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Critically appraised paper: Neck-specific exercise with internet support for chronic whiplash-associated disorders is noninferior to neck-specific exercise at a physiotherapy clinic [Commentary] 批评性评价论文:在网络支持下进行颈部专项运动治疗慢性鞭伤相关疾病的效果不逊于在理疗诊所进行颈部专项运动[评论]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.003
Michele Sterling
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引用次数: 0
Critically appraised paper: In adults with chronic obstructive pulmonary disease, long-term telerehabilitation and unsupervised home-based treadmill training reduced hospitalisations and emergency department presentations compared with usual care [synopsis] 批判性评价论文:与常规护理相比,长期远程康复和无监督的家庭跑步机训练减少了成人慢性阻塞性肺病患者的住院率和急诊科就诊率[摘要]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.009
Vinicius Cavalheri
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引用次数: 0
Clinimetrics: The Sport Injury Rehabilitation Adherence Scale 临床指标:运动损伤康复依从性量表。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.014
Bradley Furlong, Amanda Hall
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引用次数: 0
Journal publication information 期刊出版信息
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/S1836-9553(23)00141-8
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引用次数: 0
Aims and Scope/Editorial Board 目标和范围/编辑委员会
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/S1836-9553(23)00136-4
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引用次数: 0
In adults with chronic obstructive pulmonary disease, long-term telerehabilitation and unsupervised home-based treadmill training reduced hospitalisations and emergency department presentations compared with usual care [commentary] 对于患有慢性阻塞性肺疾病的成人,与常规护理相比,长期远程康复和无监督的家庭跑步机训练减少了住院和急诊科就诊。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.008
Claire M Nolan
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引用次数: 0
Appraisal of Clinical Practice Guideline: Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: 2018 临床实践评价指南:择期结直肠手术围手术期护理指南:增强术后恢复(ERAS)学会推荐:2018。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.007
Ianthe Boden
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引用次数: 0
Active pelvic movements on a Swiss ball reduced labour duration, pain, fatigue and anxiety in parturient women: a randomised trial 在瑞士球上积极的骨盆运动减少了产妇的分娩时间、疼痛、疲劳和焦虑:一项随机试验。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.001
Alexandre Delgado , Melania M Amorim , Andreza do Amaral Paraiba Oliveira , Keytte Camilla Souza Amorim , Marina Wanderley Selva , Yasmin Eduarda Silva , Andrea Lemos , Leila Katz

Question

How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes?

Method

A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis.

Participants

Two-hundred parturient women.

Intervention

The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower.

Outcome measures

The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes.

Results

The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear.

Conclusion

Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect.

Registration

NCT04124835.

问题:分娩时在瑞士球上的盆腔活动对产妇和新生儿的结局有多大影响?方法:采用隐式分配、盲法评估和意向治疗分析的随机试验。参与者:200名产妇。干预:实验组根据个人产科评估(胎位、胎位、宫颈扩张、有无早期推压冲动),在瑞士球上进行盆腔前倾和后倾、盆腔外侧倾斜和髋关节圆周运动。对照组接受常规护理。两组人都被允许散步和淋浴。观察指标:主要观察指标为第一产程持续时间。次要结局是第二产程持续时间、疼痛强度、分娩方式、药物使用、局部肿胀、疲劳、焦虑、满意度和新生儿结局。结果:实验干预在第一阶段减少了179分钟(95% CI 146至213),在第二阶段减少了19分钟(95% CI 13至25)。在30分钟、60分钟和90分钟时,疼痛在0到10分的范围内减少了大约2分(95% CI 2到2)。它降低了剖宫产的风险(ARR 0.14, 95% CI 0.03 ~ 0.25;NNT 7, 95% CI 4 ~ 32)和外阴肿胀(ARR 0.11, 95% CI 0.03 ~ 0.19;NNT 9, 95% CI 5 ~ 31)。在15到75分的量表上,它减少了18分(95% CI 16到21)的疲劳,在18到72分的量表上减少了9分(95% CI 8到11)的焦虑。其他影响可以忽略不计或不清楚。结论:分娩时在瑞士球上的主动盆腔运动减少了分娩时间、疼痛强度、产妇疲劳和焦虑;它们还降低了剖腹产和外阴肿胀的风险。有几个效果超过了最小的有价值的效果。注册:NCT04124835。
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引用次数: 0
Preoperative respiratory muscle training reduces the risk of pulmonary complications and the length of hospital stay after cardiac surgery: a systematic review 术前呼吸肌训练可降低心脏手术后肺部并发症的风险和住院时间:一项系统综述。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.012
José Francisco Cursino de Moura , Crystian Bitencourt Oliveira , Ana Paula Coelho Figueira Freire , Mark Russell Elkins , Francis Lopes Pacagnelli

Questions

What is the effect of preoperative respiratory muscle training (RMT) on the incidence of postoperative pulmonary complications (PPCs) after open cardiac surgery? What is the effect of RMT on the duration of mechanical ventilation, postoperative length of stay and respiratory muscle strength?

Design

Systematic review of randomised trials with meta-analysis.

Participants

Adults undergoing elective open cardiac surgery.

Intervention

The experimental groups received preoperative RMT and the comparison groups received no intervention.

Outcome measures

The primary outcomes were PPCs, length of hospital stay, respiratory muscle strength, oxygenation and duration of mechanical ventilation. The methodological quality of studies was assessed using the PEDro scale and the overall certainty of the evidence was assessed using the GRADE approach.

Results

Eight trials involving 696 participants were included. Compared with the control group, the respiratory training group had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44, 95% CI 0.25 to 0.78), shorter hospital stay (MD −1.7 days, 95% CI −2.4 to −1.1) and higher maximal inspiratory pressure values at the end of the training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical ventilation time was similar in both groups. The quality of evidence was high for pneumonia, length of hospital stay and maximal inspiratory pressure.

Conclusion

Preoperative RMT reduced the risk of PPCs and pneumonia after cardiac surgery. The training also improved the maximal inspiratory pressure and reduced hospital stay. The effects on PPCs were large enough to warrant use of RMT in this population.

Registration

CRD42021227779

问题:术前呼吸肌训练(RMT)对心脏直视手术后肺部并发症(PPCs)的发生率有何影响?RMT对机械通气时间、术后停留时间和呼吸肌力量有何影响?设计:采用荟萃分析对随机试验进行系统评价。参与者:接受择期心脏直视手术的成年人。干预:实验组术前行RMT治疗,对照组不进行干预。结局指标:主要结局为PPCs、住院时间、呼吸肌力量、氧合和机械通气持续时间。使用PEDro量表评估研究的方法学质量,使用GRADE方法评估证据的总体确定性。结果:纳入8项试验,696名受试者。与对照组相比,呼吸训练组PPCs发生率较低(RR 0.51, 95% CI 0.38 ~ 0.70),肺炎发生率较低(RR 0.44, 95% CI 0.25 ~ 0.78),住院时间较短(MD -1.7天,95% CI -2.4 ~ -1.1),训练方案结束时最大吸气压力值较高(MD 12 cmH2O, 95% CI 8 ~ 16)。两组患者机械通气时间相似。肺炎、住院时间和最大吸气压力的证据质量较高。结论:术前RMT可降低心脏手术后PPCs和肺炎的发生风险。该训练还提高了最大吸气压力,缩短了住院时间。对PPCs的影响足够大,足以保证在该人群中使用RMT。注册:CRD42021227779。
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引用次数: 0
Research Note: Discrete choice experiments to elicit preferences for decision-making in physiotherapy 研究说明:通过离散选择实验得出物理治疗决策偏好
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.004
Rakhee Raghunandan, Kirsten Howard
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Journal of Physiotherapy
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