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Eye & Contact Lens Jul 2018Myopia occurs in more than 50% of the population in many industrialized countries and is expected to increase; complications associated with axial elongation from myopia... (Meta-Analysis)
Meta-Analysis Review
Myopia occurs in more than 50% of the population in many industrialized countries and is expected to increase; complications associated with axial elongation from myopia are the sixth leading cause of blindness. Thus, understanding its etiology, epidemiology, and the results of various treatment regiments may modify current care and result in a reduction in morbidity from progressive myopia. This rapid increase cannot be explained by genetics alone. Current animal and human research demonstrates that myopia development is a result of the interplay between genetic and the environmental factors. The prevalence of myopia is higher in individuals whose both parents are myopic, suggesting that genetic factors are clearly involved in myopia development. At the same time, population studies suggest that development of myopia is associated with education and the amount time spent doing near work; hence, activities increase the exposure to optical blur. Recently, there has been an increase in efforts to slow the progression of myopia because of its relationship to the development of serious pathological conditions such as macular degeneration, retinal detachments, glaucoma, and cataracts. We reviewed meta-analysis and other of current treatments that include: atropine, progressive addition spectacle lenses, orthokeratology, and multifocal contact lenses.
Topics: Atropine; Contact Lenses; Disease Progression; Eyeglasses; Humans; Muscarinic Antagonists; Mydriatics; Myopia; Orthokeratologic Procedures; Recreation
PubMed: 29901472
DOI: 10.1097/ICL.0000000000000499 -
Developmental Medicine and Child... Jan 2020To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).
AIM
To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).
METHOD
We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal graphs for each GMFCS level, depicting change across time using centiles. Using multinomial models, we analyzed the relationship between therapies (amount, focus, family-centeredness, and the extent therapies met children's needs) and whether change in balance, walking endurance, and participation was 'more than' and 'less than' the reference of 'as expected'.
RESULTS
Children were more likely to progress 'more than expected' when participating in recreation when therapies were family-centered, met children's needs, and focused on structured play/recreation. A focus on health and well-being was positively associated with participation and self-care. The amount of therapy did not predict outcomes.
INTERPRETATION
Therapy services that are family-centered, consider the needs of the child, and focus on structured play/recreational activities and health/well-being may enhance the development of children with CP.
WHAT THIS PAPER ADDS
Family-centered rehabilitation therapies were positively associated with greater participation in family/recreation activities and walking endurance. Parental perception that rehabilitation therapies met children's needs was associated with greater participation in family/recreation activities. Structured play, recreational activities, and health/well-being are important for self-care and participation when planning rehabilitation therapy. The amount of rehabilitation therapy was not related to developmental outcomes.
Topics: Cerebral Palsy; Child; Child, Preschool; Family; Female; Humans; Infant; Longitudinal Studies; Male; Occupational Therapy; Outcome and Process Assessment, Health Care; Patient Satisfaction; Physical Therapy Modalities; Recreation Therapy; Severity of Illness Index; Speech Therapy
PubMed: 31353456
DOI: 10.1111/dmcn.14325 -
Current Neuropharmacology 2019Ayahuasca, a traditional Amazonian decoction with psychoactive properties, is made from bark of the Banisteriopsis caapi vine (containing beta-carboline alkaloids) and... (Review)
Review
BACKGROUND
Ayahuasca, a traditional Amazonian decoction with psychoactive properties, is made from bark of the Banisteriopsis caapi vine (containing beta-carboline alkaloids) and leaves of the Psychotria viridis bush (supplying the hallucinogen N,N-dimethyltryptamine, DMT). Originally used by indigenous shamans for the purposes of spirit communication, magical experiences, healing, and religious rituals across several South American countries, ayahuasca has been incorporated into folk medicine and spiritual healing, and several Brazilian churches use it routinely to foster a spiritual experience. More recently, it is being used in Europe and North America, not only for religious or healing reasons, but also for recreation.
OBJECTIVE
To review ayahuasca's behavioral effects, possible adverse effects, proposed mechanisms of action and potential clinical uses in mental illness.
METHOD
We searched Medline, in English, using the terms ayahuasca, dimethyltryptamine, Banisteriopsis caapi, and Psychotria viridis and reviewed the relevant publications.
RESULTS
The following aspects of ayahuasca are summarized: Political and legal factors; acute and chronic psychological effects; electrophysiological studies and imaging; physiological effects; safety and adverse effects; pharmacology; potential psychiatric uses.
CONCLUSION
Many years of shamanic wisdom have indicated potential therapeutic uses for ayahuasca, and several present day studies suggest that it may be useful for treating various psychiatric disorders and addictions. The side effect profile appears to be relatively mild, but more detailed studies need to be done. Several prominent researchers believe that government regulations with regard to ayahuasca should be relaxed so that it could be provided more readily to recognized, credible researchers to conduct comprehensive clinical trials.
Topics: Banisteriopsis; Hallucinogens; Humans; Mental Disorders; N,N-Dimethyltryptamine; Plant Extracts; Substance-Related Disorders
PubMed: 29366418
DOI: 10.2174/1570159X16666180125095902 -
The Cochrane Database of Systematic... Sep 2018Art therapy is defined by the British Association of Art Therapists as: "a form of psychotherapy that uses art media as its primary mode of communication. Clients who... (Review)
Review
BACKGROUND
Art therapy is defined by the British Association of Art Therapists as: "a form of psychotherapy that uses art media as its primary mode of communication. Clients who are referred to an art therapist need not have experience or skill in art. The art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client's image. The overall aim of its practitioners is to enable a client to change and grow on a personal level through the use of art materials in a safe and facilitating environment". Historically, drawings and paintings have been recognised as a useful part of therapeutic processes within psychiatric and psychological specialties, and this has been acknowledged within medical and neurology-based disciplines.Arts-based therapies are generally considered as interventions managing manifestations of dementia, as they may help to slow cognitive deterioration, address symptoms related to psychosocially challenging behaviours and improve quality of life.
OBJECTIVES
To review the effects of art therapy as an adjunctive treatment for dementia compared with standard care and other non-pharmacological interventions.
SEARCH METHODS
We identified trials from ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialised Register - on 12 May 2014, 20 March 2015, 15 January 2016, 4 November 2016, and 4 October 2017. We also handsearched the grey literature and contacted specialists in the field and authors of relevant reviews or studies to enquire about other sources of relevant information.
SELECTION CRITERIA
All randomised controlled trials examining art therapy as an intervention for dementia.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data. We examined scales measuring cognition, affect and emotional well-being, social functioning, behaviour and quality of life.
MAIN RESULTS
We found two studies that met the inclusion criteria, incorporating data on a total of 60 participants (from 88 randomised), in experimental groups (n = 29) and active control groups (n = 31). One study compared group art therapy with simple calculation activities over 12 weeks. The other study compared group art therapy with recreational activities over 40 weeks. It was not possible to pool the data for analysis from the included studies, due to heterogeneity in terms of differences in the interventions, control treatments and choice of outcome measures.In both studies there were no clear changes reported between the intervention group and the control group in the important outcome measures. According to GRADE ratings, we judged the quality of evidence for these outcome measures to be 'very low'.
AUTHORS' CONCLUSIONS
There is insufficient evidence about the efficacy of art therapy for people with dementia. More adequately-powered and high-quality studies using relevant outcome measures are needed.
Topics: Art Therapy; Dementia; Humans; Randomized Controlled Trials as Topic; Recreation Therapy
PubMed: 30215847
DOI: 10.1002/14651858.CD011073.pub2 -
The New England Journal of Medicine Jul 2010The optimal management of a torn anterior cruciate ligament (ACL) of the knee is unknown. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The optimal management of a torn anterior cruciate ligament (ACL) of the knee is unknown.
METHODS
We conducted a randomized, controlled trial involving 121 young, active adults with acute ACL injury in which we compared two strategies: structured rehabilitation plus early ACL reconstruction and structured rehabilitation with the option of later ACL reconstruction if needed. The primary outcome was the change from baseline to 2 years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS)--pain, symptoms, function in sports and recreation, and knee-related quality of life (KOOS(4); range of scores, 0 [worst] to 100 [best]). Secondary outcomes included results on all five KOOS subscales, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the score on the Tegner Activity Scale.
RESULTS
Of 62 subjects assigned to rehabilitation plus early ACL reconstruction, 1 did not undergo surgery. Of 59 assigned to rehabilitation plus optional delayed ACL reconstruction, 23 underwent delayed ACL reconstruction; the other 36 underwent rehabilitation alone. The absolute change in the mean KOOS(4) score from baseline to 2 years was 39.2 points for those assigned to rehabilitation plus early ACL reconstruction and 39.4 for those assigned to rehabilitation plus optional delayed reconstruction (absolute between-group difference, 0.2 points; 95% confidence interval, -6.5 to 6.8; P=0.96 after adjustment for the baseline score). There were no significant differences between the two treatment groups with respect to secondary outcomes. Adverse events were common in both groups. The results were similar when the data were analyzed according to the treatment actually received.
CONCLUSIONS
In young, active adults with acute ACL tears, a strategy of rehabilitation plus early ACL reconstruction was not superior to a strategy of rehabilitation plus optional delayed ACL reconstruction. The latter strategy substantially reduced the frequency of surgical reconstructions. (Funded by the Swedish Research Council and the Medical Faculty of Lund University and others; Current Controlled Trials number, ISRCTN84752559.)
Topics: Adolescent; Adult; Analysis of Variance; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Combined Modality Therapy; Female; Humans; Joint Instability; Knee Injuries; Male; Plastic Surgery Procedures; Rupture; Time Factors; Treatment Outcome; Young Adult
PubMed: 20660401
DOI: 10.1056/NEJMoa0907797 -
International Journal of Environmental... Jul 2017Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is... (Review)
Review
BACKGROUND
Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental Japan and China. Furthermore, we aim to encourage healthcare professionals to conduct longitudinal research in Western cultures regarding the clinically therapeutic effects of Shinrin-Yoku and, for healthcare providers/students to consider practicing Shinrin-Yoku to decrease undue stress and potential burnout.
METHODS
A thorough review was conducted to identify research published with an initial open date range and then narrowing the collection to include papers published from 2007 to 2017. Electronic databases (PubMed, PubMed Central, CINAHL, PsycINFO and Scopus) and snowball references were used to cull papers that evaluated the use of Shinrin-Yoku for various populations in diverse settings.
RESULTS
From the 127 papers initially culled using the Boolean phrases: "Shinrin-yoku" AND/OR "forest bathing" AND/OR "nature therapy", 64 studies met the inclusion criteria and were included in this summary review and then divided into "physiological," "psychological," "sensory metrics" and "frameworks" sub-groups.
CONCLUSIONS
Human health benefits associated with the immersion in nature continue to be currently researched. Longitudinal research, conducted worldwide, is needed to produce new evidence of the relationships associated with Shinrin-Yoku and clinical therapeutic effects. Nature therapy as a health-promotion method and potential universal health model is implicated for the reduction of reported modern-day "stress-state" and "technostress.".
Topics: Adult; Aged; Aged, 80 and over; China; Female; Forests; Humans; Japan; Male; Middle Aged; Nature; Recreation Therapy; Stress, Psychological; Walking
PubMed: 28788101
DOI: 10.3390/ijerph14080851 -
BMC Musculoskeletal Disorders Jul 2022Total hip or knee arthroplasties (THA/TKA) show favorable long-term effects, yet the recovery process may take weeks to months. Physical therapy (PT) following discharge... (Observational Study)
Observational Study
BACKGROUND
Total hip or knee arthroplasties (THA/TKA) show favorable long-term effects, yet the recovery process may take weeks to months. Physical therapy (PT) following discharge from hospital is an effective intervention to enhance this recovery process. To investigate the relation between recovery and postoperative PT usage, including the presence of comorbidities, 6 months after THA/TKA.
METHODS
Multicenter, observational study in primary THA/TKA patients who completed preoperative and 6 months postoperative assessments. The assessments included questions on PT use (yes/no and duration; long term use defined as ≥ 12 weeks), comorbidities (musculoskeletal, non-musculoskeletal, sensory comorbidities and frequency of comorbidities). Recovery was assessed with the HOOS/KOOS on all 5 subdomains. Logistic regression with long term PT as outcome was performed adjusted for confounding including an interaction term (comorbidity*HOOS/KOOS-subdomain).
RESULTS
In total, 1289 THA and 1333 TKA patients were included, of whom 95% received postoperative PT, 56% and 67% received postoperative PT ≥ 12 weeks respectively. In both THA and TKA group, less improvement on all HOOS/KOOS domain scores was associated with ≥ 12 weeks of postoperative PT (range Odds Ratios 0.97-0.99). In the THA group the impact of recovery was smaller in patient with comorbidities as non- musculoskeletal comorbidities modified all associations between recovery and postoperative PT duration (Odds Ratios range 1.01-1.05). Musculoskeletal comorbidities modified the associations between Function-in-Daily-Living-and Sport-and-recreation recovery and postoperative PT. Sensory comorbidities only had an effect on Sport-and-recreation recovery and postoperative PT. Also the frequency of comorbidities modified the relation between Function-in-Daily-Living, pain and symptoms recovery and postoperative PT. In the TKA group comorbidity did not modify the associations.
CONCLUSION
Worse recovery was associated with longer duration of postoperative PT suggesting that PT provision is in line with patients' needs. The impact of physical recovery on the use of long-term postoperative PT was smaller in THA patients with comorbidities.
TRIAL REGISTRATION
Registered in the Dutch Trial Registry on March 13, 2012. TRIAL ID NTR3348; registration number: P12.047. https://www.trialregister.nl/trial/3197 .
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Humans; Physical Therapy Modalities; Recovery of Function; Treatment Outcome
PubMed: 35831841
DOI: 10.1186/s12891-022-05429-z -
Orthopaedic Journal of Sports Medicine Apr 2020Osgood-Schlatter disease (OSD) affects 1 in 10 adolescents. There is a lack of evidence-based interventions, and passive approaches (eg, rest and avoidance of painful...
BACKGROUND
Osgood-Schlatter disease (OSD) affects 1 in 10 adolescents. There is a lack of evidence-based interventions, and passive approaches (eg, rest and avoidance of painful activities) are often prescribed.
PURPOSE
To investigate an intervention consisting of education on activity modification and knee-strengthening exercises designed for adolescents with OSD.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
This study included 51 adolescents (51% female; age range, 10-14 years) with OSD. The 12-week intervention consisted of an activity ladder designed to manage patellar tendon loading and pain, knee-strengthening exercises, and a gradual return to sport. The primary outcome was the global reporting of change at 12 weeks, evaluated with a 7-point Likert scale (successful outcome was considered "much improved" or "improved"). Additional endpoints were at 4, 8, 26, and 52 weeks. Secondary outcomes included the Knee injury and Osteoarthritis Outcome Score (KOOS), objective strength, and jump performance.
RESULTS
Adolescents reported a mean pain duration of 21 months at enrollment. After 12 weeks, 80% reported a successful outcome, which increased to 90% at 12 months. At 12 weeks, 16% returned to playing sport, which increased to 69% at 12 months. The KOOS subscores of Pain, Activities of Daily Living, Sport and Recreation, and Quality of Life improved significantly (7-20 points), and there were improvements in knee extension strength (32%; < .001), hip abduction strength (24%; < .001), and jumping for distance (14%; < .001) and height (19%; < .001) at 12 weeks.
CONCLUSION
An intervention consisting of activity modification, pain monitoring, progressive strengthening, and a return-to-sport paradigm was associated with improved self-reported outcomes, hip and knee muscle strength, and jumping performance. This approach may offer an alternative to passive approaches such as rest or wait-and-see, often prescribed for adolescents with OSD.
REGISTRATION
NCT02799394 (ClinicalTrials.gov identifier).
PubMed: 32284945
DOI: 10.1177/2325967120911106 -
BMJ (Clinical Research Ed.) Jul 2016To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears.
DESIGN
Randomised controlled superiority trial.
SETTING
Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway.
PARTICIPANTS
140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis.
INTERVENTIONS
12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone.
MAIN OUTCOME MEASURES
Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months.
RESULTS
No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval -4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit.
CONCLUSION
The observed difference in treatment effect was minute after two years of follow-up, and the trial's inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.Trial registration www.clinicaltrials.gov (NCT01002794).
Topics: Adult; Arthroscopy; Exercise Therapy; Female; Follow-Up Studies; Humans; Knee Joint; Magnetic Resonance Imaging; Male; Middle Aged; Muscle Strength; Norway; Pain; Pain Measurement; Quality of Life; Severity of Illness Index; Single-Blind Method; Tibial Meniscus Injuries; Treatment Outcome
PubMed: 27440192
DOI: 10.1136/bmj.i3740 -
Health and Quality of Life Outcomes Nov 2003The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and... (Review)
Review
The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL), Function in Sport and Recreation (Sport/Rec), and knee-related Quality of Life (QOL). The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.
Topics: Activities of Daily Living; Adolescent; Adult; Aged; Aged, 80 and over; Humans; Knee Injuries; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Psychometrics; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Treatment Outcome
PubMed: 14613558
DOI: 10.1186/1477-7525-1-64