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BMC Neurology Jun 2024The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients.
METHOD
A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale.
RESULTS
A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P < 0.00001; heterogeneity, I = 74%, P = 0.0003). The pooled results from 4 studies with 173 participants showed that cerebellar TMS could significantly improve the post-intervention Time Up and Go (TUG) (MD=-1.51, 95%CI=-2.8 to -0.22, P = 0.02; heterogeneity, I = 0%, P = 0.41). The pooled results from 6 studies with 280 participants showed that cerebellar TMS could significantly improve the post-intervention ADL (MD = 7.75, 95%CI = 4.33 to 11.17, P < 0.00001; heterogeneity, I = 56%, P = 0.04). The subgroup analysis showed that cerebellar TMS could improve BBS post-intervention and ADL post-intervention for both subacute and chronic stage stroke patients. Cerebellar high frequency TMS could improve BBS post-intervention and ADL post-intervention. Cerebellar TMS could still improve BBS post-intervention and ADL post-intervention despite of different cerebellar TMS sessions (less and more than 10 TMS sessions), different total cerebellar TMS pulse per week (less and more than 4500 pulse/week), and different cerebellar TMS modes (repetitive TMS and Theta Burst Stimulation). None of the studies reported severe adverse events except mild side effects in three studies.
CONCLUSIONS
Cerebellar TMS is an effective and safe technique for improving balance capacity and ADL in stroke patients. Further larger-sample, higher-quality, and longer follow-up RCTs are needed to explore the more reliable evidence of cerebellar TMS in the balance capacity and ADL, and clarify potential mechanisms.
Topics: Humans; Transcranial Magnetic Stimulation; Activities of Daily Living; Postural Balance; Stroke Rehabilitation; Cerebellum; Stroke; Randomized Controlled Trials as Topic
PubMed: 38879485
DOI: 10.1186/s12883-024-03720-1 -
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 -
Journal of Bodywork and Movement... Jul 2024To examine the effects of Cawthorne-Cooksey exercises on individuals with vestibular dysfunction symptoms. (Review)
Review
OBJECTIVES
To examine the effects of Cawthorne-Cooksey exercises on individuals with vestibular dysfunction symptoms.
METHODS
Systematic search was conducted using PubMed, EBSCO SCOPUS, Web of Science, and Google Scholar from inception to March 2023. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate the risk of bias in the included studies.
RESULTS
Ten randomized controlled trials met the eligibility criteria. In total, 610 participants, 41.31 % of whom were men were included in this review. The PEDro scale scores ranged from 6 to 8 with a median of 6.5/10. Our findings revealed improvements in patients' vestibular dysfunction symptoms after Cawthorne-Cooksey exercises and other conventional interventions.
CONCLUSIONS
The initial findings showed that Cawthorne-Cooksey exercises are not superior to other concurrent vestibular rehabilitation interventions in improving vestibular dysfunction symptoms. Additional trials with long-term follow-ups are strongly recommended to understand the impacts of Cawthorne-Cooksey exercises on vestibular dysfunction symptoms.
Topics: Humans; Randomized Controlled Trials as Topic; Vestibular Diseases; Exercise Therapy; Postural Balance
PubMed: 38876618
DOI: 10.1016/j.jbmt.2024.02.026 -
BMC Psychiatry Jun 2024Anxiety and depression can seriously undermine mental health and quality of life globally. The consumption of junk foods, including ultra-processed foods, fast foods,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Anxiety and depression can seriously undermine mental health and quality of life globally. The consumption of junk foods, including ultra-processed foods, fast foods, unhealthy snacks, and sugar-sweetened beverages, has been linked to mental health. The aim of this study is to use the published literature to evaluate how junk food consumption may be associated with mental health disorders in adults.
METHODS
A systematic search was conducted up to July 2023 across international databases including PubMed/Medline, ISI Web of Science, Scopus, Cochrane, Google Scholar, and EMBASE. Data extraction and quality assessment were performed by two independent reviewers. Heterogeneity across studies was assessed using the I statistic and chi-square-based Q-test. A random/fixed effect meta-analysis was conducted to pool odds ratios (ORs) and hazard ratios (HRs).
RESULTS
Of the 1745 retrieved articles, 17 studies with 159,885 participants were suitable for inclusion in the systematic review and meta-analysis (seven longitudinal, nine cross-sectional and one case-control studies). Quantitative synthesis based on cross-sectional studies showed that junk food consumption increases the odds of having stress and depression (OR = 1.15, 95% CI: 1.06 to 1.23). Moreover, pooling results of cohort studies showed that junk food consumption is associated with a 16% increment in the odds of developing mental health problems (OR = 1.16, 95% CI: 1.07 to 1.24).
CONCLUSION
Meta-analysis revealed that consumption of junk foods was associated with an increased hazard of developing depression. Increased consumption of junk food has heightened the odds of depression and psychological stress being experienced in adult populations.
Topics: Humans; Fast Foods; Depression; Adult; Stress, Psychological; Anxiety; Snacks
PubMed: 38867156
DOI: 10.1186/s12888-024-05889-8 -
Medical Education Online Dec 2024Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve... (Meta-Analysis)
Meta-Analysis Review
Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, < 0.0001). Lastly, the results also showed a significant (z = -2.52, = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.
Topics: Yoga; Humans; Blood Pressure; Heart Rate; Stress, Psychological; Anxiety; Education, Medical; Depression; Students, Medical; Respiratory Function Tests
PubMed: 38861675
DOI: 10.1080/10872981.2024.2364486 -
Multiple Sclerosis and Related Disorders Jul 2024Balance disorders are a common concern in people with multiple sclerosis (PwMS). Core stability exercises are recommended as one of the treatment principles of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND OBJECTIVES
Balance disorders are a common concern in people with multiple sclerosis (PwMS). Core stability exercises are recommended as one of the treatment principles of rehabilitation in patients with balance disorders. This systematic review and meta-analysis investigate the effects of core stabilization exercises (CSE) on balance in PwMS.
METHODS
Online databases were searched from 1980 to December 15, 2022, including PubMed/Medline, Scopus, Web of Science, CINAHL, PEDro, Embase, and ProQuest to identify randomized controlled trials (RCTs) investigating the effects of CSE on balance in PwMS. The methodological qualities of the included studies were assessed using the modified Cochrane risk bias tool for randomized trials. Random-effect meta-analyzes were performed on the Berg balance test and Biodex balance system outcomes.
RESULTS
Seven RCTs were included in this study. A total of 379 patients (EDSS<6) were enrolled in the included studies. All researchers had applied CSE within six to ten weeks with the frequency of two to three sessions/week. According to qualitative results, core stability exercise significantly changes the most balanced outcomes. The meta-analyses illustrated that allocated participants to experimental groups had statistically significantly higher Berg balance test scores (standardized mean difference: 1.1; 95 % CI: [0.1, 2.1]) and insignificant lower Biodex score (standardized mean difference: -0.59; 95 % CI: [-1.09, -0.09]) compared to the control groups.
CONCLUSION
Six to ten weeks of CSEs is an effective therapeutic strategy for balance improvement in PwMS that can help improve balance, especially in patients with moderate disability levels (EDSS3.5-6). Further randomized clinical trials are needed to compare the efficacy of CSEs and routine balance training in PwMS.
Topics: Humans; Postural Balance; Multiple Sclerosis; Exercise Therapy; Gait; Randomized Controlled Trials as Topic
PubMed: 38850684
DOI: 10.1016/j.msard.2024.105686 -
Eating and Weight Disorders : EWD Jun 2024Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by... (Review)
Review
PURPOSE
Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by exposure to minority-specific stressors, such as discrimination and violence. This systematic review aims to summarize available evidence on the role of minority stress in disordered eating and SGM-specific aspects.
METHODS
Following PRISMA guidelines, scientific search engines (EBSCO, PUBMED, Web of Science) were screened up to 31st of January 2024, including English-language original research papers containing analyses of the relationship between minority stress and disordered eating. 2416 records were gathered for screening. After application of inclusion and exclusion criteria, thematic analysis was conducted regarding 4 research questions: effects of minority stress on disordered eating, mediating factors, specificities of SGMs and differences between identity categories.
RESULTS
30 studies were included. Several aspects of minority stress are reliably associated with different forms of disordered eating. The relationship between minority stressors and disordered eating is mediated by aspects such as shame, body shame, or negative affect. SGMs show several specificities, such as the presence of a role of LGBTQIA + communities and additional gender-related pressures. Bisexual people and gender minorities appear to feature comparatively higher risks, and gender-related factors shape paths leading to disordered eating risk.
CONCLUSION
Minority stress is an important predictor of disordered eating, making SGM people's health particularly at risk. Institutional and organizational anti-discrimination policies are needed, as well as further research. Clinical interventions may benefit from exploring and incorporating how minority stressors impact SGM people. Evidence level I-Systematic review.
Topics: Humans; Feeding and Eating Disorders; Stress, Psychological; Sexual and Gender Minorities; Minority Groups; Female; Male
PubMed: 38850334
DOI: 10.1007/s40519-024-01671-7 -
Systematic Reviews Jun 2024Memory and attention are important for daily functioning, and their function deteriorates due to aging. However, fruit and vegetable consumption are one of the...
BACKGROUND
Memory and attention are important for daily functioning, and their function deteriorates due to aging. However, fruit and vegetable consumption are one of the protective factors against deterioration in memory and attention. This systematic review of randomized controlled trials (RCTs) aims to identify the effects of fruit and vegetable consumption on memory and attention.
METHODS
We conducted a systematic search in EBSCOhost, ProQuest, PubMed, Embase, and Web of Science from inception up to 06/09/2022. The inclusion criteria were peer-reviewed articles, fruit and vegetable intake measured using randomized controlled trials, and the outcome measures that showed the results of memory and attention scores. Two researchers independently extracted articles that met the selection criteria and evaluated the quality of each study.
RESULTS
There were 70 articles identified from the databases, of which 13 articles met the inclusion criteria and were included in this systematic review. There were 493 participants in total. The results show that consumption of fruit and vegetable intake improved memory and attention in longitudinal studies (10 to 12 weeks). Children showed improvement in immediate recall after supplementation with blueberries. Older adults required a higher dose of fruit and vegetable intake consumption to achieve significant improvement compared with children and younger adults. Furthermore, the effect of fruits and vegetables on memory showed better immediate memory recall than delayed recall.
CONCLUSION
This systematic review showed that there is an improvement in memory and attention with fruit and vegetable intake consumption. Hence, awareness of fruit and vegetable intake consumption is important to maintain cognitive health.
Topics: Humans; Vegetables; Fruit; Randomized Controlled Trials as Topic; Memory; Attention; Diet
PubMed: 38849879
DOI: 10.1186/s13643-024-02547-8 -
BMC Medical Education Jun 2024Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively associated with burnout in physicians. Our objective was to quantitatively review the available literature on associations between empathy and burnout in medical students, and to explore associations between specific empathy aspects (cognitive and affective) and burnout sub-dimensions (emotional exhaustion, depersonalization and personal accomplishment).
METHODS
A comprehensive search of the literature published up until January 2024 was undertaken in the PubMed, EMBASE, CINAHL, The Cochrane Library, and PsycINFO databases. Two independent reviewers screened 498 records and quality-rated and extracted data from eligible studies. The effect size correlations (ESr) were pooled using a random-effects model and between-study variation explored with meta-regression. The review was preregistered with PROSPERO (#CRD42023467670) and reported following the PRISMA guidelines.
RESULTS
Twenty-one studies including a total of 27,129 medical students published between 2010 and 2023 were included. Overall, empathy and burnout were negatively and statistically significantly associated (ESr: -0.15, 95%CI [-0.21; -0.10], p < .001). When analyzing sub-dimensions, cognitive empathy was negatively associated with emotional exhaustion (ESr: -0.10, 95%CI [-0.17; -0.03], p = .006) and depersonalization (ESr: -0.15, 95%CI [-0.24; 0.05], p = .003), and positively associated with personal accomplishment (ESr: 0.21, 95%CI [0.12; 0.30], p < .001). Affective empathy was not statistically significantly associated with emotional exhaustion, depersonalization or personal accomplishment. Supplementary Bayesian analysis indicated the strongest evidence for the positive association between cognitive empathy and personal accomplishment. Response rate and gender moderated the relationship so that higher response rates and more male respondents strengthen the negative association between empathy and burnout.
CONCLUSION
Greater empathy, in particular cognitive empathy, is associated with lower burnout levels in medical students. This appears to be primarily driven by cognitive empathy's positive association with personal accomplishment.
PROTOCOL REGISTRATION
#CRD42023467670.
Topics: Humans; Students, Medical; Empathy; Burnout, Professional; Depersonalization
PubMed: 38849794
DOI: 10.1186/s12909-024-05625-6 -
PLoS Neglected Tropical Diseases Jun 2024Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7-10 days.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7-10 days. However, debilitating symptoms can persist for months or years. Despite the substantial impact of this disease, a comprehensive assessment of its clinical picture is currently lacking.
METHODS
We conducted a systematic literature review on the clinical manifestations of chikungunya, their prevalence and duration, and related hospitalization. Embase and MEDLINE were searched with no time restrictions. Subsequently, meta-analyses were conducted to quantify pooled estimates on clinical outcomes, the symptomatic rate, the mortality rate, and the hospitalization rate. The pooling of effects was conducted using the inverse-variance weighting methods and generalized linear mixed effects models, with measures of heterogeneity reported.
RESULTS
The systematic literature review identified 316 articles. Out of the 28 outcomes of interest, we were able to conduct 11 meta-analyses. The most prevalent symptoms during the acute phase included arthralgia in 90% of cases (95% CI: 83-94%), and fever in 88% of cases (95% CI: 85-90%). Upon employing broader inclusion criteria, the overall symptomatic rate was 75% (95% CI: 63-84%), the chronicity rate was 44% (95% CI: 31-57%), and the mortality rate was 0.3% (95% CI: 0.1-0.7%). The heterogeneity between subpopulations was more than 92% for most outcomes. We were not able to estimate all predefined outcomes, highlighting the existing data gap.
CONCLUSION
Chikungunya is an emerging public health concern. Consequently, a thorough understanding of the clinical burden of this disease is necessary. Our study highlighted the substantial clinical burden of chikungunya in the acute phase and a potentially long-lasting chronic phase. Understanding this enables health authorities and healthcare professionals to effectively recognize and address the associated symptoms and raise awareness in society.
Topics: Chikungunya Fever; Humans; Chikungunya virus; Arthralgia; Hospitalization; Fever; Prevalence
PubMed: 38848443
DOI: 10.1371/journal.pntd.0012254