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Revista Espanola de Salud Publica Jan 2023Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical... (Review)
Review
OBJECTIVE
Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical intervention, caesarean section is not exempt from complications and these can be classified as short-term (acute pain) and long-term (adhesions in the scar, lumbar and pelvic pain, intestinal obstruction and ectopic pregnancies). Physiotherapy has different tools to address these complications. The aim of this study was to review the scientific bibliography to know the effects of physiotherapy on patients who have given birth by cesarean section.
METHODS
A search for articles was carried out during the month of December 2021 in the databases: PubMed, Medline, Cinahl, Scopus, PEDro and WOS using the search terms Cesarean Section, Physical Therapy Modalities and Physical therapy. As an inclusion criterion, it was established that the type of study was a Randomized Clinical Trial (RCT).
RESULTS
A total of 280 articles were obtained, of which 9 were selected after applying the eligibility criteria. In them, the most used physiotherapy intervention was electrotherapy, followed by massage therapy and therapeutic exercise. Studies show effects of these forms of physiotherapy, with a determined duration and frequency, with improvements in pain, activities of daily living, comfort level, joint ranges and reduction in the consumption of analgesics.
CONCLUSIONS
Physiotherapy has various modalities with which to attend complications after cesarean section, both in an immediate and a late phase, especially highlighting the reduction of pain.
Topics: Pregnancy; Female; Humans; Spain; Cesarean Section; Physical Therapy Modalities; Exercise Therapy; Pain; Randomized Controlled Trials as Topic
PubMed: 36636805
DOI: No ID Found -
BMC Women's Health Oct 2021Endometriosis is a common benign gynecological disease that has the potential to debilitate due to pain and reduced quality of life. Treatment modalities such as... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Endometriosis is a common benign gynecological disease that has the potential to debilitate due to pain and reduced quality of life. Treatment modalities such as hormones and surgery have limitations and do not treat all dimensions of the problems caused by endometriosis, and physical activity (PA) and exercise have been suggested as alternative treatments. Aim of this study was to perform a systematic review and meta-analysis to assess the effect of PA and exercise on endometriosis-associated symptoms.
METHODS
Eleven databases were searched systematically. Study selection, quality assessment, and data extraction were carried out by two independent researchers in accordance with PRISMA guidelines. Eligibility criteria were women with diagnosed endometriosis receiving an intervention (PA and/or exercise). The primary outcome was pain intensity, but all outcomes were accepted.
RESULTS
This study screened 1045 citations for eligibility. Four interventional studies were identified, of which one showed fatal design flaws and so was excluded. Three studies, two randomized controlled trials (RCT) and one pre-post study with no control group, involving 109 patients were included in a descriptive synthesis. The interventions included flexibility and strength training, cardiovascular fitness, and yoga, and were performed from one to four times per week for a total duration of 8-24 weeks, with or without supervision. Only one study found improvements in pain intensity. One study showed decreases in stress levels. Due to the heterogeneity of the study outcomes and measures, as well as confounding factors, a quantitative meta-analysis could not be performed.
CONCLUSION
The effect of PA and exercise as treatments for endometrioses-associated symptoms could not be determined due to significant limitations of the included studies. Future research should be based on RCTs of high methodological quality, measuring and reporting relevant core outcomes such as pain, improvements in symptoms and quality of life, and acceptability and satisfaction from the perspectives of patients. Furthermore, these outcomes need to be measured using reliable and validated tools.
TRIAL REGISTRATION NUMBER
CRD42021233138.
Topics: Endometriosis; Exercise; Exercise Therapy; Female; Humans; Pain; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 34627209
DOI: 10.1186/s12905-021-01500-4 -
Journal of Neuroengineering and... Jun 2013This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical... (Review)
Review
This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback signals. VR and exergaming technology have been primarily investigated in post-CVA rehabilitation, however, more recent work has shown this type of biofeedback to be effective in improving exercise technique in musculoskeletal populations. While a number of studies in this area have been conducted, further large scale studies and reviews investigating different biofeedback applications in different clinical populations are required.
Topics: Biofeedback, Psychology; Humans; Rehabilitation
PubMed: 23777436
DOI: 10.1186/1743-0003-10-60 -
BMC Musculoskeletal Disorders Dec 2019To systematically assess the evidence of Craniosacral Therapy (CST) for the treatment of chronic pain. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To systematically assess the evidence of Craniosacral Therapy (CST) for the treatment of chronic pain.
METHODS
PubMed, Central, Scopus, PsycInfo and Cinahl were searched up to August 2018. Randomized controlled trials (RCTs) assessing the effects of CST in chronic pain patients were eligible. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for pain intensity and functional disability (primary outcomes) using Hedges' correction for small samples. Secondary outcomes included physical/mental quality of life, global improvement, and safety. Risk of bias was assessed using the Cochrane tool.
RESULTS
Ten RCTs of 681 patients with neck and back pain, migraine, headache, fibromyalgia, epicondylitis, and pelvic girdle pain were included. CST showed greater post intervention effects on: pain intensity (SMD = -0.32, 95%CI = [- 0.61,-0.02]) and disability (SMD = -0.58, 95%CI = [- 0.92,-0.24]) compared to treatment as usual; on pain intensity (SMD = -0.63, 95%CI = [- 0.90,-0.37]) and disability (SMD = -0.54, 95%CI = [- 0.81,-0.28]) compared to manual/non-manual sham; and on pain intensity (SMD = -0.53, 95%CI = [- 0.89,-0.16]) and disability (SMD = -0.58, 95%CI = [- 0.95,-0.21]) compared to active manual treatments. At six months, CST showed greater effects on pain intensity (SMD = -0.59, 95%CI = [- 0.99,-0.19]) and disability (SMD = -0.53, 95%CI = [- 0.87,-0.19]) versus sham. Secondary outcomes were all significantly more improved in CST patients than in other groups, except for six-month mental quality of life versus sham. Sensitivity analyses revealed robust effects of CST against most risk of bias domains. Five of the 10 RCTs reported safety data. No serious adverse events occurred. Minor adverse events were equally distributed between the groups.
DISCUSSION
In patients with chronic pain, this meta-analysis suggests significant and robust effects of CST on pain and function lasting up to six months. More RCTs strictly following CONSORT are needed to further corroborate the effects and safety of CST on chronic pain.
PROTOCOL REGISTRATION AT PROSPERO
CRD42018111975.
Topics: Chronic Pain; Humans; Manipulation, Osteopathic; Pain Management; Pain Measurement; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome
PubMed: 31892357
DOI: 10.1186/s12891-019-3017-y -
Seminars in Interventional Radiology Mar 2018Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the... (Review)
Review
Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency. The etiology of PCS is diverse involving both mechanical and hormonal factors contributing to venous dilatation (>5 mm) and insufficiency. Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy to identify insufficiency compared with catheter venogram. A systematic review of the literature evaluating patient outcomes following percutaneous treatment of PCS is presented.
PubMed: 29628614
DOI: 10.1055/s-0038-1636519 -
Reproductive Biology and Endocrinology... Dec 2022There is a growing body of human, animal and in vitro studies on vitamin D (vit D) substitution in endometriosis. The aim of this systematic review is to critically... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is a growing body of human, animal and in vitro studies on vitamin D (vit D) substitution in endometriosis. The aim of this systematic review is to critically appraise and qualitatively synthesize the results of the available studies that examine the supplementation of vit D for endometriosis treatment.
METHODS
A systematic search of the literature was conducted in four electronic databases (Medline, Cochrane, Scopus, Embase) and grey literature for original research articles on humans, animals and in vitro models published in any language.
RESULTS
Four human studies, four animal studies and four in vitro studies were included. Quantitative synthesis of human studies showed no significant effect of vit D intake for dysmenorrhea (2 studies, 44 vit D vs 44 placebo, mean -0.71, 95% CI -1.94, 0.51) and non-cyclic pelvic pain (2 studies, 42 vit D vs 38 placebo, mean 0.34, 95% CI -0.02, 0.71). Regarding reproductive outcomes in women with endometriosis after in vitro fertilization, the only available study showed no differences between women taking vit D and women taking placebo. Three of the four included animal studies showed regression of endometriotic implants when treated with vit D. The in vitro studies demonstrated that vit D decreases invasion and proliferation of endometriotic lesions without affecting apoptosis.
CONCLUSIONS
Although in vitro and animal studies suggest regression of the endometriotic implants and decrease of invasion and proliferation after vit D supplementation, this was not reflected in the results of the meta-analysis, which showed no benefit of vit D supplementation in patients with endometriosis and dysmenorrhea or non-cyclic pelvic pain as well as on the outcome of IVF treatment. However, given the heterogeneity and the diversity of the available studies, more research is required to shed light on the role of vit D supplementation in women with endometriosis.
Topics: Animals; Humans; Female; Endometriosis; Dysmenorrhea; Vitamin D; Vitamins; Pelvic Pain; Dietary Supplements
PubMed: 36578019
DOI: 10.1186/s12958-022-01051-9 -
International Journal of Environmental... Oct 2020This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of...
This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.
Topics: Cumulative Trauma Disorders; Foot; Humans; Medial Tibial Stress Syndrome; Risk Factors; Rotation; Running; Tomography, X-Ray Computed
PubMed: 33066291
DOI: 10.3390/ijerph17207457 -
JBRA Assisted Reproduction Jan 2019Primary dysmenorrhea is a painful uterine contraction caused by endometrial laceration. Drug therapies and complementary medicine have been used to treat dysmenorrhea....
OBJECTIVES
Primary dysmenorrhea is a painful uterine contraction caused by endometrial laceration. Drug therapies and complementary medicine have been used to treat dysmenorrhea. The aim of this study was to investigate and offer an updated perspective on the treatments for dysmenorrhea.
METHODS
The present study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. The required information was collected based on searches for the following keywords: treatment, primary dysmenorrhea, medicinal plants, chemical drugs, and herbs. Searches were performed on databases Pubmed, Web of Sciences, Scopus, Iran medex, and SID by March 2018 to find literature in the English and Persian languages on this subject without a time limit.
RESULTS
This review included 17 papers, 10 of which on complementary medicine, three on drug therapies, and four on acupuncture and acupressure. The largest and smallest samples had 303 and 24 patients, respectively. Length of treatment ranged from one to six months and the measures most commonly used in the studies were the visual analogue scale and clinical efficacy. Reported complications included gastrointestinal events, nausea, vomiting, diarrhea, abdominal pain, and liver and kidney disorders.
CONCLUSION
Medicinal plants, drugs, and acupressure seem to suppress pain by reducing the level of prostaglandins, mediating nitric oxide, increasing beta-endorphin levels, blocking the calcium channel, and enhancing circulatory flow through the uterine pathway. Further trials are required to confirm the benefits of the procedures described and ensure the absence of complications.
Topics: Acupressure; Acupuncture Therapy; Complementary Therapies; Drug Therapy; Drug-Related Side Effects and Adverse Reactions; Dysmenorrhea; Female; Gynecology; Humans; Treatment Outcome
PubMed: 30521155
DOI: 10.5935/1518-0557.20180083 -
Oxidative Medicine and Cellular... 2017Endometriosis is one of the most common gynaecologic diseases in women of reproductive age. It is characterized by the presence of endometrial tissue outside the uterine... (Review)
Review
Endometriosis is one of the most common gynaecologic diseases in women of reproductive age. It is characterized by the presence of endometrial tissue outside the uterine cavity. The women affected suffer from pelvic pain and infertility. The complex etiology is still unclear and it is based on three main theories: retrograde menstruation, coelomic metaplasia, and induction theory. Genetics and epigenetics also play a role in the development of endometriosis. Recent studies have put the attention on the role of oxidative stress, defined as an imbalance between reactive oxygen species (ROS) and antioxidants, which may be implicated in the pathophysiology of endometriosis causing a general inflammatory response in the peritoneal cavity. Reactive oxygen species are intermediaries produced by normal oxygen metabolism and are inflammatory mediators known to modulate cell proliferation and to have deleterious effects. A systematic review was performed in order to clarify the different roles of oxidative stress and its role in the development of endometriosis. Several issues have been investigated: iron metabolism, oxidative stress markers (in the serum, peritoneal fluid, follicular fluid, peritoneal environment, ovarian cortex, and eutopic and ectopic endometrial tissue), genes involved in oxidative stress, endometriosis-associated infertility, and cancer development.
Topics: Endometriosis; Female; Humans; Oxidative Stress
PubMed: 29057034
DOI: 10.1155/2017/7265238 -
PloS One 2017Endometriosis is a multifactorial, oestrogen-dependent, inflammatory, gynaecological condition that can result in long-lasting visceral pelvic pain and infertility.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Endometriosis is a multifactorial, oestrogen-dependent, inflammatory, gynaecological condition that can result in long-lasting visceral pelvic pain and infertility. Acupuncture could be an effective treatment for endometriosis and may relieve pain. Our aim in the present study was to determine the effectiveness of acupuncture as a treatment for endometriosis-related pain.
METHODS
In December 2016, six databases were searched for randomised controlled trials that determined the effectiveness of acupuncture in the treatment of endometriosis-related pain. Ultimately, 10 studies involving 589 patients were included. The main outcomes assessed were variation in pain level, variation in peripheral blood CA-125 level, and clinical effective rate. All analyses were performed using comprehensive meta-analysis statistical software.
RESULTS
Of the 10 studies included, only one pilot study used a placebo control and assessed blinding; the rest used various controls (medications and herbs), which were impossible to blind. The sample sizes were small in all studies, ranging from 8 to 36 patients per arm. The mean difference (MD) in pain reduction (pre- minus post-interventional pain level-measured on a 0-10-point scale) between the acupuncture and control groups was 1.36 (95% confidence intervals [CI] = 1.01-1.72, P<0.0001). Acupuncture had a positive effect on peripheral blood CA-125 levels, as compared with the control groups (MD = 5.9, 95% CI = 1.56-10.25, P = 0.008). Similarly, the effect of acupuncture on clinical effective rate was positive, as compared with the control groups (odds ratio = 2.07; 95% CI = 1.24-3.44, P = 0.005).
CONCLUSIONS
Few randomised, blinded clinical trials have addressed the efficacy of acupuncture in treating endometriosis-related pain. Nonetheless, the current literature suggests that acupuncture reduces pain and serum CA-125 levels, regardless of the control intervention used. To confirm these findings, additional, blinded studies with proper controls and adequate sample sizes are needed.
Topics: Acupuncture; Endometriosis; Female; Humans; Pain Management; Pain Measurement; Publication Bias
PubMed: 29077705
DOI: 10.1371/journal.pone.0186616