scholarly journals Effect of Therapeutic Aquatic Exercise on Symptoms and Function Associated With Lower Limb Osteoarthritis: Systematic Review With Meta-Analysis

2014 ◽  
Vol 94 (10) ◽  
pp. 1383-1395 ◽  
Author(s):  
Benjamin Waller ◽  
Anna Ogonowska-Slodownik ◽  
Manuel Vitor ◽  
Johan Lambeck ◽  
Daniel Daly ◽  
...  

BackgroundCurrent management of osteoarthritis (OA) focuses on pain control and maintaining physical function through pharmacological, nonpharmacological, and surgical treatments. Exercise, including therapeutic aquatic exercise (TAE), is considered one of the most important management options. Nevertheless, there is no up-to-date systematic review describing the effect of TAE on symptoms and function associated with lower limb OA.PurposeThe purpose of this study was to conduct a systematic review with meta-analysis to determine the effect of TAE on symptoms and function associated with lower limb OA.Data SourcesThe data sources used in this study were: MEDLINE, PubMed, EMBASE, CINAHL, PEDro, and SPORTDiscus.Study SelectionAll studies selected for review were randomized controlled trials with an aquatic exercise group and a nontreatment control group. In total, 11 studies fulfilled the inclusion criteria and were included in the synthesis and meta-analysis.Data ExtractionData were extracted and checked for accuracy by 3 independent reviewers.Data SynthesisStandardized mean difference (SMD) with 95% confidence interval (95% CI) was calculated for all outcomes. The meta-analysis showed a significant TAE effect on pain (SMD=0.26 [95% CI=0.11, 0.41]), self-reported function (SMD=0.30 [95% CI=0.18, 0.43]), and physical functioning (SMD=0.22 [95% CI=0.07, 0.38]). Additionally, a significant effect was seen on stiffness (SMD=0.20 [95% CI=0.03, 0.36]) and quality of life (SMD=0.24 [95% CI=0.04, 0.45]).LimitationsHeterogeneity of outcome measures and small sample sizes for many of the included trials imply that conclusions based on these results should be made with caution.ConclusionsThe results indicate that TAE is effective in managing symptoms associated with lower limb OA.

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joanne W. Y. Chung ◽  
Vincent C. M. Yan ◽  
Hongwei Zhang

Aim.To summarize all relevant trials and critically evaluate the effect of acupuncture on heart rate variability (HRV).Method.This was a systematic review with meta-analysis. Keyword search was conducted in 7 databases for randomized controlled trials (RCTs). Data extraction and risk of bias were done.Results.Fourteen included studies showed a decreasing effect of acupuncture on low frequency (LF) and low frequency to high frequency ratio (LF/HF ratio) of HRV for nonhealthy subjects and on normalized low frequency (LF norm) for healthy subjects. The overall effect was in favour of the sham/control group for high frequency (HF) in nonhealthy subjects and for normalized high frequency (HF norm) in healthy subjects. Significant decreasing effect on HF and LF/HF ratio of HRV when acupuncture was performed on ST36 among healthy subjects and PC6 among both healthy and nonhealthy subjects, respectively.Discussion.This study partially supports the possible effect of acupuncture in modulating the LF of HRV in both healthy and nonhealthy subjects, while previous review reported that acupuncture did not have any convincing effect on HRV in healthy subjects. More published work is needed in this area to determine if HRV can be an indicator of the therapeutic effect of acupuncture.


Author(s):  
Li Wang ◽  
Yiwen Zhang ◽  
Jiajun Zhong ◽  
Yuan Zhang ◽  
Shuisheng Zhou ◽  
...  

Objective: The efficacy of mesenchymal stem cell (MSC) therapy in acetaminophen-induced liver injury has been investigated in animal experiments, but individual studies with a small sample size cannot be used to draw a clear conclusion. Therefore, we conducted a systematic review and meta-analysis of preclinical studies to explore the potential of using MSCs in acetaminophen-induced liver injury. Methods: Eight databases were searched for studies reporting the effects of MSCs on acetaminophen hepatoxicity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. SYRCLE’s risk of bias tool for animal studies was applied to assess the methodological quality. A meta-analysis was performed by using RevMan 5.4 and STATA/SE 16.0 software. Results: Eleven studies involving 159 animals were included according to PRISMA statement guidelines. Significant associations were found for MSCs with the levels of alanine transaminase (ALT) (standardized mean difference (SMD) − 2.58, p < 0.0001), aspartate aminotransferase (AST) (SMD − 1.75, p = 0.001), glutathione (GSH) (SMD 3.7, p < 0.0001), superoxide dismutase (SOD) (SMD 1.86, p = 0.022), interleukin 10 (IL-10) (SMD 5.14, p = 0.0002) and tumor necrosis factor-α (TNF-α) (SMD − 4.48, p = 0.011) compared with those in the control group. The subgroup analysis showed that the tissue source of MSCs significantly affected the therapeutic efficacy (p < 0.05). Conclusion: Our meta-analysis results demonstrate that MSCs could be a potential treatment for acetaminophen-related liver injury.


2019 ◽  
Vol 53 (17) ◽  
pp. 1070-1077 ◽  
Author(s):  
Myles Calder Murphy ◽  
Mervyn J Travers ◽  
Paola Chivers ◽  
James Robert Debenham ◽  
Sean Iain Docking ◽  
...  

ObjectiveTo assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy.DesignA systematic review and meta-analysis were conducted as per the PRISMA guidelines.Data sourcesPUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018.Eligibility criteriaRandomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles.ResultsSeven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of −5.65 (-10.51 to −0.79, three studies). However, this difference is unlikely to be clinically significant.ConclusionCurrent evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different.Systematic review registryPROSPERO registration number: CRD4201804493Protocol referenceThis protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? Systematic Reviews 2018; 7: 58


2018 ◽  
Vol 29 (4) ◽  
pp. 443-461 ◽  
Author(s):  
Sara Hanaei ◽  
Khashayar Afshari ◽  
Armin Hirbod-Mobarakeh ◽  
Bahram Mohajer ◽  
Delara Amir Dastmalchi ◽  
...  

Abstract Although different immunotherapeutic approaches have been developed for the treatment of glioma, there is a discrepancy between clinical trials limiting their approval as common treatment. So, the current systematic review and meta-analysis were conducted to assess survival and clinical response of specific immunotherapy in patients with glioma. Generally, seven databases were searched to find eligible studies. Controlled clinical trials investigating the efficacy of specific immunotherapy in glioma were found eligible. After data extraction and risk of bias assessment, the data were analyzed based on the level of heterogeneity. Overall, 25 articles with 2964 patients were included. Generally, mean overall survival did not statistically improve in immunotherapy [median difference=1.51; 95% confidence interval (CI)=−0.16–3.17; p=0.08]; however, it was 11.16 months higher in passive immunotherapy (95% CI=5.69–16.64; p<0.0001). One-year overall survival was significantly higher in immunotherapy groups [hazard ratio (HR)=0.69; 95% CI=0.52–0.92; p=0.01]. As the hazard rate in the immunotherapy approach was 0.83 of the control group, 2-year overall survival was significantly higher in immunotherapy (HR=0.83; 95% CI=0.69–0.99; p=0.04). Three-year overall survival was significantly higher in immunotherapy as well (HR=0.67; 95% CI=0.48–0.92; p=0.01). Overall, median progression-free survival was significantly higher in immunotherapy (standard median difference=0.323; 95% CI=0.110–0.536; p=0.003). However, 1-year progression-free survival was not remarkably different between immunotherapy and control groups (HR=0.94; 95% CI=0.74–1.18; p=0.59). Specific immunotherapy demonstrated remarkable improvement in survival of patients with glioma and could be a considerable choice of treatment in the future. Despite the current promising results, further high-quality randomized controlled trials are required to approve immunotherapeutic approaches as the standard of care and the front-line treatment for glioma.


2021 ◽  
Author(s):  
Guilherme Tadeu de Barcelos¹ ◽  
Isabel Heberle¹ ◽  
Juliana Cavestré Coneglian¹ ◽  
Bruno Allan Vieira¹ ◽  
Rodrigo Sudatti Delevatti¹ ◽  
...  

Abstract Objective: To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults.Method: The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. Results: Of the 13028 studies found, 24 were selected and included in this review. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p <0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p <0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p <0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). Conclusion: Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.


2020 ◽  
Author(s):  
Manuel Rubio-Rivas ◽  
Jose M. Mora-Lujan ◽  
Abelardo Montero ◽  
Narcis A. Homs ◽  
Jordi Rello ◽  
...  

Objectives: Pending for randomized control trials, the use of tocilizumab (TCZ) in COVID-19 remains controversial. We performed a systematic review and meta-analysis to investigate the effect on clinical outcomes of TCZ to treat severe COVID-19. Methods: From 1 January to 21 August 2020, we searched PubMed (via MEDLINE), Scopus, and medRxiv repository databases for observational studies in any language reporting efficacy and safety of TCZ use in hospitalized adults with COVID-19. Independent and dually data extraction and quality assessment were performed. Results: Of 57 eligible studies, 27 controlled and 30 not. The overall included patients were 8,128: 4,021 treated with TCZ, in addition to standard of care (SOC), and 4,107 only receiving SOC. The pooled mortality was lower in the TCZ-group, with a relative risk (RR) of 0.73 (95%CI 0.57-0.93; p=0.010). TCZ-treated patients were transferred to the intensive care unit (ICU) in a higher proportion, but ICU mortality was lower than in the control group. Conversely, a higher proportion of TCZ-treated patients developed secondary infections after TCZ use. Conclusions: TCZ seems beneficial in preventing in-hospital mortality in severe, non-critically ill COVID-19 patients. However, patients receiving TCZ appear to be at higher risk for secondary infections, especially those admitted to ICU.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1950 ◽  
Author(s):  
Mercedes Castaño ◽  
Rubén Gómez-Gordo ◽  
David Cuevas ◽  
Concepción Núñez

We aimed to estimate the seroprevalence and the prevalence of coeliac disease (CD) in women with reproductive problems. A systematic review of English published articles until June 2019 was performed in PubMed and Scopus using the terms: (infertility and (coeliac disease OR gluten) OR (miscarriage and (coeliac disease OR gluten) OR (abortion and (coeliac disease OR gluten). All articles showing numerical data of anti-transglutaminase type 2 or anti-endomisium antibodies, or intestinal biopsy information were included. The study group comprised women with overall infertility, unexplained infertility, or recurrent spontaneous abortions. Two authors independently performed data extraction using a predefined data sheet. The initial search yielded 310 articles, and 23 were selected for data extraction. After meta-analysis, the pooled seroprevalence was very similar for overall and unexplained infertility, with a pooled proportion of around 1.3%–1.6%. This implies three times higher odds of having CD in infertility when compared to controls. The pooled prevalence could not be accurately calculated due to the small sample sizes. Further studies with increased sample sizes are necessary before giving specific recommendations for CD screening in women with reproductive problems, but current data seem to support a higher risk of CD in these women.


2021 ◽  
Author(s):  
Christian Moretti Anfossi ◽  
Christian Tobar Fredes ◽  
Eduardo Quiñelen Rojas ◽  
Jamie Ross ◽  
Jenny Head ◽  
...  

Abstract Background: Cardiovascular Diseases (CVDs) are the number one cause of death, representing 31.8% of all global deaths. Several lifestyle behaviours are associated with the development and clinical manifestation of CVDs, however, these behavioural risk factors by themselves do not fully explain the population burden of CVDs. There is increasing recognition that working conditions and risk factors of the work environment are associated with health, including the development of CVDs. We will systematically review observational studies of adults exposed to work risk factors and their association with CVDs.Methods: We will follow the Navigation Guide framework. We will include cohort and case-control studies. The population will be adults of working age (18-65). The exposure will include six categories of work exposure: job strain, effort-reward imbalance, long working hours, job insecurity, shift work and occupational noise; the comparator will be the unexposed group or specified control group. The outcomes will be cerebrovascular diseases, ischaemic heart disease and hypertensive diseases. Published and unpublished studies will be included. The selection, data extraction, risk of bias assessment, quality assessment and strength of evidence will be carried out by two reviewers independently and disagreements will be solved by a third. Due to the diversity in the populations and exposures in the studies, the synthesis of the results, the quality and the strength of the evidence will be done by a synthesis without meta-analysis (SWiM), following the SWiM reporting guideline.Discussion: This systematic review will identify and synthesise the evidence for the association between work risk factors and risk of CVDs. This work will underpin and inform a broader objective to examine the effectiveness of interventions to minimise the effects of risk factors for CVDs in workplaces, with the final aim of informing occupational health policies in the future. Systematic review registration: PROSPERO CRD42020179972.


Author(s):  
Marie A Cornelis ◽  
Michele Tepedino ◽  
Neel de Vos Riis ◽  
Xiaowen Niu ◽  
Paolo M Cattaneo

Summary Objective The aim of this systematic review was to determine which evidence level supports maxillary advancement after bone-anchored maxillary protraction (BAMP) in growing patients compared to controls. Search methods PubMed, Cochrane, Embase, Scopus, and Web-of-Science databases were searched with no restrictions on publication status or year. Selection criteria Prospective and retrospective human studies about BAMP, in at least three patients, were included. Authors were contacted when necessary, and reference lists of the included studies were screened. Data collection and analysis Two authors undertook independent data extraction with conflict resolution by a third author. Risks of bias were assessed. A meta-analysis for estimates of changes for ANB angle, Wits appraisal, and incisor to mandibular plane angle (IMPA) angle of BAMP treatment compared to control groups was performed. Results A total of 449 articles were initially retrieved; 28 full-text articles met the inclusion criteria. Sample sizes ranged from 3 to 52 patients. There was heterogeneity in cephalometric outcomes reported, which prevented the comparison of certain outcomes. ANB angle improved more with BAMP in the maxilla combined with facemask (bone-anchored facemask, BAFM) compared to traditional facemask therapy: this was statistically but not clinically significant (0.2 degrees). No data are available for BAMP with skeletal anchorage in both jaws in combination with Class III elastics (bone-anchored Class III elastics, BAC3E). Likewise, no statistically significant differences in Wits appraisal were found (less than 1 mm). Lower incisor retroclination and facial height seemed to be better controlled with BAC3E compared to BAFM. Conclusions The level of evidence available to support the maxillary advancement effect after BAMP was low. Publications reporting results based on identical samples tended to suggest overly positive results of BAMP. The differences in sagittal correction between BAMP and traditional facemask therapy were small and of questionable clinical significance. Long-term follow-up results are not available and, therefore, much needed. Limitations Most articles had a low level of evidence and some included a historical control group. Registration PROSPERO database number CRD42015023366.


Sign in / Sign up

Export Citation Format

Share Document