-
BMJ Clinical Evidence Jun 2011Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among... (Review)
Review
INTRODUCTION
Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 37 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, advice to stay active, analgesics, antidepressants, bed rest, corticosteroids (epidural injections), cytokine inhibitors (infliximab), discectomy (automated percutaneous, laser, microdiscectomy, standard), exercise therapy, heat, ice, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), percutaneous disc decompression, spinal manipulation, and traction.
Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Diskectomy; Humans; Injections, Epidural; Intervertebral Disc Displacement; Manipulation, Spinal; Traction
PubMed: 21711958
DOI: No ID Found -
The Cochrane Database of Systematic... Aug 2012Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine . While AIS can progress during growth and cause a surface deformity, it is usually... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine . While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of scoliosis-specific exercises (SSE) to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial.
OBJECTIVES
To evaluate the efficacy of SSE in adolescent patients with AIS.
SEARCH METHODS
The following databases (up to 30 March 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SportDiscus (from January 1975), PsycInfo (from January 1887), PEDro (from January 1929). We screened reference lists of articles and also conducted an extensive handsearch of grey literature.
SELECTION CRITERIA
Randomised controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected studies, assessed risk of bias and extracted data.
MAIN RESULTS
Two studies (154 participants) were included. There is low quality evidence from one randomised controlled study that exercises as an adjunctive to other conservative treatments increase the efficacy of these treatments (thoracic curve reduced: mean difference (MD) 9.00, (95% confidence interval (CI) 5.47 to 12.53); lumbar curve reduced:MD 8.00, (95% CI 5.08 to 10.92)). There is very low quality evidence from a prospective controlled cohort study that scoliosis-specific exercises structured within an exercise programme can reduce brace prescription (risk ratio (RR) 0.24, (95% CI 0.06 to1.04) as compared to usual physiotherapy (many different kinds of general exercises according to the preferences of the single therapists within different facilities).
AUTHORS' CONCLUSIONS
There is a lack of high quality evidence to recommend the use of SSE for AIS. One very low quality study suggested that these exercises may be more effective than electrostimulation, traction and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice.
Topics: Adolescent; Disease Progression; Electric Stimulation Therapy; Exercise Therapy; Humans; Physical Therapy Modalities; Posture; Randomized Controlled Trials as Topic; Scoliosis; Traction
PubMed: 22895967
DOI: 10.1002/14651858.CD007837.pub2 -
International Journal of Environmental... Jun 2021The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations...
The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.
Topics: Humans; Musculoskeletal Manipulations; Neck; Neck Pain; Radiculopathy; Randomized Controlled Trials as Topic; Traction
PubMed: 34200510
DOI: 10.3390/ijerph18116176 -
Computational and Mathematical Methods... 2022This study is aimed at exploring the clinical effect of mechanical traction on lumbar disc herniation (LDH). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study is aimed at exploring the clinical effect of mechanical traction on lumbar disc herniation (LDH).
METHODS
Related literatures were retrieved from PubMed, Medline, Embase, CENTRAL, and CNKI databases. Inclusion of literature topic was comparison of mechanical traction and conventional physical therapy for lumbar disc herniation. Jadad scale was used to evaluate the quality of the included RCT studies. The Chi-square test was used for the heterogeneity test, and a random effect model was used with heterogeneity. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. If there was no heterogeneity, the fixed effect model was used, and funnel plots were used to test publication bias.
RESULTS
Visual analog scale (VAS) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = -1.39 (95% CI (-1.81, -0.98)), = 6.56, and < 0.00001). There was no heterogeneity among studies (Chi = 6.62, = 0.25, and = 24%) and no publication bias. Oswestry disability index (ODI) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = -6.34 (95% CI (-10.28, -2.39)), = 3.15, and = 0.002). There was no heterogeneity between studies (Chi = 6.27, = 0.18, and = 36%) and no publication bias. There was no significant difference in Schober test scores between the mechanical traction group and the conventional physical therapy group (MD = -0.40 (95% CI (-1.07, 0.28)), = 1.16, and = 0.25). There was no heterogeneity among studies (Chi = 1.61, = 0.66, and = 0%) and no publication bias.
CONCLUSION
Mechanical traction can effectively relieve lumbar and leg pain and improve ODI in patients with lumbar disc herniation but has no significant effect on spinal motion. The therapeutic effect of mechanical traction was significantly better than that of conventional physical therapy. Lumbar traction can be used in conjunction with other traditional physical therapy.
Topics: Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Physical Therapy Modalities; Traction; Treatment Outcome
PubMed: 35774300
DOI: 10.1155/2022/5670303 -
Biophysical Journal Aug 2021Cells interact mechanically with their surroundings by exerting and sensing forces. Traction force microscopy (TFM), purported to map cell-generated forces or stresses,...
Cells interact mechanically with their surroundings by exerting and sensing forces. Traction force microscopy (TFM), purported to map cell-generated forces or stresses, represents an important tool that has powered the rapid advances in mechanobiology. However, to solve the ill-posed mathematical problem, conventional TFM involved compromises in accuracy and/or resolution. Here, we applied neural network-based deep learning as an alternative approach for TFM. We modified a neural network designed for image processing to predict the vector field of stress from displacements. Furthermore, we adapted a mathematical model for cell migration to generate large sets of simulated stresses and displacements for training and testing the neural network. We found that deep learning-based TFM yielded results that resemble those using conventional TFM but at a higher accuracy than several conventional implementations tested. In addition, a trained neural network is appliable to a wide range of conditions, including cell size, shape, substrate stiffness, and traction output. The performance of deep learning-based TFM makes it an appealing alternative to conventional methods for characterizing mechanical interactions between adherent cells and the environment.
Topics: Computer Simulation; Deep Learning; Microscopy, Atomic Force; Models, Theoretical; Traction
PubMed: 34214526
DOI: 10.1016/j.bpj.2021.06.011 -
The Journal of Biological Chemistry May 2022Traction force microscopy (TFM) has emerged as a versatile technique for the measurement of single-cell-generated forces. TFM has gained wide use among mechanobiology... (Review)
Review
Traction force microscopy (TFM) has emerged as a versatile technique for the measurement of single-cell-generated forces. TFM has gained wide use among mechanobiology laboratories, and several variants of the original methodology have been proposed. However, issues related to the experimental setup and, most importantly, data analysis of cell traction datasets may restrain the adoption of TFM by a wider community. In this review, we summarize the state of the art in TFM-related research, with a focus on the analytical methods underlying data analysis. We aim to provide the reader with a friendly compendium underlying the potential of TFM and emphasizing the methodological framework required for a thorough understanding of experimental data. We also compile a list of data analytics tools freely available to the scientific community for the furtherance of knowledge on this powerful technique.
Topics: Biophysics; Cell Adhesion; Microscopy, Atomic Force; Traction
PubMed: 35351517
DOI: 10.1016/j.jbc.2022.101867 -
Journal of Biomedical Materials... May 2023Cells integrate endogenous and exogenous mechanical forces to sense and respond to environmental signals. In particular, cell-generated microscale traction forces...
Cells integrate endogenous and exogenous mechanical forces to sense and respond to environmental signals. In particular, cell-generated microscale traction forces regulate cellular functions and impact macroscale tissue function and development. Many groups have developed tools for measuring cellular traction forces, including microfabricated post array detectors (mPADs). mPADs are a powerful tool that provides direct traction force measurements through imaging post deflections and utilizing Bernoulli-Euler beam theory. In this technical note, we investigated how mPADs presenting two different top surface areas but similar effective stiffness influence cellular spread area and traction forces for murine embryonic fibroblasts and human mesenchymal stromal cells. When focal adhesion size was restricted via mPAD top surface area, we observed a decrease in both cell spread area and cell traction forces as the mPAD top surface area decreased, but the traction force-cell area linear relationship was maintained, which is indicative of cell contractility. We conclude that the mPAD top surface area is an important parameter to consider when utilizing mPADs to measure cellular traction forces. Furthermore, the slope of the traction force-cell area linear relationship provides a useful metric to characterize cell contractility on mPADs.
Topics: Animals; Humans; Mice; Traction; Mechanotransduction, Cellular; Mechanical Phenomena; Focal Adhesions; Cells, Cultured; Cell Adhesion
PubMed: 36808220
DOI: 10.1002/jbm.a.37518 -
Gut and Liver Nov 2020This systematic review aimed to assess the efficacy of the current approach to tissue traction during the endoscopic submucosal dissection (ESD) of superficial... (Review)
Review
This systematic review aimed to assess the efficacy of the current approach to tissue traction during the endoscopic submucosal dissection (ESD) of superficial esophageal cancer, early gastric cancer, and colorectal neoplasms. We performed a systematic electronic literature search of articles published in PubMed and selected comparative studies to investigate the treatment outcomes of tractionassisted versus conventional ESD. Using the keywords, we retrieved 381 articles, including five eligible articles on the esophagus, 13 on the stomach, and 12 on the colorectum. A total of seven randomized controlled trials and 23 retrospective studies were identified. Clip line traction and submucosal tunneling were effective in reducing the procedural time during esophageal ESD. The efficacy of traction methods in gastric ESD varied in terms of the devices and strategies used depending on the lesion location and degree of submucosal fibrosis. Several prospective and retrospective studies utilized traction devices without the need to reinsert the colonoscope. When pocket creation is included, the traction devices and methods effectively shorten the procedural time during colorectal ESD. Although the efficacy is dependent on the organ and tumor locations, several traction techniques have been demonstrated to be efficacious in facilitating ESD by maintaining satisfactory traction during dissection.
Topics: Dissection; Endoscopic Mucosal Resection; Humans; Prospective Studies; Retrospective Studies; Traction; Treatment Outcome
PubMed: 31887810
DOI: 10.5009/gnl19266 -
Journal of Orthopaedics and... Jun 2021Historical papers on the treatment of congenital dislocation of the hip suggest the use of preliminary traction to facilitate closed reduction or to decrease the risk of...
BACKGROUND
Historical papers on the treatment of congenital dislocation of the hip suggest the use of preliminary traction to facilitate closed reduction or to decrease the risk of avascular necrosis (AVN) of the femoral head. In the 1980s, some authors questioned the role of preliminary traction and suspended its use, yielding satisfactory results. Since then, several studies called into question this method, and some authors have continued to recommend preliminary traction while other authors have discouraged its use.
MATERIALS AND METHODS
We reanalysed the full set of radiographs of 71 hips (52 patients) surgically treated by a medial approach after 4 weeks of preoperative longitudinal traction. The mean age at operation was 16 months. Before and after traction, the height of the dislocation was graded according to the Gage and Winter method. The hips were divided into two groups: group 1, in which the traction was effective, and group 2, in which the traction was not effective. These two groups were statistically analysed regarding the severity of the dislocation, the age of the patient at surgery and the incidence of AVN.
RESULTS
Preliminary traction was effective in 48 hips (68%, group 1), while it was not effective in the remaining 23 (32%, group 2). The effectiveness of preliminary traction was statistically related to the height of the dislocation and to the age of the patient at surgery, with traction being less effective in more severe dislocations and in older children. The incidence of AVN was statistically lower in group 1 than in group 2.
CONCLUSIONS
In our study population, despite not having a control group, preliminary traction-when effective-seemed to reduce the incidence of AVN in patients surgically treated for congenital dislocation of the hip. The effectiveness of the traction was influenced by the severity of the dislocation and the age of the patient; it worked better for less severe dislocations and in younger children. To reduce hospital costs, traction should be applied at home.
LEVEL OF EVIDENCE
3.
Topics: Age Factors; Child, Preschool; Female; Femur Head Necrosis; Hip Dislocation, Congenital; Humans; Infant; Male; Preoperative Care; Retrospective Studies; Risk Factors; Traction; Trauma Severity Indices; Treatment Outcome
PubMed: 34180020
DOI: 10.1186/s10195-021-00586-8 -
BMC Surgery Jan 2023The recently developed endoscopic full-thickness resection technique requires reliable closure. The main closure methods are the purse-string suture (PSS) technique and...
BACKGROUND
The recently developed endoscopic full-thickness resection technique requires reliable closure. The main closure methods are the purse-string suture (PSS) technique and over-the-scope clip (OTSC) technique; however, basic data on the closure strength of each technique are lacking. This study was performed to compare the closure strengths of these two methods in an ex vivo porcine model.
METHODS
In the traction test, a virtual 5-cm full-thickness closure line was closed by the following six methods three times each: conventional hemoclips, mucosal PSS, seromuscular PSS, mucosal OTSC, seromuscular OTSC, and surgical suture. The primary endpoint was the tension at the starting point of dehiscence, measured in Newtons (N) by an automatic traction machine. In the leak test, a 15-mm gastric full-thickness defect was closed by PSS or OTSC six times each, and the closed stomach was then pressurized in a water container. The primary endpoint was the leak pressure when air bubbles appeared. The secondary endpoints were the procedure time and presence of complete inverted closure.
RESULTS
The mean tension was 2.16, 3.68, 5.15, 18.30, 19.30, and 62.40 N for conventional hemoclips, mucosal PSS, seromuscular PSS, mucosal OTSC, seromuscular OTSC, and surgical suture, respectively. Complete inverted closure was observed for seromuscular PSS, seromuscular OTSC, and surgical suture. The mean leak pressure was 13.7 and 24.8 mmHg in the PSS and OTSC group, respectively (P < 0.01). The mean procedure time was 541 and 169 s in the PSS and OTSC group, respectively (P < 0.01). Complete inverted closure was observed in OTSC alone.
CONCLUSION
The OTSC, which allows complete inverted closure, showed greater closure strength than PSS. Considering the size limitation suitable for single OTSC, a therapeutic strategy for closing the larger size is further warranted.
Topics: Swine; Animals; Traction; Stomach; Endoscopy; Sutures; Suture Techniques
PubMed: 36703127
DOI: 10.1186/s12893-023-01920-z