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Research Note: Trial sequential analysis in systematic reviews with meta-analysis 研究说明:系统综述中的试验序列分析与荟萃分析。
IF 9.7 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.05.008
Christian Gunge Riberholt , Markus Harboe Olsen , Christian Gluud
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引用次数: 0
Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains in people with chronic obstructive pulmonary disease: a systematic review 以实现行为改变为明确重点的干预措施对于保持慢性阻塞性肺病患者在培训方面的收获非常重要:一项系统性综述。
IF 9.7 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.06.003
Sarah Hug , Vinicius Cavalheri , Hollie Lawson-Smith , Daniel F Gucciardi , Kylie Hill

Questions

In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains?

Design

Systematic review, meta-analysis and meta-regression of randomised controlled trials.

Participants

People with stable COPD.

Intervention

Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component.

Outcome measures

Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living.

Data sources

EMBASE, PEDro, PubMed and the Cochrane Library.

Results

Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program.

Conclusion

At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains.

Registration

CRD42020193833.

问题:慢性阻塞性肺病(COPD)患者在完成足够剂量的运动训练计划(ETP)以获得与训练相关的收益后,这些收益在计划完成 12 个月后的维持程度如何?行为改变技术的应用等变量是否会影响这些训练相关收益的维持?随机对照试验的系统回顾、荟萃分析和荟萃回归:干预措施:干预措施:如果试验中全身 ETP 的使用时间≥ 4 周,并在项目完成后立即报告结果数据,以及在初始项目完成后 12 个月报告结果数据,则纳入该试验。对照组接受不包括正式运动训练内容的常规护理:数据来源:EMBASE、PEDro、Professional Journal、Professional Journal、Professional Journal、Professional Journal、Professional Journal、Professional Journal 等:数据来源:EMBASE、PEDro、PubMed 和 Cochrane 图书馆:结果:共发现 19 项随机试验,2103 名参与者,其中 12 项试验的设计足够相似,可以进行荟萃分析。在 ETP 完成 12 个月后,与对照组相比,实验组显示出更好的运动耐受性(SMD 0.48,95% CI 0.19 至 0.77)和生活质量(SMD 0.22,95% CI 0.03 至 0.41),但对呼吸困难没有明显影响。利用所有19项试验的数据进行的元回归表明,在12个月的随访中,组间差异的大小受以下因素的影响:行为改变是ETP完成后所实施策略的核心目标;试验组在计划期间接受了更多的行为改变技巧;以及从计划中获得的组间改变的大小:结论:在完成≥ 4 周的 ETP 计划 12 个月后,运动耐受力和与健康相关的生活质量仍有小幅提高。应用行为改变技术,明确关注参与者在最初计划完成后将运动融入日常生活,对于保持与培训相关的成果非常重要:注册号:CRD42020193833。
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引用次数: 0
Critically appraised paper: A combined digital technology program was not superior to usual care on knee pain following total knee replacement [Commentary] 经过严格评审的论文:在全膝关节置换术后膝关节疼痛方面,数字技术联合方案并不优于常规护理方案[评论]。
IF 9.7 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.04.001
Daniel K White
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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 [commentary] 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、更持久地改善患者的平衡能力[评论]。
IF 9.7 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.05.013
Sarah J Donkers
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引用次数: 0
Real-time video telerehabilitation shows comparable satisfaction and similar or better attendance and adherence compared with in-person physiotherapy: a systematic review 实时视频远程康复与面对面物理治疗相比,满意度相当,出勤率和坚持率相似或更高:系统综述。
IF 9.7 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jphys.2024.06.001
Joshua Simmich, Megan H Ross, Trevor Russell

Question

How does physiotherapy delivered by real-time, video-based telerehabilitation compare with in-person delivery for the outcomes of attendance, adherence and satisfaction?

Design

Systematic review of randomised control trials indexed in PubMed, CINAHL, Embase, Cochrane and PEDro on 12 March 2024.

Participants

Adults aged > 18 years.

Intervention

Physiotherapy delivered via real-time video telerehabilitation.

Outcome measures

Attendance, adherence and satisfaction.

Results

Eight studies were included for attendance (n = 1,110), nine studies for adherence (n = 1,190) and 12 studies for satisfaction (n = 1,247). Telerehabilitation resulted in attendance at treatment sessions that was 8% higher (95% CI −1 to 18) and adherence to exercise programs that was 9% higher (95% CI 2 to 16) when compared with in-person physiotherapy. Satisfaction was similar with both modes of delivery (SMD 0.03 in favour of telerehabilitation, 95% CI −0.23 to 0.28). The level of certainty assessed by GRADE ranged from very low to low, primarily due to inconsistency and high risk of bias.

Discussion

Attendance at appointments among participants assigned to telerehabilitation was somewhere between similar to and considerably higher than among control participants. Adherence to self-management with telerehabilitation was better than with in-person delivery, although with some uncertainty about the magnitude of the effect. Reported satisfaction levels were similar between the two modes of treatment delivery. Given the significance of attendance, adherence and satisfaction for successful outcomes, telerehabilitation offers a valuable alternative mode for physiotherapy delivery.

Conclusion

Real-time telerehabilitation has potentially favourable effects on attendance at treatment appointments and adherence to exercise programs, with similar satisfaction when compared with traditional in-person physiotherapy.

Registration

PROSPERO CRD42022329906

问题在出勤率、依从性和满意度方面,通过实时视频远程康复提供的物理治疗与面对面提供的物理治疗相比效果如何?对 2024 年 3 月 12 日在 PubMed、CINAHL、Embase、Cochrane 和 PEDro 中索引的随机对照试验进行系统回顾:干预:干预措施:通过实时视频远程康复提供物理治疗:结果测量:出勤率、依从性和满意度:结果:8 项研究纳入了出勤率(n = 1,110),9 项研究纳入了坚持率(n = 1,190),12 项研究纳入了满意度(n = 1,247)。与面对面物理治疗相比,远程康复治疗的出勤率高出 8%(95% CI -1-18),坚持锻炼计划的比例高出 9%(95% CI 2-16)。两种治疗模式的满意度相似(远程康复的满意度为0.03,95% CI为-0.23至0.28)。GRADE评估的确定性从很低到很低不等,主要原因是不一致和高偏倚风险:接受远程康复治疗的患者的就诊率介于与对照组患者的就诊率相近和高出对照组患者很多之间。远程康复治疗的自我管理依从性优于面对面治疗,但效果的大小还不确定。两种治疗方式的满意度相似。鉴于出勤率、坚持率和满意度对成功治疗的重要性,远程康复治疗为物理治疗提供了一种有价值的替代模式:结论:与传统的面对面物理治疗相比,实时远程康复对治疗预约的出席率和运动计划的坚持率具有潜在的有利影响,满意度也相似:注册:PROCROPERO CRD42022329906。
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引用次数: 0
Cover image and highlights 封面图片和亮点
IF 12.1 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-04-01 DOI: 10.1016/S1836-9553(24)00027-4
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引用次数: 0
Clinimetrics: The Victorian Institute of Sport Questionnaire - gluteal tendinopathy (VISA-G) 临床测量学:维多利亚体育学院问卷--臀部肌腱病(VISA-G)
IF 12.1 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.009
Anthony Nasser , Alison Grimaldi
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引用次数: 0
Health coaching improves physical activity, disability and pain in adults with chronic non-cancer pain: a systematic review 健康指导可改善慢性非癌性疼痛成人的体育活动、残疾和疼痛状况:系统性综述。
IF 12.1 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.01.001
Talia Barnet-Hepples , Amabile Dario , Juliana Oliveira , Christopher Maher , Anne Tiedemann , Anita Amorim

Question

What is the effect of health coaching on physical activity, disability, pain and quality of life compared with a non-active control in adults with chronic non-cancer pain?

Design

Systematic review and meta-analysis of randomised controlled trials. Evidence was synthesised as standardised mean differences with 95% confidence intervals using random-effects models. Risk of bias was assessed using the revised Cochrane risk of bias tool. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine evidence certainty.

Data sources

MEDLINE, Embase, CENTRAL, CINAHL, Scopus and PEDro were searched from inception to November 2023.

Participants

Adults with chronic non-cancer pain.

Intervention

Health coaching to increase physical activity.

Outcome measures

Measures of physical activity, disability, pain and quality of life.

Results

Twenty-six randomised trials (n = 4,403) were included. Trials had moderate to high risk of bias. Health coaching had a trivial to small effect on improving physical activity compared with control (15 trials; SMD 0.21, 95% CI 0.07 to 0.35; low certainty evidence). Health coaching had a small effect on improving disability (19 trials; SMD 0.25, 95% CI 0.17 to 0.32; moderate certainty evidence) and pain (19 trials; SMD 0.31, 95% CI 0.18 to 0.43; very low certainty evidence) compared with control. The effect of health coaching on quality of life was unclear due to significant imprecision in the effect estimate (five trials; SMD 0.19, 95% CI –0.14 to 0.53; moderate certainty evidence).

Conclusion

Health coaching promotes a trivial to small improvement in physical activity and small improvements in disability and pain in adults with chronic non-cancer pain. The effect of health coaching on quality of life remains unclear.

Registration

PROSPERO CRD42020182740.

问题在患有慢性非癌性疼痛的成年人中,健康指导对身体活动、残疾、疼痛和生活质量的影响与非活动对照组相比如何?对随机对照试验进行系统回顾和荟萃分析。采用随机效应模型,以标准化平均差和 95% 置信区间对证据进行综合。使用修订版 Cochrane 偏倚风险工具评估偏倚风险。采用建议评估、发展和评价分级(GRADE)确定证据的确定性:检索了从开始到 2023 年 11 月的 MEDLINE、Embase、CENTRAL、CINAHL、Scopus 和 PEDro:干预措施:增加体育锻炼的健康指导:干预措施:健康指导以增加体育锻炼:结果:对身体活动、残疾、疼痛和生活质量进行测量:结果:共纳入 26 项随机试验(n = 4 403)。试验存在中度至高度偏倚风险。与对照组相比,健康指导对提高身体活动量的影响微不足道(15 项试验;SMD 0.21,95% CI 0.07 至 0.35;证据确定性低)。与对照组相比,健康指导对改善残疾(19 项试验;SMD 0.25,95% CI 0.17 至 0.32;中等确定性证据)和疼痛(19 项试验;SMD 0.31,95% CI 0.18 至 0.43;极低确定性证据)的影响较小。健康指导对生活质量的影响尚不明确,因为其效果估计值极不精确(5项试验;SMD为0.19,95% CI为-0.14至0.53;中度确定性证据):结论:对患有慢性非癌症疼痛的成年人而言,健康指导可促进其体育锻炼的微小改善以及残疾和疼痛的小幅改善。健康指导对生活质量的影响尚不明确:ProCOMO CRD42020182740.
{"title":"Health coaching improves physical activity, disability and pain in adults with chronic non-cancer pain: a systematic review","authors":"Talia Barnet-Hepples ,&nbsp;Amabile Dario ,&nbsp;Juliana Oliveira ,&nbsp;Christopher Maher ,&nbsp;Anne Tiedemann ,&nbsp;Anita Amorim","doi":"10.1016/j.jphys.2024.01.001","DOIUrl":"10.1016/j.jphys.2024.01.001","url":null,"abstract":"<div><h3>Question</h3><p>What is the effect of health coaching on physical activity, disability, pain and quality of life compared with a non-active control in adults with chronic non-cancer pain?</p></div><div><h3>Design</h3><p>Systematic review and meta-analysis of randomised controlled trials. Evidence was synthesised as standardised mean differences with 95% confidence intervals using random-effects models. Risk of bias was assessed using the revised Cochrane risk of bias tool. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine evidence certainty.</p></div><div><h3>Data sources</h3><p>MEDLINE, Embase, CENTRAL, CINAHL, Scopus and PEDro were searched from inception to November 2023.</p></div><div><h3>Participants</h3><p>Adults with chronic non-cancer pain.</p></div><div><h3>Intervention</h3><p>Health coaching to increase physical activity.</p></div><div><h3>Outcome measures</h3><p>Measures of physical activity, disability, pain and quality of life.</p></div><div><h3>Results</h3><p>Twenty-six randomised trials (n = 4,403) were included. Trials had moderate to high risk of bias. Health coaching had a trivial to small effect on improving physical activity compared with control (15 trials; SMD 0.21, 95% CI 0.07 to 0.35; low certainty evidence). Health coaching had a small effect on improving disability (19 trials; SMD 0.25, 95% CI 0.17 to 0.32; moderate certainty evidence) and pain (19 trials; SMD 0.31, 95% CI 0.18 to 0.43; very low certainty evidence) compared with control. The effect of health coaching on quality of life was unclear due to significant imprecision in the effect estimate (five trials; SMD 0.19, 95% CI –0.14 to 0.53; moderate certainty evidence).</p></div><div><h3>Conclusion</h3><p>Health coaching promotes a trivial to small improvement in physical activity and small improvements in disability and pain in adults with chronic non-cancer pain. The effect of health coaching on quality of life remains unclear.</p></div><div><h3>Registration</h3><p>PROSPERO CRD42020182740.</p></div>","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"70 2","pages":"Pages 115-123"},"PeriodicalIF":12.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S183695532400002X/pdfft?md5=18b0268dbfa50d8d528be30d176f02c5&pid=1-s2.0-S183695532400002X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Title page 扉页
IF 12.1 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-04-01 DOI: 10.1016/S1836-9553(24)00028-6
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引用次数: 0
Critically appraised paper: Hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) improves bimanual performance and gross motor function in pre-school children with unilateral cerebral palsy [commentary] 经过严格评审的论文:包括下肢在内的手臂双臂强化疗法(HABIT-ILE)可改善单侧脑瘫学龄前儿童的双臂表现和大运动功能[评论]。
IF 12.1 1区 医学 Q1 ORTHOPEDICS Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.004
Sarah Reedman
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引用次数: 0
期刊
Journal of Physiotherapy
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