Pub Date : 2023-03-04DOI: 10.1080/10833196.2023.2195214
N. Krzyżaniak, M. Cardona, R. Peiris, Z. Michaleff, Hannah Greenwood, J. Clark, A. Scott, P. Glasziou
Abstract Background Musculoskeletal conditions such as spinal pain and osteoarthritis are among the leading causes of years lived with disability worldwide. With the COVID-19 pandemic forcing many healthcare providers to change the way in which care for chronic conditions is delivered, telehealth is an alternative to face-to-face consultations that can be used for both assessment and provision of therapy and support. Objectives To identify, appraise and synthesise findings from all randomised controlled trials (RCTs) that compared telehealth to face-to-face consultations for patients with any type of musculoskeletal condition. Methods Systematic review and meta-analysis. We used the GRADE approach to assess the quality of evidence related to all outcomes. We searched three electronic databases (PubMed, Embase, CENTRAL), clinical trial registries and citing-cited references of included studies. Results Five RCTs were includable: one in patients with osteoarthritis of the knee, one in patients with osteoarthritis of the knee or hip in preparation for a total joint arthroscopy and three after total knee replacement. Telehealth was conducted by video in four trials and by phone in one. A total of 402 participants were analysed across the five trials. There were no significant differences in pain outcomes (WOMAC) between telehealth and face-to-face therapy immediate post-intervention (mean difference (MD): 0.12 (95% CI −2.3 to 2.6, p = .92) or two months post-intervention (MD): 1.2, (95% CI: −2.7 to 5.1, p = .55). Similarly, outcomes related to function, quality of life and satisfaction were comparable between the two modes of delivery immediate post-intervention, with no significant differences reported. Conclusion There is limited low quality evidence that there is no significant differences between telehealth-based delivery of rehabilitation to patients with osteoarthritis or following knee surgery and face-to-face therapy for pain, function, quality of life and satisfaction. These findings should be should be interpreted with caution due to the small number of included studies and small sample size. HIGHLIGHTS Findings based on a small number of trials and very low-quality evidence suggest that there is no difference between telehealth and face-to-face consultation for rehabilitation for adults post-knee surgery. Outcomes related to pain, function and quality of life were comparable between the two modes of delivery. There is a significant gap in knowledge relating to cost outcomes, warranting studies that further evaluate cost-effectiveness of telehealth and the subsequent long-term sustainability of telehealth.
{"title":"Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis","authors":"N. Krzyżaniak, M. Cardona, R. Peiris, Z. Michaleff, Hannah Greenwood, J. Clark, A. Scott, P. Glasziou","doi":"10.1080/10833196.2023.2195214","DOIUrl":"https://doi.org/10.1080/10833196.2023.2195214","url":null,"abstract":"Abstract Background Musculoskeletal conditions such as spinal pain and osteoarthritis are among the leading causes of years lived with disability worldwide. With the COVID-19 pandemic forcing many healthcare providers to change the way in which care for chronic conditions is delivered, telehealth is an alternative to face-to-face consultations that can be used for both assessment and provision of therapy and support. Objectives To identify, appraise and synthesise findings from all randomised controlled trials (RCTs) that compared telehealth to face-to-face consultations for patients with any type of musculoskeletal condition. Methods Systematic review and meta-analysis. We used the GRADE approach to assess the quality of evidence related to all outcomes. We searched three electronic databases (PubMed, Embase, CENTRAL), clinical trial registries and citing-cited references of included studies. Results Five RCTs were includable: one in patients with osteoarthritis of the knee, one in patients with osteoarthritis of the knee or hip in preparation for a total joint arthroscopy and three after total knee replacement. Telehealth was conducted by video in four trials and by phone in one. A total of 402 participants were analysed across the five trials. There were no significant differences in pain outcomes (WOMAC) between telehealth and face-to-face therapy immediate post-intervention (mean difference (MD): 0.12 (95% CI −2.3 to 2.6, p = .92) or two months post-intervention (MD): 1.2, (95% CI: −2.7 to 5.1, p = .55). Similarly, outcomes related to function, quality of life and satisfaction were comparable between the two modes of delivery immediate post-intervention, with no significant differences reported. Conclusion There is limited low quality evidence that there is no significant differences between telehealth-based delivery of rehabilitation to patients with osteoarthritis or following knee surgery and face-to-face therapy for pain, function, quality of life and satisfaction. These findings should be should be interpreted with caution due to the small number of included studies and small sample size. HIGHLIGHTS Findings based on a small number of trials and very low-quality evidence suggest that there is no difference between telehealth and face-to-face consultation for rehabilitation for adults post-knee surgery. Outcomes related to pain, function and quality of life were comparable between the two modes of delivery. There is a significant gap in knowledge relating to cost outcomes, warranting studies that further evaluate cost-effectiveness of telehealth and the subsequent long-term sustainability of telehealth.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42728389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-04DOI: 10.1080/10833196.2023.2195213
Wayne A. Fausett, D. Reid, P. Larmer
Abstract Background Functional rehabilitation following anterior cruciate ligament reconstruction (ACLR) is often physiotherapist-led, and generally required to achieve patient goals. The quantity and duration of physiotherapist-led following could therefore potentially influence outcomes following ACLR, although the nature of this relationship is not clear. Objective To clarify the relationship between the quantity and duration of post-operative physiotherapy treatment and patient outcomes following ACLR. Methods A search of the PubMed/MEDLINE, Google Scholar, Cochrane Library, and EBSCO databases was made from inception to March 2021 to identify relevant studies. Key characteristics of the selected studies were extracted, with methodological quality evaluated using a modified version of the Downs and Black appraisal tool. Results The search strategy identified 1137 studies, 15 of which met inclusion criteria. Two studies were rated strong methodological quality, eight were rated moderate, and five were rated limited. Results across all 15 studies provided conflicting evidence regarding the effects of the quantity and duration of physiotherapy treatment on patient outcomes following ACLR. Conclusions Based on evidence of variable methodological quality, a clear relationship between the quantity and duration of physiotherapy treatment and patient outcomes following ACLR could not be established. Several themes were identified to guide future research in this area, including ensuring participant homogeneity, monitoring participant adherence to unsupervised rehabilitation, and utilising rehabilitation interventions that replicate everyday physiotherapy practice.
{"title":"The relationship between the quantity and duration of post-operative physiotherapy treatment and patient outcomes following primary anterior cruciate ligament reconstruction: a systematic review","authors":"Wayne A. Fausett, D. Reid, P. Larmer","doi":"10.1080/10833196.2023.2195213","DOIUrl":"https://doi.org/10.1080/10833196.2023.2195213","url":null,"abstract":"Abstract Background Functional rehabilitation following anterior cruciate ligament reconstruction (ACLR) is often physiotherapist-led, and generally required to achieve patient goals. The quantity and duration of physiotherapist-led following could therefore potentially influence outcomes following ACLR, although the nature of this relationship is not clear. Objective To clarify the relationship between the quantity and duration of post-operative physiotherapy treatment and patient outcomes following ACLR. Methods A search of the PubMed/MEDLINE, Google Scholar, Cochrane Library, and EBSCO databases was made from inception to March 2021 to identify relevant studies. Key characteristics of the selected studies were extracted, with methodological quality evaluated using a modified version of the Downs and Black appraisal tool. Results The search strategy identified 1137 studies, 15 of which met inclusion criteria. Two studies were rated strong methodological quality, eight were rated moderate, and five were rated limited. Results across all 15 studies provided conflicting evidence regarding the effects of the quantity and duration of physiotherapy treatment on patient outcomes following ACLR. Conclusions Based on evidence of variable methodological quality, a clear relationship between the quantity and duration of physiotherapy treatment and patient outcomes following ACLR could not be established. Several themes were identified to guide future research in this area, including ensuring participant homogeneity, monitoring participant adherence to unsupervised rehabilitation, and utilising rehabilitation interventions that replicate everyday physiotherapy practice.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42947168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-04DOI: 10.1080/10833196.2023.2187996
Kiran H. Satpute, N. Bedekar, T. Hall
Abstract Background: People with cervicogenic headache (CGH) typically present with headache symptoms similar to other headache forms but with distinguishing features of neuro-musculoskeletal impairments. With current diagnostic criteria it is unclear which impairments are important for CGH diagnosis. Objective: To comprehensively review the evidence for cervical neuromusculoskeletal impairments in people with a diagnosis of CGH when compared to asymptomatic controls. Methods: Eight databases were searched for relevant studies evaluating neuro-musculoskeletal impairments in people with CGH. Risk-of-bias and overall quality of the evidence were assessed and meta-analyses performed. Results: Sixteen studies were included, the majority with low risk of bias. In comparison with asymptomatic controls the subjects with CGH presented with reduced combined cervical flexion-extension ROM (MD −9.26˚, 95% CI: −12.24˚, −6.27˚, I2 = 6%), side flexion ROM (MD: −2.97˚, 95% CI: 5.48˚, −0.46˚, I2 = 51%), and rotation ROM (MD: −13.57, 95% CI: −16.10, −11.03, I2 = 99%). Upper cervical rotation ROM was markedly reduced towards the headache side (MD: −15.07˚, 95% CI: −16.61˚, −13.53˚, I2 = 68%). Similarly, cervical flexor (MD: −33.70˚, 95% CI: −47.23˚, −20.16˚, I2 = 0%) and extensor strength (MD: −55.78, 95% CI: −77.56, −34.00, I2 = 0%) was reduced in subjects with CGH along with reduced craniovertebral angle. Kinaesthetic sense was not significantly impaired in subjects with CGH. The overall rating score for certainty of evidence was high to very low for all assessed outcomes. Conclusion: People with CGH have significantly decreased cervical ROM and muscle function with level of evidence ranging from high to very low.
{"title":"Cervical neuro-musculoskeletal impairments in people with cervicogenic headache: a systematic review and meta-analysis","authors":"Kiran H. Satpute, N. Bedekar, T. Hall","doi":"10.1080/10833196.2023.2187996","DOIUrl":"https://doi.org/10.1080/10833196.2023.2187996","url":null,"abstract":"Abstract Background: People with cervicogenic headache (CGH) typically present with headache symptoms similar to other headache forms but with distinguishing features of neuro-musculoskeletal impairments. With current diagnostic criteria it is unclear which impairments are important for CGH diagnosis. Objective: To comprehensively review the evidence for cervical neuromusculoskeletal impairments in people with a diagnosis of CGH when compared to asymptomatic controls. Methods: Eight databases were searched for relevant studies evaluating neuro-musculoskeletal impairments in people with CGH. Risk-of-bias and overall quality of the evidence were assessed and meta-analyses performed. Results: Sixteen studies were included, the majority with low risk of bias. In comparison with asymptomatic controls the subjects with CGH presented with reduced combined cervical flexion-extension ROM (MD −9.26˚, 95% CI: −12.24˚, −6.27˚, I2 = 6%), side flexion ROM (MD: −2.97˚, 95% CI: 5.48˚, −0.46˚, I2 = 51%), and rotation ROM (MD: −13.57, 95% CI: −16.10, −11.03, I2 = 99%). Upper cervical rotation ROM was markedly reduced towards the headache side (MD: −15.07˚, 95% CI: −16.61˚, −13.53˚, I2 = 68%). Similarly, cervical flexor (MD: −33.70˚, 95% CI: −47.23˚, −20.16˚, I2 = 0%) and extensor strength (MD: −55.78, 95% CI: −77.56, −34.00, I2 = 0%) was reduced in subjects with CGH along with reduced craniovertebral angle. Kinaesthetic sense was not significantly impaired in subjects with CGH. The overall rating score for certainty of evidence was high to very low for all assessed outcomes. Conclusion: People with CGH have significantly decreased cervical ROM and muscle function with level of evidence ranging from high to very low.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49207239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-22DOI: 10.1080/10833196.2023.2180710
H. Lavis, P. van Vliet, M. Tavener
Abstract Background Following the initial period of hospitalisation, stroke rehabilitation is increasingly occurring within the home. As such, the home setting becomes a critical environment in the context of rehabilitation service provision. Objectives This study aimed to explore what factors influence the experiences of stroke survivors, caregivers and therapists participating in home-based rehabilitation. Methods A systematic approach to thematic synthesis of qualitative studies began with search term development, followed by database search (CINAHL, Emcare, Medline, Scopus) from inception to 1 November 2022 using keywords and synonyms of ‘stroke survivor’, ‘therapist’, ‘caregiver’, ‘home rehabilitation’ and ‘experience’. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Data were analysed inductively for themes using a three-step thematic synthesis approach. Results A total of 26 studies were included in this thematic synthesis. Across the data, three overarching analytical themes were constructed, including (i) The significance of place, (ii) The impact of relationships, and (iii) The meaning of therapy. Conclusions The home setting offers benefits and challenges to delivery and participation in physical rehabilitation after stroke, shaped by various psychosocial and environmental factors that influence outcomes. Altered roles and relationships developed within the home setting influence participatory experience, whilst the setting can offer a familiar and relevant context to promote engagement in meaningful and purposeful therapy. Prior to hospital discharge, therapists who integrate personalised contexts into therapeutic environments can better prepare stroke survivors and caregivers for therapeutic participation within the home. Furthermore, future studies conducted before, during and after therapy focussing on stroke survivor, caregiver and therapist experiences of home-based rehabilitation can provide greater insight into the barriers and facilitators of home-based rehabilitation acceptance, adherence and implementation.
{"title":"Stroke survivor, caregiver and therapist experiences of home-based stroke rehabilitation: a thematic synthesis of qualitative studies","authors":"H. Lavis, P. van Vliet, M. Tavener","doi":"10.1080/10833196.2023.2180710","DOIUrl":"https://doi.org/10.1080/10833196.2023.2180710","url":null,"abstract":"Abstract Background Following the initial period of hospitalisation, stroke rehabilitation is increasingly occurring within the home. As such, the home setting becomes a critical environment in the context of rehabilitation service provision. Objectives This study aimed to explore what factors influence the experiences of stroke survivors, caregivers and therapists participating in home-based rehabilitation. Methods A systematic approach to thematic synthesis of qualitative studies began with search term development, followed by database search (CINAHL, Emcare, Medline, Scopus) from inception to 1 November 2022 using keywords and synonyms of ‘stroke survivor’, ‘therapist’, ‘caregiver’, ‘home rehabilitation’ and ‘experience’. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Data were analysed inductively for themes using a three-step thematic synthesis approach. Results A total of 26 studies were included in this thematic synthesis. Across the data, three overarching analytical themes were constructed, including (i) The significance of place, (ii) The impact of relationships, and (iii) The meaning of therapy. Conclusions The home setting offers benefits and challenges to delivery and participation in physical rehabilitation after stroke, shaped by various psychosocial and environmental factors that influence outcomes. Altered roles and relationships developed within the home setting influence participatory experience, whilst the setting can offer a familiar and relevant context to promote engagement in meaningful and purposeful therapy. Prior to hospital discharge, therapists who integrate personalised contexts into therapeutic environments can better prepare stroke survivors and caregivers for therapeutic participation within the home. Furthermore, future studies conducted before, during and after therapy focussing on stroke survivor, caregiver and therapist experiences of home-based rehabilitation can provide greater insight into the barriers and facilitators of home-based rehabilitation acceptance, adherence and implementation.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48904560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-13DOI: 10.1080/10833196.2023.2177792
K. Smart
Abstract Background The biopsychosocial model of pain may aid the understanding pain and its clinical presentations. Objectives This paper presents a discussion of the past, present and future state of the biopsychosocial model of pain within physiotherapy. Main Findings The biopsychosocial model of pain acknowledges the dynamic interdependent biological, psychological and social dimensions of peoples pain experiences and has been widely endorsed. However, the biopsychosocial model is not beyond criticism and its applicability to clinical practice has been questioned. Researchers have investigated how clinicians understand and apply the biopsychosocial model in clinical practice. Evidence suggests that physiotherapists demonstrate varying levels of confidence and proficiency in their psychosocially-oriented clinical knowledge and practice. Psychologically informed physiotherapy treatment approaches have been described and trialled and show inconsistent results and effect sizes with respect to patient-related outcomes. In addition, commentators suggest that the ‘-social’ dimension of the model has been relatively neglected. While there is some evidence that the biopsychosocial model is evolving, and efforts are underway to develop and validate clinically-applicable tools, physiotherapy clinicians, educators and researchers have been invited to consider existing barriers and enablers to the implementation of the biopsychosocial model in clinical practice in order to improve its understanding and application within healthcare. Conclusion The biopsychosocial model invites clinicians to understand and address the biological, psychological, and social dimensions of patients pain. Understanding and implementation of the biopsychosocial model of pain in physiotherapy is mixed. Improving education and training and developing and evaluating innovative biopsychosocial-oriented interventions appear to be important ways forward. The biopsychosocial model of pain is evolving in response to scientific and clinical developments.
{"title":"The biopsychosocial model of pain in physiotherapy: past, present and future","authors":"K. Smart","doi":"10.1080/10833196.2023.2177792","DOIUrl":"https://doi.org/10.1080/10833196.2023.2177792","url":null,"abstract":"Abstract Background The biopsychosocial model of pain may aid the understanding pain and its clinical presentations. Objectives This paper presents a discussion of the past, present and future state of the biopsychosocial model of pain within physiotherapy. Main Findings The biopsychosocial model of pain acknowledges the dynamic interdependent biological, psychological and social dimensions of peoples pain experiences and has been widely endorsed. However, the biopsychosocial model is not beyond criticism and its applicability to clinical practice has been questioned. Researchers have investigated how clinicians understand and apply the biopsychosocial model in clinical practice. Evidence suggests that physiotherapists demonstrate varying levels of confidence and proficiency in their psychosocially-oriented clinical knowledge and practice. Psychologically informed physiotherapy treatment approaches have been described and trialled and show inconsistent results and effect sizes with respect to patient-related outcomes. In addition, commentators suggest that the ‘-social’ dimension of the model has been relatively neglected. While there is some evidence that the biopsychosocial model is evolving, and efforts are underway to develop and validate clinically-applicable tools, physiotherapy clinicians, educators and researchers have been invited to consider existing barriers and enablers to the implementation of the biopsychosocial model in clinical practice in order to improve its understanding and application within healthcare. Conclusion The biopsychosocial model invites clinicians to understand and address the biological, psychological, and social dimensions of patients pain. Understanding and implementation of the biopsychosocial model of pain in physiotherapy is mixed. Improving education and training and developing and evaluating innovative biopsychosocial-oriented interventions appear to be important ways forward. The biopsychosocial model of pain is evolving in response to scientific and clinical developments.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49119804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-24DOI: 10.1080/10833196.2023.2168850
Saleh M. Aloraini, Arwa A. Abu Mismar, Haifa F. Aloqaily, M. Aldaihan
Abstract Background and purpose Balance assessment following stroke is a significant part of the rehabilitation program. The Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS) and the Balance Evaluation Systems Test (BESTest) are multi-item balance scales commonly used for assessing balance for people post-stroke. The purpose of our systematic review is to identify and appraise the literature on the psychometric properties of these balance measures (BBS, PASS and BESTest) in studies involving people post-stroke. Methods A comprehensive electronic literature search was performed in five databases PubMed, CINAHL, Embase, Scopus and Web of Science; in addition to hand searching of relevant references. Two independent reviewers screened the literature search results to include studies that were: written in the English language and published in peer-reviewed journals; participants were adults (>18 years) and had a diagnosis of stroke; Balance of participants was assessed using one (or more) of the following measures: BBS, PASS, BESTest or a shortened version of these measures; and the study reported at least one psychometric property for the balance measure. Two independent reviewers extracted the data using a standardized form. Quality of included studies was assessed using a critical appraisal tool. Results A total of 65 studies met our inclusion criteria and were included in our review. The majority of studies reported on the psychometric properties of the BBS, followed by the PASS and then the BESTest. Results of the critical appraisal scale showed that the overall quality of studies was good. A variety of psychometric properties were reported, with validity being the most reported property followed by reliability. Discussion The BBS, BESTest and PASS and their variants show overall excellent psychometric properties when used among people post-stroke. However, further research is needed to investigate the responsiveness of these measures following rehabilitation programs.
摘要背景和目的脑卒中后的平衡评估是康复计划的重要组成部分。Berg平衡量表（BBS）、中风姿势评估量表（PASS）和平衡评估系统测试（BESTest）是常用于评估中风后患者平衡的多项目平衡量表。我们系统综述的目的是识别和评价在涉及脑卒中后人群的研究中关于这些平衡测量（BBS、PASS和BESTest）的心理测量特性的文献。方法在PubMed、CINAHL、Embase、Scopus和Web of Science五个数据库中进行综合电子文献检索；除了手动搜索相关参考文献之外。两名独立评审员对文献搜索结果进行了筛选，以包括以下研究：用英语撰写并发表在同行评审期刊上；参与者为成年人（>18 年），并被诊断为中风；使用以下一项（或多项）指标评估参与者的平衡：BBS、PASS、BESTest或这些指标的缩短版；该研究报告了平衡测量的至少一个心理测量特性。两名独立评审员使用标准化表格提取数据。纳入研究的质量使用关键评估工具进行评估。结果共有65项研究符合我们的纳入标准，并被纳入我们的综述。大多数研究报告了BBS的心理测量特性，其次是PASS，然后是BESTest。批判性评价量表的结果表明，研究的总体质量良好。报告了各种心理测量特性，有效性是报告最多的特性，其次是可靠性。讨论BBS、BESTest和PASS及其变体在中风后人群中使用时显示出总体上优异的心理测量特性。然而，还需要进一步的研究来调查这些措施在康复计划后的反应性。
{"title":"Balance assessment tools and their psychometric properties among individuals post-stroke: a systematic review","authors":"Saleh M. Aloraini, Arwa A. Abu Mismar, Haifa F. Aloqaily, M. Aldaihan","doi":"10.1080/10833196.2023.2168850","DOIUrl":"https://doi.org/10.1080/10833196.2023.2168850","url":null,"abstract":"Abstract Background and purpose Balance assessment following stroke is a significant part of the rehabilitation program. The Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS) and the Balance Evaluation Systems Test (BESTest) are multi-item balance scales commonly used for assessing balance for people post-stroke. The purpose of our systematic review is to identify and appraise the literature on the psychometric properties of these balance measures (BBS, PASS and BESTest) in studies involving people post-stroke. Methods A comprehensive electronic literature search was performed in five databases PubMed, CINAHL, Embase, Scopus and Web of Science; in addition to hand searching of relevant references. Two independent reviewers screened the literature search results to include studies that were: written in the English language and published in peer-reviewed journals; participants were adults (>18 years) and had a diagnosis of stroke; Balance of participants was assessed using one (or more) of the following measures: BBS, PASS, BESTest or a shortened version of these measures; and the study reported at least one psychometric property for the balance measure. Two independent reviewers extracted the data using a standardized form. Quality of included studies was assessed using a critical appraisal tool. Results A total of 65 studies met our inclusion criteria and were included in our review. The majority of studies reported on the psychometric properties of the BBS, followed by the PASS and then the BESTest. Results of the critical appraisal scale showed that the overall quality of studies was good. A variety of psychometric properties were reported, with validity being the most reported property followed by reliability. Discussion The BBS, BESTest and PASS and their variants show overall excellent psychometric properties when used among people post-stroke. However, further research is needed to investigate the responsiveness of these measures following rehabilitation programs.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48963193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-02DOI: 10.1080/10833196.2022.2163076
A. Bansal, J. Sethi, R. Parasher
Abstract Background Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting up to 10% of women of reproductive age. Several pharmacological and non-pharmacological interventions are used to manage symptoms in women with PCOS. Objective The objective of this review was to identify and discuss evidence pertaining specifically to the benefits of structured exercise programs on clinical features and biomarkers relevant to PCOS. Methods Potential studies published between 2000 and 2019 were identified by systematically searching PubMed, Cochrane Library, and CINAHL by using key concepts of PCOS. The PEDro scale was used to evaluate studies’ strength of evidence. Result Thirteen manuscripts of moderate to strong quality were identified. All studies involved structured exercise regimes lasting from 8 weeks to 24 weeks duration with variable frequency (2–5 sessions per week) and duration (25–60 min). Most of the studies reported improvements in menstrual cyclicity, Ferriman-Gallwey scores, testosterone, DHEA-S, sex hormone binding globulin levels and free androgen index scores. Conclusion Structured well-defined aerobic and resistance training protocols, independently or in combination with diet control, that lasted for at least 12 weeks led to improvements in a number of clinical parameters and biomarkers related to PCOS.
{"title":"Role of structured exercise programs in polycystic ovary syndrome: a systematic review","authors":"A. Bansal, J. Sethi, R. Parasher","doi":"10.1080/10833196.2022.2163076","DOIUrl":"https://doi.org/10.1080/10833196.2022.2163076","url":null,"abstract":"Abstract Background Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting up to 10% of women of reproductive age. Several pharmacological and non-pharmacological interventions are used to manage symptoms in women with PCOS. Objective The objective of this review was to identify and discuss evidence pertaining specifically to the benefits of structured exercise programs on clinical features and biomarkers relevant to PCOS. Methods Potential studies published between 2000 and 2019 were identified by systematically searching PubMed, Cochrane Library, and CINAHL by using key concepts of PCOS. The PEDro scale was used to evaluate studies’ strength of evidence. Result Thirteen manuscripts of moderate to strong quality were identified. All studies involved structured exercise regimes lasting from 8 weeks to 24 weeks duration with variable frequency (2–5 sessions per week) and duration (25–60 min). Most of the studies reported improvements in menstrual cyclicity, Ferriman-Gallwey scores, testosterone, DHEA-S, sex hormone binding globulin levels and free androgen index scores. Conclusion Structured well-defined aerobic and resistance training protocols, independently or in combination with diet control, that lasted for at least 12 weeks led to improvements in a number of clinical parameters and biomarkers related to PCOS.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44384297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-02DOI: 10.1080/10833196.2022.2157945
N. Adams, J. McVeigh, A. Cuesta-Vargas, Sedik A Abokdeer
Abstract Background Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome characterized primarily by widespread pain, fatigue, sleep dysfunction and low exercise tolerance. The pathophysiology is complex and its understanding evolving, and clinical management is difficult, with heterogeneous interventions employed. Objectives This scoping review provides an overview of fibromyalgia syndrome, and the evidence for the principal rehabilitation approaches. CINAHL, Cochrane, Medline and PubMed databases were searched from 1996 to 2021. Rehabilitation approaches included exercise, psychologically-based approaches, multicomponent approaches, and complementary and alternative therapies. Major findings Due to factors such as methodological shortcomings of existing studies, and the lack of evidence on individual modalities, it is difficult to draw definitive conclusions as to which is the most appropriate rehabilitation approach in FMS. However, there is evidence from meta-analyses and several international guidelines for the use of approaches incorporating exercise. There is also some evidence for the use of psychologically-informed interventions such as cognitive-behavioural therapy (CBT) approaches. Evidence for other interventions is more equivocal. Conclusions It appears that a combination of interventions (e.g. exercises combined with education and psychological approaches), is the most promising means of managing patients with FMS. Issues such as high numbers of drop-outs from exercise programmes, lack of long-term follow-up in many studies, and patients’ preferences warrant further investigation. An individualized approach based upon extent of psychological involvement, severity of symptoms and level of disability is also recommended.
{"title":"Evidence-based approaches for the management of fibromyalgia syndrome: a scoping review","authors":"N. Adams, J. McVeigh, A. Cuesta-Vargas, Sedik A Abokdeer","doi":"10.1080/10833196.2022.2157945","DOIUrl":"https://doi.org/10.1080/10833196.2022.2157945","url":null,"abstract":"Abstract Background Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome characterized primarily by widespread pain, fatigue, sleep dysfunction and low exercise tolerance. The pathophysiology is complex and its understanding evolving, and clinical management is difficult, with heterogeneous interventions employed. Objectives This scoping review provides an overview of fibromyalgia syndrome, and the evidence for the principal rehabilitation approaches. CINAHL, Cochrane, Medline and PubMed databases were searched from 1996 to 2021. Rehabilitation approaches included exercise, psychologically-based approaches, multicomponent approaches, and complementary and alternative therapies. Major findings Due to factors such as methodological shortcomings of existing studies, and the lack of evidence on individual modalities, it is difficult to draw definitive conclusions as to which is the most appropriate rehabilitation approach in FMS. However, there is evidence from meta-analyses and several international guidelines for the use of approaches incorporating exercise. There is also some evidence for the use of psychologically-informed interventions such as cognitive-behavioural therapy (CBT) approaches. Evidence for other interventions is more equivocal. Conclusions It appears that a combination of interventions (e.g. exercises combined with education and psychological approaches), is the most promising means of managing patients with FMS. Issues such as high numbers of drop-outs from exercise programmes, lack of long-term follow-up in many studies, and patients’ preferences warrant further investigation. An individualized approach based upon extent of psychological involvement, severity of symptoms and level of disability is also recommended.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46331285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-02DOI: 10.1080/10833196.2022.2163082
B. Kinne, R. Breuer, Olivia Margeurite Fitkin, Rebecca Lynn Kelly
Abstract Background A 2021 systematic review reported that all of the included maneuvers for the treatment of geotropic horizontal canal benign paroxysmal positional vertigo (BPPV) demonstrated high efficacy and few contraindications. However, a similar systematic review for the apogeotropic subtype of horizontal canal BPPV has not been published. Objectives The purpose of this systematic review was to evaluate the effectiveness of current treatment options for apogeotropic horizontal canal BPPV. Methods The databases accessed from inception through 2021 were CINAHL Complete, PubMed, and Web of Science. The search terms utilized were (ageotropic OR apogeotropic) AND (horizontal OR lateral) AND vertigo. A 10-item tool developed by Medlicott and Harris was utilized to assess methodological rigor. Results Three of the included maneuvers (the Gufoni maneuver, the Zuma maneuver, and the Cupulolith Repositioning maneuver) demonstrated 100% efficacy after only one treatment session. The Gufoni maneuver may be preferable for individuals who are elderly, obese, or have problems with their general mobility because it does not require the individual to perform a roll. Although the Zuma maneuver is also easy to perform on these types of individuals, only one study has been completed on this maneuver. Because the Cupulolith Repositioning maneuver is a roll maneuver, it may not be tolerated by all individuals. Conclusions The Gufoni maneuver may be the best maneuver to initially consider because it has been more well-studied than the Zuma maneuver; and it may be more comfortable than the Cupulolith Repositioning maneuver for certain types of individuals.
摘要背景2021年的一项系统综述报告称，所有纳入的治疗向地水平管良性阵发性位置性眩晕（BPPV）的手法均显示出较高的疗效和较少的禁忌症。然而，关于水平管BPPV的无向地亚型的类似系统综述尚未发表。目的本系统综述的目的是评估目前治疗无向性水平管BPPV的有效性。方法从成立到2021年访问的数据库为CINAHL Complete、PubMed和Web of Science。使用的搜索词是（年龄相关或无地理相关）和（水平或横向）和眩晕。Medlicott和Harris开发的10项工具用于评估方法的严谨性。结果其中三种手法（Gufoni手法、Zuma手法和Cupulolith复位手法）仅在一次治疗后就显示出100%的疗效。Gufoni动作可能更适合老年人、肥胖者或行动不便的人，因为它不需要个人进行翻滚。尽管祖马动作也很容易对这些类型的人进行，但只有一项关于这种动作的研究完成。因为Cupulolith重新定位动作是一种滚转动作，所以可能不是所有人都能容忍。结论Gufoni机动可能是最初考虑的最佳机动，因为它比Zuma机动得到了更好的研究；并且对于某些类型的个体来说，它可能比Cupulolith重新定位策略更舒适。
{"title":"Interventions for apogeotropic horizontal canal benign paroxysmal positional vertigo: a systematic review","authors":"B. Kinne, R. Breuer, Olivia Margeurite Fitkin, Rebecca Lynn Kelly","doi":"10.1080/10833196.2022.2163082","DOIUrl":"https://doi.org/10.1080/10833196.2022.2163082","url":null,"abstract":"Abstract Background A 2021 systematic review reported that all of the included maneuvers for the treatment of geotropic horizontal canal benign paroxysmal positional vertigo (BPPV) demonstrated high efficacy and few contraindications. However, a similar systematic review for the apogeotropic subtype of horizontal canal BPPV has not been published. Objectives The purpose of this systematic review was to evaluate the effectiveness of current treatment options for apogeotropic horizontal canal BPPV. Methods The databases accessed from inception through 2021 were CINAHL Complete, PubMed, and Web of Science. The search terms utilized were (ageotropic OR apogeotropic) AND (horizontal OR lateral) AND vertigo. A 10-item tool developed by Medlicott and Harris was utilized to assess methodological rigor. Results Three of the included maneuvers (the Gufoni maneuver, the Zuma maneuver, and the Cupulolith Repositioning maneuver) demonstrated 100% efficacy after only one treatment session. The Gufoni maneuver may be preferable for individuals who are elderly, obese, or have problems with their general mobility because it does not require the individual to perform a roll. Although the Zuma maneuver is also easy to perform on these types of individuals, only one study has been completed on this maneuver. Because the Cupulolith Repositioning maneuver is a roll maneuver, it may not be tolerated by all individuals. Conclusions The Gufoni maneuver may be the best maneuver to initially consider because it has been more well-studied than the Zuma maneuver; and it may be more comfortable than the Cupulolith Repositioning maneuver for certain types of individuals.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41762009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-11DOI: 10.1080/10833196.2022.2145444
Renata F L Martínez, T. Sato, J. B. D. Silva, V. B. Figueiredo, M. A. Ávila, P. Driusso
Abstract Background: Pelvic floor muscle (PFM) activation during efforts activities may predispose to urinary loss. However, there is unclear evidence on the behavior of PFM during situations of coughing and Valsalva maneuver. Objectives: Hence, the present review aimed to evaluate the current evidence on electromyographic (EMG) activity of PFM during coughing and Valsalva maneuver in continent women and women with stress urinary incontinence (SUI). Methods: The databases EMBASE, PubMed, Science Direct, Scopus and were searched up to August, 2021. Two independent reviewers conducted the selection process based on titles, abstracts, and full-text reading. In addition, studies reporting PFM EMG activity during coughing and/or the Valsalva maneuver with surface EMG were included. The methodological quality of the primary studies was assessed through the checklist proposed by the Joanna Briggs Institute for cross-sectional studies. Results: Seven cross-sectional studies were included in this review, four of which were on PFM activation of continent women, while the other three compared continent women versus women with SUI. During both Valsalva maneuver and coughing, an increase of PFM EMG activity compared to rest was observed for continent women and women with SUI. Limitations of the present systematic review are that comparison among studies and a meta-analysis were not possible due to heterogeneity of EMG techniques and devices used. Conclusions: Coughing and Valsalva maneuver lead to an increase in PFM electrical activity compared to rest. This increase was more prominent in women with SUI during Valsalva, with no differences during coughing.
{"title":"Pelvic floor muscle activity during coughing and valsalva maneuver in continent women and women with stress urinary incontinence: a systematic review","authors":"Renata F L Martínez, T. Sato, J. B. D. Silva, V. B. Figueiredo, M. A. Ávila, P. Driusso","doi":"10.1080/10833196.2022.2145444","DOIUrl":"https://doi.org/10.1080/10833196.2022.2145444","url":null,"abstract":"Abstract Background: Pelvic floor muscle (PFM) activation during efforts activities may predispose to urinary loss. However, there is unclear evidence on the behavior of PFM during situations of coughing and Valsalva maneuver. Objectives: Hence, the present review aimed to evaluate the current evidence on electromyographic (EMG) activity of PFM during coughing and Valsalva maneuver in continent women and women with stress urinary incontinence (SUI). Methods: The databases EMBASE, PubMed, Science Direct, Scopus and were searched up to August, 2021. Two independent reviewers conducted the selection process based on titles, abstracts, and full-text reading. In addition, studies reporting PFM EMG activity during coughing and/or the Valsalva maneuver with surface EMG were included. The methodological quality of the primary studies was assessed through the checklist proposed by the Joanna Briggs Institute for cross-sectional studies. Results: Seven cross-sectional studies were included in this review, four of which were on PFM activation of continent women, while the other three compared continent women versus women with SUI. During both Valsalva maneuver and coughing, an increase of PFM EMG activity compared to rest was observed for continent women and women with SUI. Limitations of the present systematic review are that comparison among studies and a meta-analysis were not possible due to heterogeneity of EMG techniques and devices used. Conclusions: Coughing and Valsalva maneuver lead to an increase in PFM electrical activity compared to rest. This increase was more prominent in women with SUI during Valsalva, with no differences during coughing.","PeriodicalId":46541,"journal":{"name":"Physical Therapy Reviews","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42388611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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