEX or FR without vibration, the pooled results did not reveal significant differences (SMD: 6.75, 95% CI - 76.4 to 89.9, p = 0.49 and SMD: 0.66, 95% CI - 1.5 to 2.8, p = 0.32). According to the moderator analysis, most potential effect modifiers (e.g., BMI, speed or duration) do not have a significant impact (p > 0.05) but FR may be less effective in men (p < 0.05).
CONCLUSION
FR represents an effective method to induce acute improvements in joint ROM. The impact of moderators should be further elucidated in future research.
Topics: Healthy Volunteers; Humans; Muscle Stretching Exercises; Muscle Tonus; Range of Motion, Articular; Trigger Points
PubMed: 31628662
DOI: 10.1007/s40279-019-01205-7 -
European Journal of Physical and... Aug 2018The Modified Ashworth Scale is the most widely clinical scale used to measure the increase of muscle tone. Reliability is not an immutable property of a scale and can... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The Modified Ashworth Scale is the most widely clinical scale used to measure the increase of muscle tone. Reliability is not an immutable property of a scale and can vary as a function of the variability and composition of the sample to which it is administered. The best method to examine how the reliability of a test scores varies is by conducting a systematic review and meta-analysis of the reliability coefficients obtained in different applications of the test with the data at hand. The objectives of this systematic revision are: what is the mean inter- and intra-rater reliability of the Modified Ashworth Scale's scores in upper and lower extremities? Which study characteristics affect the reliability of the scores in this scale?
EVIDENCE ACQUISITION
The PubMed, Embase and CINAHL databases were searched from 1987 to February 2015. Two reviewers independently selected empirical studies published in English or in Spanish that applied the Modified Ashworth Scale and reported any reliability coefficient with the data at hand in children, adolescents or adults with spasticity.
EVIDENCE SYNTHESIS
Thirty-three studies reported any reliability estimate of Modified Ashworth Scale scores (N.=1065 participants). For lower extremities and inter-rater agreement, the mean intraclass correlation was ICC+=0.686 (95% CI: 0.563 and 0.780) and for kappa coefficients, κ+=0.360 (95% CI: 0.241 and 0.468); for intra-rater agreement: ICC+=0.644 (95% CI: 0.543 and 0.726) and κ+=0.488 (95% CI: 0.370 and 0.591). For upper extremities and inter-rater agreement: ICC+=0.781 (95% CI: 0.679 and 0.853) and κ+=0.625 (95% CI: 0.350 and 0.801); for intra-rater agreement: ICC+=0.748 (95% CI: 0.671 and 0.809) and κ+=0.593 (95% CI: 0.467 and 0.696). The type of design, the study focus, and the number of raters presented statistically significant relationships with ICC both for lower and upper extremities.
CONCLUSIONS
Inter- and intra-rater agreement for Modified Ashworth Scale scores was satisfactory. Modified Ashworth Scale' scores exhibited better reliability when measuring upper extremities than lower. Several characteristics of the studies were statistically associated to inter-rater reliability of the scores for lower and upper extremities.
Topics: Disability Evaluation; Evidence-Based Medicine; Female; Humans; Male; Muscle Spasticity; Muscle Tonus; Observer Variation; Physical and Rehabilitation Medicine; Severity of Illness Index
PubMed: 28901119
DOI: 10.23736/S1973-9087.17.04796-7 -
Journal of Voice : Official Journal of... Sep 2018The present study aimed to carry out a systematic review of the effects of voice therapy on individuals diagnosed with muscle tension dysphonia (MTD) or hyperfunctional...
The present study aimed to carry out a systematic review of the effects of voice therapy on individuals diagnosed with muscle tension dysphonia (MTD) or hyperfunctional dysphonia. This is a systematic literature review on the databases Medline (via PubMed), Cochrane Library, Scopus, and Lilacs using a search strategy related to the theme of the study. The selection included clinical trials that assessed the effects of speech therapy intervention on patients diagnosed with MTD or hyperfunctional dysphonia published over the last 10 years in Portuguese, English, or Spanish. The Physiotherapy Evidence-Based Database (PEDro) Scale was used to assess the methodology of the studies. Of the 634 publications, 12 studies were included in this review, of which three were excluded due to a low score on the PEDro Scale, resulting in a final number of nine publications. Regarding the techniques approached, semioccluded vocal tract exercises (22.22%), nasal sound and frequency modulation (22.22%), maximum phonation time (MPT) technique and vocal hygiene (11.11%), vocal function exercises (11.11%), respiratory exercises along with phonoarticulatory sounds (11.11%), manual laryngeal therapy (11.11%), and manual laryngeal therapy associated with respiratory exercises (11.11%) were identified. These techniques promoted the following effects: improvement in intraoral and subglottal pressure, positive alterations in the glottal contact quotient, significant changes in fundamental frequency measures, increased MPT, and reduced voice roughness. Methodology was identified to be a shortcoming in the studies. The clinical trials reviewed showed positive results in using the therapeutic techniques selected in the speech therapy approach.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dysphonia; Female; Humans; Male; Middle Aged; Muscle Tonus; Phonation; Recovery of Function; Treatment Outcome; Vocal Cords; Voice Quality; Voice Training; Young Adult
PubMed: 28739332
DOI: 10.1016/j.jvoice.2017.06.015 -
The Cochrane Database of Systematic... Jun 2017Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with... (Review)
Review
BACKGROUND
Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with fibromyalgia that will replace the "Exercise for treating fibromyalgia syndrome" review first published in 2002.
OBJECTIVES
• To evaluate the benefits and harms of aerobic exercise training for adults with fibromyalgia• To assess the following specific comparisons ० Aerobic versus control conditions (eg, treatment as usual, wait list control, physical activity as usual) ० Aerobic versus aerobic interventions (eg, running vs brisk walking) ० Aerobic versus non-exercise interventions (eg, medications, education) We did not assess specific comparisons involving aerobic exercise versus other exercise interventions (eg, resistance exercise, aquatic exercise, flexibility exercise, mixed exercise). Other systematic reviews have examined or will examine these comparisons (Bidonde 2014; Busch 2013).
SEARCH METHODS
We searched the Cochrane Library, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), Thesis and Dissertation Abstracts, the Allied and Complementary Medicine Database (AMED), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and the ClinicalTrials.gov registry up to June 2016, unrestricted by language, and we reviewed the reference lists of retrieved trials to identify potentially relevant trials.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) in adults with a diagnosis of fibromyalgia that compared aerobic training interventions (dynamic physical activity that increases breathing and heart rate to submaximal levels for a prolonged period) versus no exercise or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials for inclusion, extracted data, performed a risk of bias assessment, and assessed the quality of the body of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences between groups.
MAIN RESULTS
We included 13 RCTs (839 people). Studies were at risk of selection, performance, and detection bias (owing to lack of blinding for self-reported outcomes) and had low risk of attrition and reporting bias. We prioritized the findings when aerobic exercise was compared with no exercise control and present them fully here.Eight trials (with 456 participants) provided low-quality evidence for pain intensity, fatigue, stiffness, and physical function; and moderate-quality evidence for withdrawals and HRQL at completion of the intervention (6 to 24 weeks). With the exception of withdrawals and adverse events, major outcome measures were self-reported and were expressed on a 0 to 100 scale (lower values are best, negative mean differences (MDs)/standardized mean differences (SMDs) indicate improvement). Effects for aerobic exercise versus control were as follows: HRQL: mean 56.08; five studies; N = 372; MD -7.89, 95% CI -13.23 to -2.55; absolute improvement of 8% (3% to 13%) and relative improvement of 15% (5% to 24%); pain intensity: mean 65.31; six studies; N = 351; MD -11.06, 95% CI -18.34 to -3.77; absolute improvement of 11% (95% CI 4% to 18%) and relative improvement of 18% (7% to 30%); stiffness: mean 69; one study; N = 143; MD -7.96, 95% CI -14.95 to -0.97; absolute difference in improvement of 8% (1% to 15%) and relative change in improvement of 11.4% (21.4% to 1.4%); physical function: mean 38.32; three studies; N = 246; MD -10.16, 95% CI -15.39 to -4.94; absolute change in improvement of 10% (15% to 5%) and relative change in improvement of 21.9% (33% to 11%); and fatigue: mean 68; three studies; N = 286; MD -6.48, 95% CI -14.33 to 1.38; absolute change in improvement of 6% (12% improvement to 0.3% worse) and relative change in improvement of 8% (16% improvement to 0.4% worse). Pooled analysis resulted in a risk ratio (RR) of moderate quality for withdrawals (17 per 100 and 20 per 100 in control and intervention groups, respectively; eight studies; N = 456; RR 1.25, 95%CI 0.89 to 1.77; absolute change of 5% more withdrawals with exercise (3% fewer to 12% more).Three trials provided low-quality evidence on long-term effects (24 to 208 weeks post intervention) and reported that benefits for pain and function persisted but did not for HRQL or fatigue. Withdrawals were similar, and investigators did not assess stiffness and adverse events.We are uncertain about the effects of one aerobic intervention versus another, as the evidence was of low to very low quality and was derived from single trials only, precluding meta-analyses. Similarly, we are uncertain of the effects of aerobic exercise over active controls (ie, education, three studies; stress management training, one study; medication, one study) owing to evidence of low to very low quality provided by single trials. Most studies did not measure adverse events; thus we are uncertain about the risk of adverse events associated with aerobic exercise.
AUTHORS' CONCLUSIONS
When compared with control, moderate-quality evidence indicates that aerobic exercise probably improves HRQL and all-cause withdrawal, and low-quality evidence suggests that aerobic exercise may slightly decrease pain intensity, may slightly improve physical function, and may lead to little difference in fatigue and stiffness. Three of the reported outcomes reached clinical significance (HRQL, physical function, and pain). Long-term effects of aerobic exercise may include little or no difference in pain, physical function, and all-cause withdrawal, and we are uncertain about long-term effects on remaining outcomes. We downgraded the evidence owing to the small number of included trials and participants across trials, and because of issues related to unclear and high risks of bias (performance, selection, and detection biases). Aerobic exercise appears to be well tolerated (similar withdrawal rates across groups), although evidence on adverse events is scarce, so we are uncertain about its safety.
Topics: Adult; Exercise; Fatigue; Female; Fibromyalgia; Humans; Male; Middle Aged; Muscle Tonus; Pain Measurement; Patient Dropouts; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 28636204
DOI: 10.1002/14651858.CD012700 -
Disability and Rehabilitation Apr 2017To conduct a systematic review of the evidence for the management of tone in infants 0-24 months of age, with or at risk of developing cerebral palsy. (Comparative Study)
Comparative Study Review
BACKGROUND AND OBJECTIVES
To conduct a systematic review of the evidence for the management of tone in infants 0-24 months of age, with or at risk of developing cerebral palsy.
METHOD
This review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, CINAHL Plus and PsycINFO databases were systematically searched for relevant articles. Inclusion criteria were: children aged 0-24 months, identified as at risk of, or having cerebral palsy; ≥25% of participants ≤24 months, and included a standardized assessment of tone. Only peer reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the PEDro scale for randomized controlled trials and the checklist for assessing the quality of quantitative studies of Kmet, Cook and Lee for non-randomized control trials.
RESULTS
A total of 4838 studies were identified. After removing duplicates and unrelated studies, a total of 56 full text studies were reviewed. A total of five studies met inclusion criteria, two of which were RCTs, two pre-/post-test designs and one retrospective case audit. Interventions included BoNT-A, Oral Baclofen, Neurofacilitation of Developmental Reaction and Neurodevelopmental Therapy. The quality of evidence ranged from limited to moderate.
CONCLUSION
The management of tone in infants and young children is not well described, with a dearth of high-level evidence to support intervention in the 0-24 month age-range. This is in contrast to a recent review completed by Novak et al. (2013) who report high levels of evidence of interventions for children with cerebral palsy, over 2 years of age. Implications for Rehabilitation High level of evidence to support clinical decision making for the management of tone in young children 0-24 months is not available. The lack of available evidence in the management of tone of young children underpins service delivery and intervention and impacts on patient outcomes. In the absence of clear research evidence, the systematic application of sensitive outcome measures is required to confirm treatment effects and generate new evidence. Hypertonia should not be managed in isolation. Consideration needs to be given to all components of the ICF-CY.
Topics: Age Factors; Cerebral Palsy; Child, Preschool; Humans; Infant; Infant, Newborn; Muscle Tonus
PubMed: 27027325
DOI: 10.3109/09638288.2016.1153162 -
International Journal of... Jun 2015A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders (MTVD). (Review)
Review
PURPOSE
A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders (MTVD).
METHOD
A search of 12 electronic databases and reference lists for studies published between the years 1990-2014 was conducted using the PRISMA guidelines. Inclusion and exclusion criteria included type of publication, participant characteristics, intervention, outcome measures and report of outcomes. Methodological quality rating scales and confidence in diagnostic scale supported the literature evaluation.
RESULT
Seven papers met the inclusion criteria. Significant improvement on at least one outcome measure was reported for all studies. Effect sizes were small-to-large. Methodological qualities of research were varied. No study explicitly reported treatment fidelity and cumulative intervention intensity could only be calculated for two out of seven studies. Outcome measures were used inconsistently and less than half of the measures had reported reliability values. Confidence in the accuracy of subject diagnosis on average was rated as low. Specific "active ingredients" for therapeutic change were not identified.
CONCLUSION
Voice therapy for the treatment of MTVD is associated with positive treatment outcomes; however, there is an obvious need for systematic and high quality research designs to expand the evidence base for the behavioural treatment of MTVD.
Topics: Behavior Therapy; Humans; Laryngeal Muscles; Muscle Tonus; Recovery of Function; Treatment Outcome; Voice Disorders; Voice Quality; Voice Training
PubMed: 25953458
DOI: 10.3109/17549507.2015.1024169 -
Journal of Voice : Official Journal of... Jul 2015Laryngeal palpation is a common clinical method for the assessment of neck and laryngeal muscles in muscle tension dysphonia (MTD). (Review)
Review
BACKGROUND
Laryngeal palpation is a common clinical method for the assessment of neck and laryngeal muscles in muscle tension dysphonia (MTD).
OBJECTIVE
To review the available laryngeal palpation methods used in patients with MTD for the assessment, diagnosis, or document of treatment outcomes.
STUDY DESIGN (METHOD)
A systematic review of the literature concerning palpatory methods in MTD was conducted using the databases MEDLINE (PubMed), ScienceDirect, Scopus, Web of science, Web of knowledge and Cochrane Library between July and October 2013. Relevant studies were identified by one reviewer based on screened titles/abstracts and full texts. Manual searching was also used to track the source literature.
RESULTS
There were five main as well as miscellaneous palpation methods that were different according to target anatomical structures, judgment or grading system, and using tasks. There were only a few scales available, and the majority of the palpatory methods were qualitative. Most of the palpatory methods evaluate the tension at both static and dynamic tasks. There was little information about the validity and reliability of the available methods.
CONCLUSION
The literature on the scientific evidence of muscle tension indicators perceived by laryngeal palpation in MTD is scarce. Future studies should be conducted to investigate the validity and reliability of palpation methods.
Topics: Dysphonia; Humans; Laryngeal Muscles; Muscle Tonus; Palpation; Reproducibility of Results
PubMed: 25795346
DOI: 10.1016/j.jvoice.2014.09.023 -
Ugeskrift For Laeger Feb 2012Spasticity is a frequently used diagnosis, and anti-spastic medication is used widespread. In this systematic review article we highlight difficulties in diagnosing... (Review)
Review
Spasticity is a frequently used diagnosis, and anti-spastic medication is used widespread. In this systematic review article we highlight difficulties in diagnosing spasticity correctly and thus limit the value of the diagnosis in ensuring the best possible treatment. We review recent neuroscience research and conclude that it is necessary to develop better tools for clinical diagnosis of spasticity in order to avoid potential malpractice and to limit treatment with anti-spastic drugs for patients with documented increased reflex-mediated muscle tone as their main annoyance.
Topics: Concept Formation; Humans; Muscle Relaxants, Central; Muscle Spasticity; Muscle Tonus; Physical Therapy Modalities; Reflex, Abnormal
PubMed: 22369906
DOI: No ID Found -
Sleep & Breathing = Schlaf & Atmung Dec 2010Treatment of obstructive sleep apnea (OSA) using methods for increasing upper airway muscle tonus has been controversial and poorly reported. Thus, a review of the... (Review)
Review
OBJECTIVE
Treatment of obstructive sleep apnea (OSA) using methods for increasing upper airway muscle tonus has been controversial and poorly reported. Thus, a review of the evidence is needed to evaluate the effectiveness of these methods.
DESIGN
The design used was a systematic review of randomized controlled trials.
DATA SOURCES
Data sources are from the Cochrane Library, Medline, Embase and Scielo, registries of ongoing trials, theses indexed at Biblioteca Regional de Medicina/Pan-American Health Organization of the World Health Organization and the reference lists of all the trials retrieved.
REVIEW METHODS
This was a review of randomized or quasi-randomized double-blind trials on OSA. Two reviewers independently applied eligibility criteria. One reviewer assessed study quality and extracted data, and these processes were checked by a second reviewer. The primary outcome was a decrease in the apnea/hypopnea index (AHI) of below five episodes per hour. Other outcomes were subjective sleep quality, sleep quality measured by night polysomnography, quality of life measured subjectively and adverse events associated with the treatments.
DATA SYNTHESIS
Three eligible trials were included. Two studies showed improvements through the objective and subjective analyses, and one study showed improvement of snoring, but not of AHI while the subjective analyses showed no improvement. The adverse events were reported and they were not significant.
CONCLUSIONS
There is no accepted scientific evidence that methods aiming to increase muscle tonus of the stomatognathic system are effective in reducing AHI to below five events per hour. Well-designed randomized controlled trials are needed to assess the efficacy of such methods.
Topics: Airway Resistance; Cross-Over Studies; Double-Blind Method; Electric Stimulation Therapy; Evidence-Based Medicine; Exercise Therapy; Female; Humans; Laryngeal Muscles; Male; Middle Aged; Muscle Tonus; Palatal Muscles; Pharyngeal Muscles; Randomized Controlled Trials as Topic; Sleep Apnea, Obstructive; Tongue
PubMed: 20563659
DOI: 10.1007/s11325-010-0377-9