scholarly journals How Do Somatosensory Deficits in the Arm and Hand Relate to Upper Limb Impairment, Activity, and Participation Problems After Stroke? A Systematic Review

2014 ◽  
Vol 94 (9) ◽  
pp. 1220-1231 ◽  
Author(s):  
Sarah Meyer ◽  
Auli H. Karttunen ◽  
Vincent Thijs ◽  
Hilde Feys ◽  
Geert Verheyden
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Predictive Value ◽  
Functional Performance ◽  
Data Extraction ◽  
Motor Recovery ◽  
Cochrane Library ◽  
Cutoff Score ◽  
Study Selection ◽  
The Relationship

Background The association between somatosensory impairments and outcome after stroke remains unclear. Purpose The aim of this study was to systematically review the available literature on the relationship between somatosensory impairments in the upper limb and outcome after stroke. Data Sources The electronic databases PubMed, CINAHL, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from inception until July 2013. Study Selection Studies were included if adult patients with stroke (minimum n=10) were examined with reliable and valid measures of somatosensation in the upper limb to investigate the relationship with upper limb impairment, activity, and participation measures. Exclusion criteria included measures of somatosensation involving an overall score for upper and lower limb outcome and articles including only lower limb outcomes. Data Extraction Eligibility assessment, data extraction, and quality evaluation were completed by 2 independent reviewers. A cutoff score of ≥65% of the maximal quality score was used for further inclusion in this review. Data Synthesis Six articles met all inclusion criteria. Two-point discrimination was shown to be predictive for upper limb dexterity, and somatosensory evoked potentials were shown to have predictive value in upper limb motor recovery. Proprioception was significantly correlated with perceived level of physical activity and social isolation and had some predictive value in functional movements of the upper limb. Finally, the combination of light touch and proprioception impairment was shown to be significantly related to upper limb motor recovery as well as handicap situations during activities of daily living. Limitations Heterogeneity of the included studies warrants caution when interpreting results. Conclusions Large variation in results was found due to heterogeneity of the studies. However, somatosensory deficits were shown to have an important role in upper limb motor and functional performance after stroke.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

A Review of Direct Oral Anticoagulants in Patients With Stage 5 or End-Stage Kidney Disease

2021 ◽  
pp. 106002802110400
Author(s):  
Jessica A. Starr ◽  
Nathan A. Pinner ◽  
Melanie Mannis ◽  
Mary Katherine Stuart
Keyword(s):  
Kidney Disease ◽  
Data Extraction ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Cochrane Library ◽  
End Stage Kidney Disease ◽  
Vein Thrombosis ◽  
Study Selection ◽  
Direct Acting ◽  
End Stage

Objective: To evaluate the role of oral anticoagulation in patients with stage 5 chronic kidney disease (CKD-5) or end-stage kidney disease (ESKD). Data Sources: A literature search of PubMed (January 2000 to July 1, 2021), the Cochrane Library, and Google Scholar databases (through April 1, 2021) was performed with keywords DOAC (direct-acting oral anticoagulant) OR NOAC or dabigatran OR rivaroxaban OR apixaban OR edoxaban AND end-stage kidney disease combined with atrial fibrillation (AF) or venous thromboembolism (VTE) OR pulmonary embolism OR deep-vein thrombosis. Study Selection and Data Extraction: Case-control, cohort, and randomized controlled trials comparing DOACs to an active control for AF or VTE in patients with CKD-5 or ESKD and reporting outcomes of stroke, recurrent thromboembolism, or major bleeding were included. Data Synthesis: Nine studies were included. Efficacy data supporting routine use of warfarin or DOACs in CKD-5 or ESKD are limited. Rivaroxaban and apixaban may provide enhanced safety compared to warfarin in patients with AF. Data for VTE are limited to 1 retrospective study. Relevance to Patient Care and Clinical Practice: Because of the paucity of rigorous, prospective studies in CKD-5 or ESKD, OACs should not be broadly used in this population. It is clear that data regarding efficacy of DOACs cannot be reliably and safely extrapolated from the non-ESKD population. Therefore, use of OACs in this population should be individualized. Conclusions: If OACs for stroke prevention with AF are deemed necessary, apixaban or rivaroxaban can be considered. DOACs cannot currently be recommended over warfarin in patients with CKD-5 or ESKD and VTE.

scholarly journals Unobtrusive Estimation of Cardiovascular Parameters with Limb Ballistocardiography

Sensors ◽  
2019 ◽  
Vol 19 (13) ◽  
pp. 2922 ◽  
Author(s):  
Yang Yao ◽  
Sungtae Shin ◽  
Azin Mousavi ◽  
Chang-Sei Kim ◽  
Lisheng Xu ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Linear Regression Analysis ◽  
Peripheral Resistance ◽  
Physiological Mechanism ◽  
Multivariate Linear Regression Analysis ◽  
Time Intervals ◽  
Processing Procedure ◽  
Characteristic Features ◽  
The Relationship

This study investigates the potential of the limb ballistocardiogram (BCG) for unobtrusive estimation of cardiovascular (CV) parameters. In conjunction with the reference CV parameters (including diastolic, pulse, and systolic pressures, stroke volume, cardiac output, and total peripheral resistance), an upper-limb BCG based on an accelerometer embedded in a wearable armband and a lower-limb BCG based on a strain gauge embedded in a weighing scale were instrumented simultaneously with a finger photoplethysmogram (PPG). To standardize the analysis, the more convenient yet unconventional armband BCG was transformed into the more conventional weighing scale BCG (called the synthetic weighing scale BCG) using a signal processing procedure. The characteristic features were extracted from these BCG and PPG waveforms in the form of wave-to-wave time intervals, wave amplitudes, and wave-to-wave amplitudes. Then, the relationship between the characteristic features associated with (i) the weighing scale BCG-PPG pair and (ii) the synthetic weighing scale BCG-PPG pair versus the CV parameters, was analyzed using the multivariate linear regression analysis. The results indicated that each of the CV parameters of interest may be accurately estimated by a combination of as few as two characteristic features in the upper-limb or lower-limb BCG, and also that the characteristic features recruited for the CV parameters were to a large extent relevant according to the physiological mechanism underlying the BCG.

scholarly journals Relationship between upper limb motor function and activities of daily living after removing the influence of lower limb motor function in subacute patients with stroke: A cross-sectional study

2020 ◽  
pp. 156918612092660
Author(s):  
Haruka Yamamoto ◽  
Kazuya Takeda ◽  
Soichiro Koyama ◽  
Keisuke Morishima ◽  
Yuichi Hirakawa ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Score ◽  
Cross Sectional ◽  
The Relationship

Background Previous studies have reported a relationship between upper limb motor function and activities of daily living. However, their relationship after removing the influence of lower limb motor function has not been clarified. Objective This study aimed to investigate the relationship between Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score and between Fugl-Meyer assessment upper limb and each item contained in Functional Independence Measure motor score after eliminating the influence of the motor function of the affected lower limb. Methods This retrospective cross-sectional study included 58 subacute stroke patients. To investigate the relationship between the Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score before and after removing the influence of Fugl-Meyer assessment lower limb, Spearman’s rank correlation coefficient and partial correlation analysis were used. Additionally, the relationship between Fugl-Meyer assessment upper limb and each item of Functional Independence Measure motor score after removing the influence was assessed. Results Before removing the influence of Fugl-Meyer assessment lower limb, Fugl-Meyer assessment upper limb was strongly correlated with total Functional Independence Measure motor score (r = 0.74, p < 0.001). However, it became weak after removing the influence (r = 0.27, p = 0.04). Regarding each item of Functional Independence Measure motor score, Fugl-Meyer assessment upper limb was correlated with grooming (r = 0.27, p = 0.04), bathing (r = 0.28, p = 0.03), dressing upper body (r = 0.33, p = 0.01), dressing lower body (r = 0.31, p = 0.02), and stair-climbing (r = 0.31, p = 0.02) after removing the influence. Conclusion These findings suggest that the relationship between the upper limb motor function and activities of daily living is strongly influenced by lower limb motor function.

scholarly journals Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ka Man Fong ◽  
Shek Yin Au ◽  
George Wing Yiu Ng
Keyword(s):  
Respiratory Failure ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adult Patients ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Study Selection ◽  
Screening Study

Abstract Background Patients with acute hypoxemic respiratory failure are at risk for life-threatening complications during endotracheal intubation. Preoxygenation might help reduce the risk of hypoxemia and intubation-related complications. This network meta-analysis summarizes the efficacy and safety of preoxygenation methods in adult patients with acute hypoxemic respiratory failure. Methods We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2019 for randomized controlled trials (RCT) that studied the use of conventional oxygen therapy (COT), high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), and HFNC and NIV as preoxygenation before intubation in patients with acute hypoxemic respiratory failure. Citations’ screening, study selection, data extraction, and risk of bias assessment were independently performed by two authors. The primary outcome was the lowest SpO2 during the intubation procedure. Results We included 7 RCTs (959 patients). Patients preoxygenated with NIV had significantly less desaturation than patients treated with COT (mean difference, MD 5.53, 95% CI 2.71, 8.34) and HFNC (MD 3.58, 95% CI 0.59, 6.57). Both NIV (odds ratio, OR 0.43, 95% CI 0.21, 0.87) and HFNC (OR 0.49, 95% CI 0.28, 0.88) resulted in a lower risk of intubation-related complications than COT. There were no significant mortality differences among the use of NIV, HFNC, COT, and HFNC and NIV during preoxygenation. Conclusions In adult patients with acute hypoxemic respiratory failure, NIV is a safe and probably the most effective preoxygenation method.

scholarly journals Bevacizumab Treatment of Radiation-Induced Brain Necrosis: A Systematic Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Guixiang Liao ◽  
Muhammad Khan ◽  
Zhihong Zhao ◽  
Sumbal Arooj ◽  
Maosheng Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Data Extraction ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Gadolinium Enhancement ◽  
Brain Necrosis ◽  
Study Selection ◽  
Bevacizumab Treatment ◽  
Radiation Induced

BackgroundRadiation brain necrosis (RBN) is a serious complication in patients receiving radiotherapy for intracranial disease. Many studies have investigated the efficacy and safety of bevacizumab in patients with RBN. In the present study, we systematically reviewed the medical literature for studies reporting the efficacy and safety of bevacizumab, as well as for studies comparing bevacizumab with corticosteroids.Materials and MethodsWe searched PubMed, Cochrane library, EMBASE, and ClinicalTrials.gov from their inception through 1 March, 2020 for studies that evaluated the efficacy and safety of bevacizumab in patients with RBN. Two investigators independently performed the study selection, data extraction, and data synthesis.ResultsOverall, the present systematic review included 12 studies (eight retrospective, two prospective, and two randomized control trials [RCTs]) involving 236 patients with RBN treated who were treated with bevacizumab. The two RCTs also had control arms comprising patients with RBN who were treated with corticosteroids/placebo (n=57). Radiographic responses were recorded in 84.7% (200/236) of patients, and radiographic progression was observed in 15.3% (36/236). Clinical improvement was observed in 91% (n=127) of responding patients among seven studies (n=113). All 12 studies reported volume reduction on T1 gadolinium enhancement MRI (median: 50%, range: 26%–80%) and/or T2 FLAIR MRI images (median: 59%, range: 48%–74%). In total, 46 responding patients (34%) had recurrence. The two RCTs revealed significantly improved radiographic response in patients treated with bevacizumab (Levin et al.: p = 0.0013; Xu et al.: p &lt; 0.001). Both also showed clinical improvement (Levin et al.: NA; Xu et al.: p = 0.039) and significant reduction in edema volume on both T1 gadolinium enhancement MRI (Levin et al.: p=0.0058; Xu et al.: p=0.027) and T2 FLAIR MRI (Levin et al.: p=0.0149; Xu et al.: p &lt; 0.001). Neurocognitive improvement was significantly better after 2 months of treatment in patients receiving bevacizumab than in those given corticosteroids, as assessed by the MoCA scale (p = 0.028). The recurrence rate and side effects of the treatments showed no significant differences.ConclusionsPatients with RBN respond to bevacizumab, which can improve clinical outcomes and cognitive function. Bevacizumab appears to be more efficacious than corticosteroid-based treatment. The safety profile was comparable to that of the corticosteroids.

scholarly journals Exploring the Relationship Between Social Cognition Deficits and Neurodegenerative Dementia: Protocol for a Systematic Review

2020 ◽  
Author(s):  
Esther Setién-Suero ◽  
Nancy Murillo-García ◽  
Manuel Sevilla-Ramos ◽  
Georgelina Abreu-Fernández ◽  
Diego Remón-Gallo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Cognition ◽  
Data Extraction ◽  
Critical Evaluation ◽  
Cochrane Library ◽  
Neurodegenerative Dementia ◽  
Detection And Diagnosis ◽  
Neurodegenerative Dementias ◽  
The Relationship

Abstract Background:Due to demographic evolution and the progressive aging of the population, the incidence of dementia has increased worldwide. Many questions about this syndrome have not been resolved yet, such as the relationship between dementia and deficits on social cognition.Therefore, the present review aims to explore this relationship and to establish the possible differential patterns of social cognition deficits in diverse types of neurodegenerative dementias.Methods:The literature searchwas conducted in several electronic databases, including MEDLINE database via Pubmed, Cochrane Library, Lilacs, Web of Science (WoS) and PsycINFO.In order to avoid possible bias during the data extraction, all citations, abstracts information and full-text articles will be independently screen by two reviewers. Themethodological quality of thestudies will be appraised using the Joanna Briggs Institute Critical Evaluation Checklists. All studies published in English or Spanish between October 2009 and October 2019 will be taken into account.Discussion: This systematic review will summarize the evidence provided during the last 10 years regarding the relationship between neurodegenerative dementia and social cognition deficits. This could provide a useful reference to clinicians, since properly defining social cognition profile of each type of neurodegenerative dementia would improve detection and diagnosis, which would undoubtedly guarantee better interventions.Systematic review registration: PROSPERO, ID: 152562

scholarly journals The relationship of gross upper and lower limb motor competence to measures of health and fitness in adolescents aged 13–14 years

2018 ◽  
Vol 4 (1) ◽  
pp. e000288 ◽  
Author(s):  
Benjamin David Weedon ◽  
Francesca Liu ◽  
Wala Mahmoud ◽  
Renske Metz ◽  
Kyle Beunder ◽  
...  
Keyword(s):  
Upper Limb ◽  
Aerobic Capacity ◽  
Lower Limb ◽  
Anaerobic Power ◽  
School Students ◽  
Motor Competence ◽  
Health And Fitness ◽  
Fitness Measures ◽  
Relationship Of ◽  
The Relationship

IntroductionMotor competence (MC) is an important factor in the development of health and fitness in adolescence.AimsThis cross-sectional study aims to explore the distribution of MC across school students aged 13–14 years old and the extent of the relationship of MC to measures of health and fitness across genders.MethodsA total of 718 participants were tested from three different schools in the UK, 311 girls and 407 boys (aged 13–14 years), pairwise deletion for correlation variables reduced this to 555 (245 girls, 310 boys). Assessments consisted of body mass index, aerobic capacity, anaerobic power, and upper limb and lower limb MC. The distribution of MC and the strength of the relationships between MC and health/fitness measures were explored.ResultsGirls performed lower for MC and health/fitness measures compared with boys. Both measures of MC showed a normal distribution and a significant linear relationship of MC to all health and fitness measures for boys, girls and combined genders. A stronger relationship was reported for upper limb MC and aerobic capacity when compared with lower limb MC and aerobic capacity in boys (t=−2.21, degrees of freedom=307, P=0.03, 95% CI −0.253 to –0.011).ConclusionNormally distributed measures of upper and lower limb MC are linearly related to health and fitness measures in adolescents in a UK sample.Trial registration numberNCT02517333.

Neuromuscular Excercise in Children with Down Syndrome. A Systematic Review

2022 ◽  
Author(s):  
Eliana-Isabel Rodríguez-Grande ◽  
Olga-Cecilia Vargas-Pinilla ◽  
Martha-Rocio Torres-Narvaez ◽  
Nelcy Rodríguez-Malagón
Keyword(s):  
Muscle Strength ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Cochrane Library ◽  
Exercise Frequency ◽  
Data Synthesis ◽  
Children With Down Syndrome ◽  
Maximum Resistance ◽  
Effective Interventions ◽  
Study Selection

Abstract Objective to evaluate the effects of neuromuscular exercise, specifying the parameters and characteristics of effective interventions to improve balance, muscle strength and flexibility in children with DS between the ages of 4 and 18 years. Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library. Study Selection: The search yielded 1384 eligible articles. Randomized clinical trials were selected, and that would have reported the effectiveness in the outcomes. Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. The frequency was between two and three times a week for 6 and 12 weeks and the intensity was between 60% and 80% of maximum resistance (MR). Conclusion neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years of age.

Foot Breadth in Children—Its Relationship to Limb Dominance and Age

Foot & Ankle ◽  
1988 ◽  
Vol 8 (4) ◽  
pp. 198-202 ◽  
Author(s):  
B.C. Didia ◽  
E.A. Nyenwe
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Chi Square ◽  
Test Of Significance ◽  
The Right ◽  
Chi Square Analysis ◽  
The Relationship ◽  
Limb Dominance

A total of 996 school pupils between the ages of 5 and 12 yr were studied for the relationship between foot breadth and limb dominance. The test of significance and chi-square analysis were used in the calculation. Limb dominance is divided into upper limb dominance (handedness) and lower limb dominance (footedness). No asymetry or difference was found between the right and left foot ( P < 0.69) in terms of foot breadth. A significant correlation between limb dominance and foot breadth was not found ( P < 0.01). An ipsolateral relationship exists between the two forms of limb dominance—92.37% of right handers are right footed while 51.85% of left handers are left footed. As an offshot of this work an equation for the estimation of a child's age from his foot breadth is given.

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