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The British Journal of Surgery Apr 2024Health state utility values provide the quality component of quality-adjusted life years and are essential for health economic analyses, such as the National Institute... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Health state utility values provide the quality component of quality-adjusted life years and are essential for health economic analyses, such as the National Institute for Health and Care Excellence Technology Appraisal. The aims of this systematic review were to: catalogue utility values for health states experienced by patients with hand conditions; provide pooled utility estimates for common hand conditions; and determine how utilities have been estimated.
METHODS
A PRISMA-compliant systematic review and meta-analysis was conducted (registered in PROSPERO, the international prospective register of systematic reviews (CRD42021226098)). Five databases were searched from inception until April 2023 (Embase, MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL)). All studies that reported primary utility values for hand health states in adult patients were eligible for inclusion. Pooled utility estimates were determined across conditions and intervention status using random-effects meta-analysis.
RESULTS
A total of 10 254 articles were identified; 57 studies met the full inclusion criteria and reported 363 distinct health state utility values. Health state utility values were estimated using a range of methods; the most common measure was the EQ-5D. Pooled utility estimates for carpal tunnel syndrome and hand osteoarthritis before surgical intervention were 0.69 (95% c.i. 0.66 to 0.73) and 0.63 (95% c.i. 0.60 to 0.67) respectively.
CONCLUSION
Pooled utility estimates for patients with untreated carpal tunnel syndrome and hand osteoarthritis are 11% and 18% lower than age-matched population norms respectively. Hand conditions have a significant detrimental impact on health-related quality of life and this study provides catalogued utility values for use in future economic analyses to support the delivery of value-based hand surgery.
Topics: Adult; Humans; Quality of Life; Carpal Tunnel Syndrome; Osteoarthritis
PubMed: 38593043
DOI: 10.1093/bjs/znae067 -
EFORT Open Reviews Apr 2024A variety of instabilities are grouped under multidirectional instability (MDI) of the shoulder. This makes understanding its diagnostic process, presentation and...
PURPOSE
A variety of instabilities are grouped under multidirectional instability (MDI) of the shoulder. This makes understanding its diagnostic process, presentation and treatment difficult due to lack of evidence-based consensus. This review aims to propose a novel classification for subtypes of MDI.
METHODS
A systematic search was performed on PubMed Medline and Embase. A combination of the following 'MeSH' and 'non-MesH' search terms were used: (1) Glenohumeral joint[tiab] OR Glenohumeral[tiab] OR Shoulder[tiab] OR Shoulder joint[tiab] OR Shoulder[MeSH] OR Shoulder joint[MeSH], (2) Multidirectional[tiab], (3) Instability[tiab] OR Joint instability[MeSH]. Sixty-eight publications which met our criteria were included.
RESULTS
There was a high degree of heterogeneity in the definition of MDI. Thirty-one studies (46%) included a trauma etiology in the definition, while 23 studies (34%) did not. Twenty-five studies (37%) excluded patients with labral or bony injuries. Only 15 (22%) studies defined MDI as a global instability (instability in all directions), while 28 (41%) studies considered MDI to be instability in two directions, of which one had to include the inferior direction. Six (9%) studies included the presence of global ligamentous laxity as part of the definition. To improve scientific accuracy, the authors propose a novel AB classification which considers traumatic etiology and the presence of hyperlaxity when subdividing MDI.
CONCLUSION
MDI is defined as symptomatic instability of the shoulder joint in two or more directions. A comprehensive classification system that considers predisposing trauma and the presence of hyperlaxity can provide a more precise assessment of the various existing subtypes of MDI.
LEVEL OF EVIDENCE
III.
PubMed: 38579775
DOI: 10.1530/EOR-23-0029 -
Applied Ergonomics Jul 2024This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and...
This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
Topics: Humans; Occupational Diseases; Occupational Exposure; Risk Factors; Rotator Cuff Injuries; Vibration; Tendinopathy; Shoulder Pain
PubMed: 38579494
DOI: 10.1016/j.apergo.2024.104277 -
Journal of Occupational Rehabilitation Apr 2024Musculoskeletal injuries are common after road traffic crash (RTC) and can lead to poor work-related outcomes. This review evaluated the impact of interventions on... (Review)
Review
BACKGROUND
Musculoskeletal injuries are common after road traffic crash (RTC) and can lead to poor work-related outcomes. This review evaluated the impact of interventions on work-related (e.g. sick leave), health, and functional outcomes in individuals with a RTC-related musculoskeletal injury, and explored what factors were associated with work-related outcomes.
METHODS
Searches of seven databases were conducted up until 9/03/2023. Eligible interventions included adults with RTC-related musculoskeletal injuries, a comparison group, and a work-related outcome, and were in English. Meta-analyses were conducted using RevMan and meta-regressions in Stata.
RESULTS
Studies (n = 27) were predominantly conducted in countries with third-party liability schemes (n = 26), by physiotherapists (n = 17), and in participants with whiplash injuries (94%). Pooled effects in favour of the intervention group were seen overall (SMD = - 0.14, 95% CI: - 0.29, 0.00), for time to return to work (- 17.84 days, 95% CI: - 24.94, - 10.74), likelihood of returning to full duties vs. partial duties (RR = 1.17, 95% CI: 1.01, 1.36), decreased pain intensity (- 6.17 units, 95% CI: - 11.96, - 0.39, 100-point scale), and neck disability (- 1.77 units, 95% CI: - 3.24, - 0.30, 50-point scale).
DISCUSSION
Interventions after RTC can reduce time to return to work and increase the likelihood of returning to normal duties, but the results for these outcomes were based on a small number of studies with low-quality evidence. Further research is needed to evaluate a broader range of interventions, musculoskeletal injury types, and to include better quality work-related outcomes.
PubMed: 38578601
DOI: 10.1007/s10926-024-10185-z -
PeerJ 2024Understanding differential strength capability between sexes is critical in ergonomics and task design. Variations in study designs and outcome measures generates...
BACKGROUND
Understanding differential strength capability between sexes is critical in ergonomics and task design. Variations in study designs and outcome measures generates challenges in establishing workplace guidelines for strength requirements to minimize upper extremity risk for workers. The purpose of this systematic review was to collate and summarize sex differences in strength at the shoulder across movement directions and contraction types.
METHODS
A total of 3,294 articles were screened from four databases (Embase, Medline, SCOPUS, and Web of Science). Eligibility criteria included observational studies, direct measurement of muscular joint, and healthy adult participants (18-65 years old). Strength outcome measures were normalized to percentages of male outputs to allow comparisons across articles.
RESULTS
A total of 63 studies were included within the final review. Majority of articles observed increased strength in males; the gap between male-female strength was greater in flexion and internal/external rotation, with females generating ~30% of male strength; scaption strength ratios were most consistent of the movement groups, with females generating 55-62% of male strength.
CONCLUSION
Sex strength differences should be considered as an important factor for workplace task design as women are more at risk for occupational-related injuries than men in equivalent strength requirements. Differences in strength were not synonymous across motions; females demonstrated increased disparity relative to male strength in horizontal flexion/extension, forward flexion and internal/external rotation. Some movements had an extremely limited pool of available studies for examination which identified critical research gaps within the literature. Collating and quantifying strength differences is critical for effective workstation design with a range of users to mitigate potential overexertion risk and musculoskeletal injury.
Topics: Adult; Humans; Female; Male; Adolescent; Young Adult; Middle Aged; Aged; Shoulder; Sex Characteristics; Upper Extremity; Movement; Range of Motion, Articular
PubMed: 38525275
DOI: 10.7717/peerj.16968 -
The Knee Jun 2024In order to assess the published validity of focal resurfacing of the knee, a systematic review and meta-analysis were conducted to (i) evaluate revision rates and... (Meta-Analysis)
Meta-Analysis
PURPOSE
In order to assess the published validity of focal resurfacing of the knee, a systematic review and meta-analysis were conducted to (i) evaluate revision rates and implant survival of focal resurfacing of the knee; (ii) explore surgical complications; and (iii) evaluate patient reported clinical outcome measures.
METHODS
PubMED, Cochrane Library and Medline databases were searched by 2 independent reviewers in February 2022 for prospective and retrospective cohort studies evaluating any of the following implant types: HemiCAP®, UniCAP®, Episealer® or BioBoly®. Data on incidence of revision, complications and various patient reported outcome measures, such as Knee Society Score (KSS) or Knee Injury and Osteoarthritis Outcome Score (KOOS) was sourced.
RESULTS
A total of 24 published studies were identified with a total of 1465 enrolled patients. A revision rate of 12.97% over a 5.9 year weighted mean follow-up period was observed across all implant types. However, in one series a Kaplan-Meir survival as high as 92.6% at a 10-year follow-up period was noted. A statistically significant improvement was documented across multiple subjective clinical outcomes scores, for example a mean 4.56 point improvement of the VAS (0-10) pain score. The Kellgren-Lawrence score was used to evaluate the radiological progression of osteoarthritis and showed a small significant reduction in all anatomical locations, hence not supporting the hypothesis that focal femoral implants can lead to the progression of osteoarthritis in the affected compartment. There was a low reported incidence of post-operative complications such as aseptic loosening or deep wound infection.
CONCLUSIONS
Focal femoral resurfacing appears to be a viable treatment option for focal symptomatic chondral lesions in patients beyond biological reconstruction, with low revision rates and high patient satisfaction especially at short and medium length follow-up.
Topics: Humans; Arthroplasty, Replacement, Knee; Reoperation; Osteoarthritis, Knee; Knee Prosthesis; Knee Joint; Patient Reported Outcome Measures; Prosthesis Failure
PubMed: 38521014
DOI: 10.1016/j.knee.2024.02.013 -
British Journal of Sports Medicine May 2024To determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with increased injury frequency.
DESIGN
Systematic epidemiological review and meta-analysis.
DATA SOURCES
PubMed (Medline), Embase, the Cochrane Library and SPORTDiscus were searched in September 2023.
ELIGIBILITY CRITERIA
Studies published in the English language reporting the incidence or prevalence of musculoskeletal injuries in golfers at all anatomical sites.
RESULTS
20 studies (9221 golfers, 71.9% male, 28.1% female) were included, with mean age 46.8 years. Lifetime injury prevalence was significantly greater in professional golfers (73.5% (95% CI: 47.3% to 93.0%)) than amateur golfers (56.6% (95% CI: 47.4% to 65.5%); relative risk (RR)=1.50, p<0.001). Professional golfers had a significantly greater lifetime prevalence of hand and wrist (RR=3.33, p<0.001) and lower back injury (RR=3.05, p<0.001). Soft tissue injuries were most common, and diagnoses were typically non-specific. Injury frequency was not associated with age or sex. Two studies reported a greater injury risk in amateur golfers playing more than three and four rounds per week.
CONCLUSION
Over half of golfers are at risk of sustaining a musculoskeletal injury during their lifetime. Risks and patterns of injury differ between professional and amateur golfers, with professionals significantly more likely to develop lower back, and hand and wrist injuries. A recent international consensus statement on the reporting of injury and illness in golf should aid consistency in future research assessing the epidemiology of specific diagnoses, informing golf injury prevention and management strategies.
PROSPERO REGISTRATION NUMBER
CRD42023408738.
Topics: Humans; Athletic Injuries; Back Injuries; Golf; Hand Injuries; Incidence; Musculoskeletal System; Prevalence; Risk Factors; Soft Tissue Injuries; Wrist Injuries; Male; Female; Middle Aged
PubMed: 38508702
DOI: 10.1136/bjsports-2023-107324 -
European Journal of Orthopaedic Surgery... May 2024As a therapeutic intervention for several musculoskeletal illnesses, the benefits and effectiveness of Kinesio taping (KT) are currently unclear. This systematic review... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
As a therapeutic intervention for several musculoskeletal illnesses, the benefits and effectiveness of Kinesio taping (KT) are currently unclear. This systematic review and meta-analysis's (MA) goal is to evaluate the effectiveness of KT for anterior cruciate ligament (ACL) reconstruction and its impact on clinical outcomes.
METHODS
A comprehensive search of online databases was done to discover relevant studies. Inclusion criteria included controlled or randomized clinical trials that were published in English. Changes in pain, flexion strength, and extension strength were among the outcomes of interest. RevMan 5.4 was used to extract and analyze data.
RESULTS
After satisfying the inclusion requirements, five studies were included in the MA. Pooled analysis showed that, in comparison with the intervention group, the control group had a statistically significant improvement in flexion strength (Standardized mean difference (SMD) = 0.44, 95% Confidence interval (CI) [0.01, 0.87], p = 0.04). Extension strength and pain, however, did not significantly differ between the intervention and control groups (SMD = 30, 95% CI [- 0.12, 0.72], p = 0.16), (SMD = 0.26, 95% CI [- 0.14, 0.66], p = 0.20), respectively.
CONCLUSIONS
This analysis suggests limited to no benefits of KA post-ACL reconstruction. While the control group surprisingly showed better improvement in flexion strength, no significant differences were found in extension strength and pain. Further rigorous trials are needed to confirm its utility in rehabilitation.
Topics: Humans; Anterior Cruciate Ligament Reconstruction; Athletic Tape; Anterior Cruciate Ligament Injuries; Range of Motion, Articular; Treatment Outcome; Muscle Strength
PubMed: 38502344
DOI: 10.1007/s00590-024-03878-x -
Frontiers in Public Health 2024A large number of studies have found that the musculoskeletal injury of modern and contemporary dancers has a high incidence. Previous publications have indicated that... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A large number of studies have found that the musculoskeletal injury of modern and contemporary dancers has a high incidence. Previous publications have indicated that there are many potential factors that are related to dancing injury; however, they have not been proven, and even some data are conflicting in different research.
RESULTS
The search yielded 18 prospective studies reporting on professional and pre-professional modern or contemporary dancers from companies and schools. The prevalence of modern and contemporary dancers was 0.82 (: 0.74~0.90). The injury proportion of trauma, overuse, ankle and foot, lower extremity, joint and ligaments, muscle and tendons, and time-loss were 0.40, 0.26, 0.49, 0.34, 0.33, and 0.29 in the total number of injuries. There was no evidence of a significant difference in sex, age, and education program. The factors of BMI and injury history achieved statistical significance, and the -values were less than 0.01.
CONCLUSION
Based on the results of this article, BMI and injury history may be risk factors for injury in contemporary and modern dancers. Modern and contemporary dancers have a high prevalence of musculoskeletal injuries. Lower extremity injuries are the most common in the whole body, with injuries to the foot and ankle being more frequent. The mechanism of injury is mostly overuse injury, and the injured tissues are mostly muscle tendons and joint ligaments.
Topics: Humans; Prospective Studies; Prevalence; Musculoskeletal Diseases; Lower Extremity; Dancing; Risk Factors
PubMed: 38481844
DOI: 10.3389/fpubh.2024.1325536 -
Computers in Biology and Medicine Apr 2024Physiotherapy is a critical area of healthcare that involves the assessment and treatment of physical disabilities and injuries. The use of Artificial Intelligence (AI)...
Physiotherapy is a critical area of healthcare that involves the assessment and treatment of physical disabilities and injuries. The use of Artificial Intelligence (AI) in physiotherapy has gained significant attention due to its potential to enhance the accuracy and effectiveness of clinical decision-making and treatment outcomes. Nevertheless, it is still a rather innovative field of application of these techniques and there is a need to find what aspects are highly developed and what possible job niches can be exploited. This systematic review aims to evaluate the current state of research on the use of a particular AI called deep learning models in physiotherapy and identify the key trends, challenges, and opportunities in this field. The findings of this review, conducted following the PRISMA guidelines, provide valuable insights for researchers and clinicians. The most relevant databases included were PubMed, Web of Science, Scopus, Astrophysics Data System, and Central Citation Export. Inclusion and exclusion criteria were established to determine which items would be considered for further review. These criteria were used to screen the items during the first and second peer review processes. A set of quality criteria was developed to select the papers obtained after the second screening. Finally, of the 214 initial papers, 23 studies were selected. From our analysis of the selected articles, we can draw the following conclusions: Concerning deep learning models, innovation is primarily seen in the adoption of hybrid models, with convolutional models being extensively utilized. In terms of data, it's unsurprising that body signals and images are predominantly used. However, texts and structured data present promising avenues for groundbreaking work in the field. Additionally, medical tests that involve the collection of 3D images, Functional Movement Screening, or thermographies emerge as novel areas to explore applications within the scope of physiotherapy.
Topics: Artificial Intelligence; Clinical Decision-Making; Databases, Factual; Deep Learning; Medicine; Humans
PubMed: 38461697
DOI: 10.1016/j.compbiomed.2024.108082