Journal of Physiotherapy最新文献

英文中文

Research Note: Interpreting confidence intervals 研究说明：解释置信区间。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-10-01 DOI: 10.1016/j.jphys.2024.08.010

Mark Elkins

引用次数: 0

Prophylactic non-invasive positive pressure ventilation reduces complications and length of hospital stay after invasive thoracic procedures: a systematic review 预防性无创正压通气可减少侵入性胸腔手术后的并发症和住院时间：系统性综述。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-10-01 DOI: 10.1016/j.jphys.2024.08.008

Elinaldo da Conceição dos Santos , Renan Lima Monteiro , Juliana Ribeiro Fonseca Franco de Macedo , William Poncin , Adriana Claudia Lunardi

Question

In patients undergoing invasive thoracic procedures, what are the effects of prophylactic non-invasive positive pressure ventilation (NIV)?

Design

Systematic review with meta-analysis of randomised trials. Methodological quality was assessed using the PEDro scale and the certainty of evidence with the GRADE approach.

Participants

Patients undergoing invasive thoracic procedures.

Intervention

Continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP).

Outcome measures

Length of hospital stay, postoperative pulmonary complications, need for tracheal intubation, mortality, hypoxaemia, pulmonary function and adverse events. Meta-analysis was performed for all outcomes. Subgroup analyses estimated the effects of CPAP and BIPAP independently.

Results

Sixteen trials with 1,814 participants were included. The average quality of the included studies was fair. Moderate certainty evidence indicated that NIV reduces postoperative pulmonary complications (RD –0.09, 95% CI –0.15 to –0.04) without increasing the rate of adverse events (RD 0.01, 95% CI –0.02 to 0.04). Low certainty evidence indicated that NIV reduces length of hospital stay (MD –1.4 days, 95% CI –2.2 to –0.5) compared with usual care. The effects on intubation and mortality rates were very close to no effect, indicating that NIV is safe. Subgroup analyses showed that the evidence for CPAP had more precise estimates that that for BiPAP.

Conclusion

NIV reduces postoperative pulmonary complications and length of stay after invasive chest procedures without increasing the risk of adverse events.

Registration

PROSPERO CRD42015019004.

问题在接受侵入性胸腔手术的患者中，预防性无创正压通气（NIV）的效果如何？对随机试验进行系统回顾和荟萃分析。采用 PEDro 量表评估方法学质量，并采用 GRADE 方法评估证据的确定性：干预：干预措施：持续气道正压（CPAP）或双水平气道正压（BiPAP）：住院时间、术后肺部并发症、气管插管需求、死亡率、低氧血症、肺功能和不良事件。对所有结果进行了 Meta 分析。亚组分析分别估算了 CPAP 和 BIPAP 的效果：结果：共纳入 16 项试验，1,814 名参与者。纳入研究的平均质量尚可。中度确定性证据表明，NIV可减少术后肺部并发症（RD -0.09，95% CI -0.15至-0.04），但不会增加不良事件的发生率（RD 0.01，95% CI -0.02至0.04）。低确定性证据表明，与常规护理相比，NIV可缩短住院时间（MD -1.4天，95% CI -2.2至-0.5）。对插管率和死亡率的影响非常接近于无影响，这表明 NIV 是安全的。分组分析表明，CPAP 的证据比 BiPAP 的证据有更精确的估计值：结论：NIV 可减少胸部侵入性手术后的肺部并发症和住院时间，同时不会增加不良事件的风险：注册：PREMCORD42015019004。

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引用次数: 0

Critically appraised paper: Dynamic neuromuscular stabilisation leads to superior and sustained improvements in balance compared with core stabilisation in patients with multiple sclerosis [synopsis] 经过严格评审的论文：在多发性硬化症患者中，动态神经肌肉稳定疗法与核心稳定疗法相比，能更好地持续改善患者的平衡能力[内容提要]。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.05.016

Prudence Plummer

引用次数: 0

Cover image and highlights 封面图片和亮点

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/S1836-9553(24)00065-1

引用次数: 0

Journal publication information 期刊出版信息

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/S1836-9553(24)00069-9

引用次数: 0

Preoperative physiotherapy prevents postoperative pulmonary complications after major abdominal surgery: a meta-analysis of individual patient data 术前物理治疗可预防腹部大手术后肺部并发症：对患者个体数据的荟萃分析。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.02.012

Ianthe Boden , Julie Reeve , Anna Jernås , Linda Denehy , Monika Fagevik Olsén

Questions

Among patients having elective abdominal surgery, how much does preoperative physiotherapy education with breathing exercise training reduce the incidence of postoperative pulmonary complications (PPCs), hospital length of stay and 12-month mortality? How stable are the treatment effects across different PPC definitions, including pneumonia? How much do the treatment effects on PPC, hospital length of stay and mortality vary within clinically relevant subgroups?

Design

Individual participant-level meta-analysis (n = 800) from two randomised controlled trials analysed with multivariable regression.

Participants

Adults undergoing major elective abdominal surgery.

Interventions

Experimental participants received a single preoperative session with a physiotherapist within 4 weeks of surgery and educated on PPC prevention with breathing exercises and early mobilisation. They were taught breathing exercises and instructed to start them immediately on waking from surgery. The control group received no preoperative or postoperative physiotherapy, or early ambulation alone.

Outcome measures

PPC, hospital length of stay and 12-month mortality.

Results

Participants who received preoperative physiotherapy had 47% lower odds of developing a PPC (adjusted OR 0.53, 95% CI 0.34 to 0.85). This effect was stable regardless of PPC definition. Effects were greatest in participants who smoked, were aged ≤ 45 years, had abnormal body weight, had multiple comorbidities, or were undergoing bariatric or upper gastrointestinal surgery. Participants having operations ≤ 3 hours in duration were least responsive to preoperative physiotherapy. Participants with multiple comorbidities were more likely to have a shorter hospital stay if provided with preoperative physiotherapy (adjusted MD –3.2 days, 95% CI –6.2 to –0.3). Effects on mortality were uncertain.

Conclusion

There is strong evidence to support preoperative physiotherapy in preventing PPCs after elective abdominal surgery.

问题在择期腹部手术患者中，术前物理治疗教育与呼吸运动训练能在多大程度上降低术后肺部并发症（PPC）的发生率、住院时间和 12 个月的死亡率？在不同的 PPC 定义（包括肺炎）下，治疗效果的稳定性如何？在临床相关的亚组中，对肺部并发症、住院时间和死亡率的治疗效果有多大差异？来自两项随机对照试验的个人参与者水平荟萃分析（n = 800），采用多变量回归分析：干预：实验参与者在手术前 4 周内接受理疗师的一次术前治疗，并接受通过呼吸练习和早期活动预防 PPC 的教育。他们接受了呼吸练习，并被要求在手术后立即开始呼吸练习。对照组不接受术前或术后物理治疗，或仅进行早期活动：结果：PPC、住院时间和 12 个月死亡率：结果：接受术前物理治疗的参与者发生 PPC 的几率降低了 47%（调整后 OR 为 0.53，95% CI 为 0.34 至 0.85）。无论PPC的定义如何，这一效果都很稳定。吸烟、年龄小于 45 岁、体重异常、患有多种并发症或正在接受减肥或上消化道手术的参试者所受影响最大。手术时间不超过3小时的参与者对术前物理治疗的反应最小。如果术前接受物理治疗，有多种并发症的患者更有可能缩短住院时间（调整后的MD为-3.2天，95% CI为-6.2至-0.3）。对死亡率的影响尚不确定：有强有力的证据支持术前物理治疗可预防择期腹部手术后的 PPCs。

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引用次数: 0

Clinimetrics: Douleur Neuropathique en 4 Questions (DN4) 临床医学：神经病理性疼痛四问 (DN4)。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.02.010

Michael C Ferraro , James H McAuley

引用次数: 0

Critically appraised paper: In adults with idiopathic pulmonary fibrosis, long-term pulmonary rehabilitation did not improve 6-minute walk distance, but improved endurance time compared with usual care [synopsis] 经过严格评审的论文：在特发性肺纤维化成人患者中，与常规护理相比，长期肺康复治疗不能改善 6 分钟步行距离，但能改善耐力时间[内容提要]。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.05.005

Vinicius Cavalheri

引用次数: 0

Appraisal of Clinical Practice Guideline: Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update 临床实践指南评估：加拿大骨质疏松症管理和骨折预防临床实践指南：2023 年更新版。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.05.002

Marina B Pinheiro, Vasi Naganathan

引用次数: 0

Hip, knee and ankle disorders 髋关节、膝关节和踝关节疾病。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.06.006

Megan Ross , Mark R Elkins

引用次数: 0

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