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EFORT Open Reviews Jul 2024To compile all the scientific evidence available to date to evaluate the effect of virtual reality based therapy (VRBT) on reducing pain intensity, kinesiophobia, and...
PURPOSE
To compile all the scientific evidence available to date to evaluate the effect of virtual reality based therapy (VRBT) on reducing pain intensity, kinesiophobia, and associated disability, and on increasing the hr-QoL in patients with chronic neck pain (CNP) or chronic low back pain (CLBP).
METHODS
Studies published in PubMed Medline, SCOPUS, Web of Science, CINAHL Complete, and Physiotherapy Evidence Database (PEDro) up to June 2023 were searched. All searches followed the PICOS Framework. Two authors independently screened the studies found in the searches. Any differences of opinion regarding the selection of studies were settled by a third author.
RESULTS
Twenty-five RCTs, published between 2013 and 2022, providing data from 1261 patients (20 RCTs) with CLBP and 261 patients (five RCTs) with CNP, were included. In reducing pain intensity for patients with CLBP, meta-analyses showed that VRBT is effective in reducing pain just to the end of the intervention, and this effect could be maintained 1 and 6 months after the therapy.
CONCLUSION
VRBT was found to be better than therapeutic exercise (TE), sham, and no intervention (NI), showing a major effect when VRBT was used as a complementary therapy to conventional physiotherapy (CPT). Further, VRBT showed an immediate effect and immersive VRBT was the most adequate VRBT modality in reducing pain in CNP patients. No differences were found between non-immersive VRBT and immersive VRBT in reducing pain, kinesiophobia, disability, and hr-QoL in patients with CLBP.
PubMed: 38949175
DOI: 10.1530/EOR-23-0197 -
EFORT Open Reviews Jul 2024The combination of pharmacological and non-pharmacological interventions is strongly recommended by current guidelines for knee osteoarthritis. However, few systematic...
PURPOSE
The combination of pharmacological and non-pharmacological interventions is strongly recommended by current guidelines for knee osteoarthritis. However, few systematic reviews have validated their combined efficacy. In this study, we investigated the effects of the combination of pharmacological agents and exercise on knee osteoarthritis.
METHODS
Randomized controlled trials that investigated the efficacy of pharmacological agents combined with exercise for knee osteoarthritis were searched in PubMed, Embase, and Cochrane Library up to February 2024. The network meta-analysis was performed within the frequentist framework. Standardized mean difference (SMD) with 95% CI was estimated for pain and function. Grading of recommendations, assessment, development, and evaluations were used to evaluate the certainty of evidence.
RESULTS
In total, 71 studies were included. The combination therapy outperformed pharmacological or exercise therapy alone. Among the various pharmacological agents combined with exercise, mesenchymal stem cell injection was ranked the best for short-term pain reduction (SMD: -1.53, 95% CI: -1.92 to -1.13, high certainty), followed by botulinum toxin A, dextrose, and platelet-rich plasma. For long-term pain relief, dextrose prolotherapy was the optimal (SMD: -1.76, 95% CI: -2.65 to -0.88, moderate certainty), followed by mesenchymal stem cells, platelet rich in growth factor, and platelet-rich plasma.
CONCLUSION
Exercise programs should be incorporated into clinical practice and trial design. For patients undergoing exercise therapies, mesenchymal stem cell, dextrose, platelet-rich plasma, platelet rich in growth factor, and botulinum toxin A may be the optimal agents.
PubMed: 38949167
DOI: 10.1530/EOR-23-0136 -
PeerJ 2024Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it...
INTRO
Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it possible to study sensory and cognitive processes in the brain. Previous reports have shown that aerobic exercise can have an impact on components of ERPs such as amplitude and latency. However, they focused on the measurement of ERPs after exercise.
OBJECTIVES
The aim of this systematic review was to investigate the feasibility of measuring ERPs during cycling, and to assess the impact of cycling on ERPs during cycling.
METHODS
We followed the PRISMA guidelines for new systematic reviews. To be eligible, studies had to include healthy adults and measure ERPs during cycling. All articles were found using Google Scholar and by searching references. Data extracted from the studies included: objectives of ERP studies, ERP paradigm, EEG system, study population data, exercise characteristics (duration, intensity, pedaling cadence), and ERP and behavioral outcomes. The Cochrane Risk of Bias 2 tool was used to assess study bias.
RESULTS
Twenty studies were selected. The effect of cycling on ERPs was mainly based on a comparison of P3 wave amplitude between cycling and resting states, using an attentional task. The ERP paradigm most often used was the auditory oddball task. Exercise characteristics and study methods varied considerably.
DISCUSSION
It is possible to measure ERPs during cycling under conditions that are likely to introduce more artifacts, including a 3-h athletic exercise session and cycling outdoors. Secondly, no assessment of the effect of cycling on ERPs was possible, because the methods differed too widely between studies. In addition, the theories proposed to explain the results sometimes seemed to contradict each other. Although most studies reported significant results, the direction of the effects was inconsistent. Finally, we suggest some areas for improvement for future studies on the subject.
Topics: Humans; Electroencephalography; Bicycling; Evoked Potentials; Exercise; Brain
PubMed: 38948229
DOI: 10.7717/peerj.17448 -
PeerJ 2024Fibroblast growth factor 21 (FGF21) is a key hormone factor that regulates glucose and lipid homeostasis. Exercise may regulate its effects and affect disease states.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Fibroblast growth factor 21 (FGF21) is a key hormone factor that regulates glucose and lipid homeostasis. Exercise may regulate its effects and affect disease states. Therefore, we sought to determine how exercise affects FGF21 concentrations in adults.
METHODS
The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42023471163). The Cochrane Library, PubMed, and Web of Science databases were searched for studies through July 2023. Studies that assessed the effects of exercise training on FGF21 concentration in adults were included. The random effect model, data with standardized mean difference (SMD), and 95% confidence intervals (CI) were used to evaluate the pooled effect size of exercise training on FGF21. The risk of heterogeneity and bias were evaluated. A total of 12 studies involving 401 participants were included.
RESULTS
The total effect size was 0.3 (95% CI [-0.3-0.89], = 0.33) when comparing participants who exercised to those who were sedentary. However, subgroup analysis indicated that concurrent exercise and a duration ≥10 weeks significantly decreased FGF21 concentrations with an effect size of -0.38 (95% CI [-0.74--0.01], < 0.05) and -0.38 (95% CI [-0.63--0.13], < 0.01), respectively.
CONCLUSION
Concurrent exercise and longer duration may be more efficient way to decrease FGF21 concentrations in adults with metabolic disorder.
Topics: Fibroblast Growth Factors; Humans; Exercise; Adult
PubMed: 38948228
DOI: 10.7717/peerj.17615 -
Frontiers in Neurology 2024Stroke is a cerebrovascular disease with high prevalence and mortality, and upper limb hemiparesis is a major factor limiting functional recovery in stroke patients....
BACKGROUND
Stroke is a cerebrovascular disease with high prevalence and mortality, and upper limb hemiparesis is a major factor limiting functional recovery in stroke patients. Improvement of motor function in stroke patients through various forms of constraint-induced movement therapy (CITM) has been recognized as safe and effective in recent years. This research field lacks a comprehensive systematic and clear vein combing analysis, analyzing the literature research of CIMT in the field of rehabilitation in the past three decades, summarizing the research hotspots and cutting-edge trends in this field, in an effort to offer ideas and references for subsequent researchers.
METHODS
Relevant literature on CIMT in rehabilitation was collected from 1996 to 2024 within the Web of Science database's core dataset by using CiteSpace6.1, VOSviewer1.6.18, R-bibliometrix4.6.1, Pajek5.16, Scimago Graphica 1.0.26 software for visualization and analysis.
RESULTS
There were 970 papers in all United States was ranked first with 401 papers. Alabama Univ was ranked first for institutions with 53 papers. Neurorehabilitation and Neural Repair was ranked first for journals with 78 papers, and Taub E was ranked first for author publications with 64 papers. Research keywords were CIMT, stroke rehabilitation, upper extremity function, lower extremity gait balance, randomized controlled trials, physical therapy techniques (transcranial magnetic stimulation and sensory amplitude electrical stimulation), primary motor cortex plasticity, lateral dominance (spatial behaviors), cerebral vascular accidents, activities of daily living, hand function, disability, functional restoration, bimanual training, aphasia, acquired invalidity, type A Botulinum toxin and joystick riding toys.
CONCLUSION
The current state of research shows that CIMT still has a vast potential for development in the field of rehabilitation research. The research hotspots are the clinical efficacy of CIMT combined with other therapies (botulinum toxin type A, transcranial direct current stimulation, virtual reality, mirror therapy, robotic-assisted) to enhance the functionality of upper limb hemiparesis in stroke patients, the mechanism of CIMT to improve the plasticity of the motor cortex through electrophysiological and imaging methods, and improvement of lower limb gait balance function in stroke patients and aphasia applications, the optimal intervention time and dose, and exploration of CIMT in new settings such as robot-assisted, telemedicine, and home rehabilitation.
PubMed: 38948135
DOI: 10.3389/fneur.2024.1375855 -
Annals of Agricultural and... Jun 2024As globalization and modernization continue to impact people's lives, a significant shift in lifestyle has taken place, resulting in a worldwide decrease in physical... (Review)
Review
INTRODUCTION AND OBJECTIVE
As globalization and modernization continue to impact people's lives, a significant shift in lifestyle has taken place, resulting in a worldwide decrease in physical activity and an increase in unhealthy eating patterns. Physical inactivity has become the fourth leading cause of death globally. The aim of this scoping review is to analyze the concept and development of integrating physical activity into healthcare (IPAHc), based on the principles of sports and exercise medicine (SEM) and exercise is medicine (EIM).
REVIEW METHODS
A systematic search was conducted of relevant published studies with full text using PubMed, Scopus, Web of Science, Academic Search Ultimate, Medline, and SPORTDiscus, via the EBSCO search platform.
BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE
Twenty-nine studies met the inclusion criteria. The integration pathway centres around physical activity consultation and/or referral, and information technology which has been extensively utilized in IPAHc, including websites, electronic medical records, social media, wearable devices, mobile software, and referral tools. SEM and EIM face numerous implementation challenges, such as time constraints, education/training, resources, and tools.
SUMMARY
The concept of IPAHc involves the integration of Physical Activity Vital Signs (PAVS) into electronic medical records to evaluate the physical activity levels of the general population. This can assist individuals in achieving fitness goals, preventing diseases, treating existing illnesses, and undergoing rehabilitation. IPAHc has been in development for many years and is now being explored in practice. Despite the widespread use of information technology in this integration process, a number of challenges still need addressing.
Topics: Humans; Exercise; Delivery of Health Care
PubMed: 38940098
DOI: 10.26444/aaem/183778 -
Health Technology Assessment... Jun 2024To limit the use of antimicrobials without disincentivising the development of novel antimicrobials, there is interest in establishing innovative models that fund...
BACKGROUND
To limit the use of antimicrobials without disincentivising the development of novel antimicrobials, there is interest in establishing innovative models that fund antimicrobials based on an evaluation of their value as opposed to the volumes used. The aim of this project was to evaluate the population-level health benefit of cefiderocol in the NHS in England, for the treatment of severe aerobic Gram-negative bacterial infections when used within its licensed indications. The results were used to inform the National Institute for Health and Care Excellence guidance in support of commercial discussions regarding contract value between the manufacturer and NHS England.
METHODS
The health benefit of cefiderocol was first derived for a series of high-value clinical scenarios. These represented uses that were expected to have a significant impact on patients' mortality risks and health-related quality of life. The clinical effectiveness of cefiderocol relative to its comparators was estimated by synthesising evidence on susceptibility of the pathogens of interest to the antimicrobials in a network meta-analysis. Patient-level costs and health outcomes of cefiderocol under various usage scenarios compared with alternative management strategies were quantified using decision modelling. Results were reported as incremental net health effects expressed in quality-adjusted life-years, which were scaled to 20-year population values using infection number forecasts based on data from Public Health England. The outcomes estimated for the high-value clinical scenarios were extrapolated to other expected uses for cefiderocol.
RESULTS
Among isolates with the metallo-beta-lactamase resistance mechanism, the base-case network meta-analysis found that cefiderocol was associated with a lower susceptibility relative to colistin (odds ratio 0.32, 95% credible intervals 0.04 to 2.47), but the result was not statistically significant. The other treatments were also associated with lower susceptibility than colistin, but the results were not statistically significant. In the metallo-beta-lactamase base-case network meta-analysis, cefiderocol was associated with a lower susceptibility relative to colistin (odds ratio 0.44, 95% credible intervals 0.03 to 3.94), but the result was not statistically significant. The other treatments were associated with no susceptibility. In the base case, patient-level benefit of cefiderocol was between 0.02 and 0.15 quality-adjusted life-years, depending on the site of infection, the pathogen and the usage scenario. There was a high degree of uncertainty surrounding the benefits of cefiderocol across all subgroups. There was substantial uncertainty in the number of infections that are suitable for treatment with cefiderocol, so population-level results are presented for a range of scenarios for the current infection numbers, the expected increases in infections over time and rates of emergence of resistance. The population-level benefits varied substantially across the base-case scenarios, from 896 to 3559 quality-adjusted life-years over 20 years.
CONCLUSION
This work has provided quantitative estimates of the value of cefiderocol within its areas of expected usage within the NHS.
LIMITATIONS
Given existing evidence, the estimates of the value of cefiderocol are highly uncertain.
FUTURE WORK
Future evaluations of antimicrobials would benefit from improvements to NHS data linkages; research to support appropriate synthesis of susceptibility studies; and application of routine data and decision modelling to assess enablement value.
STUDY REGISTRATION
No registration of this study was undertaken.
FUNDING
This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment Policy Research Programme (NIHR award ref: NIHR135591), conducted through the Policy Research Unit in Economic Methods of Evaluation in Health and Social Care Interventions, PR-PRU-1217-20401, and is published in full in ; Vol. 28, No. 28. See the NIHR Funding and Awards website for further award information.
Topics: Humans; Cephalosporins; Anti-Bacterial Agents; Quality-Adjusted Life Years; Cost-Benefit Analysis; England; Technology Assessment, Biomedical; Cefiderocol; Gram-Negative Bacterial Infections; State Medicine; Quality of Life
PubMed: 38938145
DOI: 10.3310/YGWR4511 -
JMIR Perioperative Medicine Jun 2024As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the... (Review)
Review
The Effectiveness of Patient Education on Laparoscopic Surgery Postoperative Outcomes to Determine Whether Direct Coaching Is the Best Approach: Systematic Review of Randomized Controlled Trials.
BACKGROUND
As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative.
OBJECTIVE
This study aims to determine which POEI could be the most effective on patient outcomes by systematically reviewing all the POEIs reported in the literature.
METHODS
In total, 4753 articles investigating various POEIs (eg, videos, presentations, mobile apps, and one-on-one education or coaching) were collected from the PubMed, Embase, and Scopus databases. Inclusion criteria were adult patients undergoing abdominal laparoscopic surgery, randomized controlled trials, and studies that provided postoperative outcomes. Exclusion criteria included studies not published in English and with no outcomes reported. Title and abstract and full-text articles with POEI randomized controlled studies were screened based on the above criteria through a blinded, dual review using Covidence (Veritas Health Innovation). Study quality was assessed through the Cochrane Risk of Bias tool. The included articles were analyzed for educational content, intervention timing, intervention type, and postoperative outcomes appropriate for a particular surgery.
RESULTS
Only 17 studies matched our criteria, with 1831 patients undergoing laparoscopic cholecystectomy, bariatric surgery (gastric bypass and gastric sleeve), and colectomy. In total, 15 studies reported a statistically significant improvement in at least 1 patient postoperative outcome. None of these studies were found to have an overall high risk of bias according to Cochrane standards. In total, 41% (7/17) of the included studies using direct individual education improved outcomes in almost all surgery types, while educational videos had the greatest statistically significant impact for anxiety, nausea, and pain postoperatively (P<.01). Direct group education demonstrated significant improvement in weight, BMI, exercise, and depressive symptoms in 33% (2/6) of the laparoscopic gastric bypass studies.
CONCLUSIONS
Direct education (individual or group based) positively impacts postoperative laparoscopic surgery outcomes.
TRIAL REGISTRATION
PROSPERO CRD42023438698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=438698.
PubMed: 38935953
DOI: 10.2196/51573 -
PloS One 2024The elderly is commonly susceptible to depression, the symptoms for which may overlap with natural aging or other illnesses, and therefore miss being captured by routine...
BACKGROUND
The elderly is commonly susceptible to depression, the symptoms for which may overlap with natural aging or other illnesses, and therefore miss being captured by routine screening questionnaires. Passive sensing data have been promoted as a tool for depressive symptoms detection though there is still limited evidence on its usage in the elderly. Therefore, this study aims to review current knowledge on the use of passive sensing data via smartphones and smartwatches in depressive symptom screening for the elderly.
METHOD
The search of literature was performed in PubMed, IEEE Xplore digital library, and PsycINFO. Literature investigating the use of passive sensing data to screen, monitor, and/or predict depressive symptoms in the elderly (aged 60 and above) via smartphones and/or wrist-worn wearables was included for initial screening. Studies in English from international journals published between January 2012 to September 2022 were included. The reviewed studies were further analyzed by a narrative analysis.
RESULTS
The majority of 21 included studies were conducted in Western countries with a few in Asia and Australia. Most studies adopted a cohort study design (n = 12), followed by cross-sectional design (n = 7) and a case-control design (n = 2). The most popular passive sensing data was related to sleep and physical activity using an actigraphy. Sleep characteristics, such as prolonged wakefulness after sleep onset, along with lower levels of physical activity, exhibited a significant association with depression. However, cohort studies expressed concerns regarding data quality stemming from incomplete follow-up and potential confounding effects.
CONCLUSION
Passive sensing data, such as sleep, and physical activity parameters should be promoted for depressive symptoms detection. However, the validity, reliability, feasibility, and privacy concerns still need further exploration.
Topics: Humans; Smartphone; Depression; Aged; Mass Screening; Wearable Electronic Devices; Sleep; Middle Aged; Exercise; Female
PubMed: 38935797
DOI: 10.1371/journal.pone.0304845 -
Heliyon Jun 2024Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast...
A evidence-based approach to selecting post-exercise cryostimulation techniques for improving exercise performance and fatigue recovery: A systematic review and meta-analysis.
RATIONALE
Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results.
INTRODUCTION
To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery.
METHODS
Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software.
RESULTS
This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = -0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = -1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05).
CONCLUSION
Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.
PubMed: 38933969
DOI: 10.1016/j.heliyon.2024.e32196