scholarly journals Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis

2016 ◽  
Vol 96 (6) ◽  
pp. 876-887 ◽  
Author(s):  
Tasha R. Stanton ◽  
Hayley B. Leake ◽  
K. Jane Chalmers ◽  
G. Lorimer Moseley
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Chronic Neck Pain ◽  
Position Sense ◽  
Joint Position Sense ◽  
Neck Proprioception ◽  
Evidence Database

Background Despite common use of proprioceptive retraining interventions in people with chronic, idiopathic neck pain, evidence that proprioceptive dysfunction exists in this population is lacking. Determining whether proprioceptive dysfunction exists in people with chronic neck pain has clear implications for treatment prescription. Purpose The aim of this study was to synthesize and critically appraise all evidence evaluating proprioceptive dysfunction in people with chronic, idiopathic neck pain by completing a systematic review and meta-analysis. Data Sources MEDLINE, CINAHL, PubMed, Allied and Complementary Medicine, EMBASE, Academic Search Premier, Scopus, Physiotherapy Evidence Database (PEDro), and Cochrane Collaboration databases were searched. Study Selection All published studies that compared neck proprioception (joint position sense) between a chronic, idiopathic neck pain sample and asymptomatic controls were included. Data Extraction Two independent reviewers extracted relevant population and proprioception data and assessed methodological quality using a modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Data Synthesis Thirteen studies were included in the present review. Meta-analysis on 10 studies demonstrated that people with chronic neck pain perform significantly worse on head-to-neutral repositioning tests, with a moderate standardized mean difference of 0.44 (95% confidence interval=0.25, 0.63). Two studies evaluated head repositioning using trunk movement (no active head movement thus hypothesized to remove vestibular input) and showed conflicting results. Three studies evaluated complex or postural repositioning tests; postural repositioning was no different between groups, and complex movement tests were impaired only in participants with chronic neck pain if error was continuously evaluated throughout the movement. Limitations A paucity of studies evaluating complex or postural repositioning tests does not permit any solid conclusions about them. Conclusions People with chronic, idiopathic neck pain are worse than asymptomatic controls at head-to-neutral repositioning tests.

scholarly journals https://painphysicianjournal.com/current

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. 335-348
Author(s):  
Nicholas Van Halm-Lutterodt
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Neck Pain ◽  
Functional Status ◽  
Spinal Stenosis ◽  
Local Anesthetic ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Epidural Injections ◽  
Significant Difference

Background: Chronic neck pain is reportedly considered the fourth leading cause of disability. Cervical interlaminar epidural injections are among the commonly administered nonsurgical interventions for managing chronic neck pain, secondary to disc herniation and radiculitis, spinal stenosis, or chronic neck pain of discogenic origin. Objectives: To systematically review the differences in the effectiveness of cervical epidural injections with local anesthetics with or without steroids for the management of chronic neck pain. Study Design: Systematic review and meta-analysis. Methods: A comprehensive search of the literature of randomized controlled trials (RCTs) that compared epidural injections with local anesthetic with or without steroids was performed, including a search of PubMed, EMBASE, and Cochrane databases for all years up to May 2019. Meta-analysis was done for pain relief based on the Numeric Rating Scale, functional status based on the Neck Disability Index, and opioid intake dosage. Results: Four studies met the inclusion criteria. A total of 370 patients were divided into 2 groups: the experimental group received cervical epidural injection with steroid and local anesthetic, and the control group received injection with local anesthetic only. Regrading pain relief, no significant difference was observed between both groups (weighted mean difference [WMD], –0.006; 95% confidence interval (CI), –0.275 to 0.263; P = 0.963; I2 = 0.0% at 12 months). There was also no significant difference in the improvement of the functional status (WMD, 0.159; 95% CI, –1.231 to 1.549; P = 0.823; I2 = 9.8% at 12 months). Similarly, there was no significant difference in opioid dosage (WMD, –0.093; 95% CI, –5.952 to 5.766; P = 0.975; I2 = 0.0% at 12 months). Limitations: Only a few studies on this premise were found in the literature. There was also a lack of heterogeneity of the included RCT studies. Conclusions: The addition of steroids to anesthetic injectates was not associated with better pain and functional score outcomes compared with anesthetic injectate alone in patients with chronic neck pain. Key words: Chronic neck pain, cervical radiculopathy, cervical disc disease, spinal stenosis, facet joint pathology, cervical epidural injections, steroid injections, local anesthetic injections, systematic review, meta-analysis, randomized control trial

scholarly journals Individuals With Chronic Neck Pain Have Lower Neck Strength Than Healthy Controls: A Systematic Review With Meta-Analysis

2019 ◽  
Vol 42 (8) ◽  
pp. 608-622
Author(s):  
Iã Ferreira Miranda ◽  
Edgar Santiago Wagner Neto ◽  
William Dhein ◽  
Guilherme A. Brodt ◽  
Jefferson F. Loss
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Healthy Controls ◽  
Neck Strength ◽  
Lower Neck

Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis

2011 ◽  
Vol 45 (8) ◽  
pp. 660-672 ◽  
Author(s):  
Claire E Hiller ◽  
Elizabeth J Nightingale ◽  
Chung-Wei Christine Lin ◽  
Garrett F Coughlan ◽  
Brian Caulfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankle Sprain ◽  
Test Performance ◽  
Postural Sway ◽  
Meta Analysis ◽  
Position Sense ◽  
Joint Position Sense ◽  
Ankle Sprains ◽  
Eyes Closed ◽  
Recurrent Ankle Sprain

ObjectiveTo examine whether people with recurrent ankle sprain, have specific physical and sensorimotor deficits.DesignA systematic review of journal articles in English using electronic databases to September 2009. Included articles compared physical or sensorimotor measures in people with recurrent (≥2) ankle sprains and uninjured controls.Main outcome groupsOutcome measures were grouped into: physical characteristics, strength, postural stability, proprioception, response to perturbation, biomechanics and functional tests. A meta-analysis was undertaken where comparable results within an outcome group were inconsistent.ResultsFifty-five articles met the inclusion criteria. Compared with healthy controls, people with recurrent sprains demonstrated radiographic changes in the talus, changes in foot position during gait and prolonged time to stabilisation after a jump. There were no differences in ankle range of motion or functional test performance. Pooled results showed greater postural sway when standing with eyes closed (SMD=0.9, 95% CI 0.4 to 1.4) or on unstable surfaces (0.5, 0.1 to 1.0) and decreased concentric inversion strength (1.1, 0.2 to 2.1) but no difference in evertor strength, inversion joint position sense or peroneal latency in response to a perturbation.ConclusionThere are specific impairments in people with recurrent ankle sprain but not necessarily in areas commonly investigated.

scholarly journals Effect of Therapeutic Exercise on Pain and Disability in the Management of Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis of Randomized Trials

2013 ◽  
Vol 93 (8) ◽  
pp. 1026-1036 ◽  
Author(s):  
Lucia Bertozzi ◽  
Ivan Gardenghi ◽  
Francesca Turoni ◽  
Jorge Hugo Villafañe ◽  
Francesco Capra ◽  
...  
Keyword(s):  
Neck Pain ◽  
Randomized Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Therapeutic Exercise ◽  
Short Term ◽  
Evidence Database

BackgroundGiven the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition.PurposeThe purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding.Data SourcesData were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked.Study SelectionAll published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP.Data ExtractionTwo reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model.Data SynthesisSeven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=−0.53, 95% confidence interval [CI]=−0.86 to −0.20, and g=−0.45, 95% CI=−0.82 to −0.07, respectively) and medium but not significant short-term and intermediate-term effects on disability (g=−0.39, 95% CI=−0.86 to 0.07, and g=−0.46, 95% CI=−1.00 to −0.08, respectively).LimitationsOnly one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention.ConclusionsConsistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.

scholarly journals Cryotherapy and Joint Position Sense in Healthy Participants: A Systematic Review

2010 ◽  
Vol 45 (3) ◽  
pp. 306-316 ◽  
Author(s):  
Joseph T. Costello ◽  
Alan E. Donnelly
Keyword(s):  
Effect Size ◽  
English Language ◽  
Data Extraction ◽  
Position Sense ◽  
Joint Position Sense ◽  
Original Research ◽  
Joint Position ◽  
Study Selection ◽  
Before And After ◽  
Evidence Database

Abstract Objective: To (1) search the English-language literature for original research addressing the effect of cryotherapy on joint position sense (JPS) and (2) make recommendations regarding how soon healthy athletes can safely return to participation after cryotherapy. Data Sources: We performed an exhaustive search for original research using the AMED, CINAHL, MEDLINE, and SportDiscus databases from 1973 to 2009 to gather information on cryotherapy and JPS. Key words used were cryotherapy and proprioception, cryotherapy and joint position sense, cryotherapy, and proprioception. Study Selection: The inclusion criteria were (1) the literature was written in English, (2) participants were human, (3) an outcome measure included JPS, (4) participants were healthy, and (5) participants were tested immediately after a cryotherapy application to a joint. Data Extraction: The means and SDs of the JPS outcome measures were extracted and used to estimate the effect size (Cohen d) and associated 95% confidence intervals for comparisons of JPS before and after a cryotherapy treatment. The numbers, ages, and sexes of participants in all 7 selected studies were also extracted. Data Synthesis: The JPS was assessed in 3 joints: ankle (n  =  2), knee (n  =  3), and shoulder (n  =  2). The average effect size for the 7 included studies was modest, with effect sizes ranging from −0.08 to 1.17, with a positive number representing an increase in JPS error. The average methodologic score of the included studies was 5.4/10 (range, 5–6) on the Physiotherapy Evidence Database scale. Conclusions: Limited and equivocal evidence is available to address the effect of cryotherapy on proprioception in the form of JPS. Until further evidence is provided, clinicians should be cautious when returning individuals to tasks requiring components of proprioceptive input immediately after a cryotherapy treatment.

scholarly journals Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel

2019 ◽  
Vol 2 (22.2) ◽  
pp. E55-E70 ◽  
Author(s):  
Ian D. Coulter
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Neck Pain ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Sample Sizes ◽  
Serious Adverse Events ◽  
Multiple Treatment

Background: Mobilization and manipulation therapies are widely used by patients with chronic nonspecific neck pain; however, questions remain around efficacy, dosing, and safety, as well as how these approaches compare to other therapies. Objectives: Based on published trials, to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic nonspecific neck pain. Study Design: A systematic literature review and meta-analysis. Methods: We identified studies published between January 2000 and September 2017, by searching multiple electronic databases, examining reference lists, and communicating with experts. We selected randomized controlled trials comparing manipulation and/or mobilization therapies to sham, no treatment, each other, and other active therapies, or when combined as multimodal therapeutic approaches. We assessed risk of bias by using the Scottish Intercollegiate Guidelines Network criteria. When possible, we pooled data using random-effects meta-analysis. Grading of Recommendations, Assessment, Development, and Evaluation was applied to determine the confidence in effect estimates. This project was funded by the National Center for Complementary and Integrative Health under award number U19AT007912 and ultimately used to inform an appropriateness panel. Results: A total of 47 randomized trials (47 unique trials in 53 publications) were included in the systematic review. These studies were rated as having low risk of bias and included a total of 4,460 patients with nonspecific chronic neck pain who were being treated by a practitioner using various types of manipulation and/or mobilization interventions. A total of 37 trials were categorized as unimodal approaches and involved thrust or nonthrust compared with sham, no treatment, or other active comparators. Of these, only 6 trials with similar intervention styles, comparators, and outcome measures/timepoints were pooled for meta-analysis at 1, 3, and 6 months, showing a small effect in favor of thrust plus exercise compared to an exercise regimen alone for a reduction in pain and disability. Multimodal approaches appeared to be effective at reducing pain and improving function from the 10 studies evaluated. Health-related quality of life was seldom reported. Some 22/47 studies did not report or mention adverse events. Of the 25 that did, either no or minor events occurred. Limitations: The current evidence is heterogeneous, and sample sizes are generally small. Conclusions: Studies published since January 2000 provide low-moderate quality evidence that various types of manipulation and/or mobilization will reduce pain and improve function for chronic nonspecific neck pain compared to other interventions. It appears that multimodal approaches, in which multiple treatment approaches are integrated, might have the greatest potential impact. The studies comparing to no treatment or sham were mostly testing the effect of a single dose, which may or may not be helpful to inform practice. According to the published trials reviewed, manipulation and mobilization appear safe. However, given the low rate of serious adverse events, other types of studies with much larger sample sizes would be required to fully describe the safety of manipulation and/or mobilization for nonspecific chronic neck pain. Key words: Chronic neck pain, nonspecific, chiropractic, manipulation, mobilization, systematic review, meta-analysis, appropriateness

scholarly journals Safety and Efficacy of Pilocarpine, Cevimeline and Diquafosol Compared to Artificial Tears for the Treatment of Dry Eye: Protocol for a Systematic Review.

2020 ◽  
Author(s):  
José Gerardo Serrano-Robles ◽  
Ana Karen Pérez-Vázquez ◽  
Alejandro Navas-Pérez ◽  
Enrique O Graue-Hernandez ◽  
Arturo Ramirez-Miranda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dry Eye ◽  
Ocular Surface ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Review Author ◽  
Artificial Tears ◽  
Ocular Surface Disease Index

Abstract Background: Dry eye disease (DED) is a condition that affects the ocular surface and affects millions of people around the world. In recent years a stepped scheme has been proposed for the treatment of DED, with the use of an artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review we aim to evaluate the effectiveness and safety of secretagogues for DED.Methods: Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, osmolarity and tear film break-up time. We will use the Cochrane Collaboration Risk of Bias (RoB) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a random versus a fixed effect model. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively.Discussion: Based on the evidence obtained we will evaluate the effect of Pilocarpine, Cevimeline and Diquafosol and compare it to artificial tears on multiple outcome measures.This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline and diquafosol to help clinicians in the decision-making process.Registration: PROSPERO CRD42020218407

Impact of anthocyanin-rich whole fruit consumption on exercise-induced oxidative stress and inflammation: a systematic review and meta-analysis

2019 ◽  
Vol 77 (9) ◽  
pp. 630-645 ◽  
Author(s):  
Taylor K Bloedon ◽  
Rock E Braithwaite ◽  
Imogene A Carson ◽  
Dorothy Klimis-Zacas ◽  
Robert A Lehnhard
Keyword(s):  
Oxidative Stress ◽  
Systematic Review ◽  
Inflammatory Marker ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Oxidative Stress Marker ◽  
Exercise Induced ◽  
The Impact ◽  
And Oxidative Stress

Abstract Context Supplementing with fruits high in anthocyanins to reduce exercise-induced oxidative stress and inflammation has produced mixed results. Objective This systematic review and meta-analysis aims to discuss the impact of whole fruits high in anthocyanins, including processing methods and the type and amount of fruit, on inflammation and oxidative stress. Data Sources PICOS reporting guidelines and a customized coding scheme were used to search 5 databases (SPORTDiscus, Science Direct, Web of Science [BIOSIS], Medline [Pubmed], and the Cochrane Collaboration) with additional cross-referencing selection. Data Extraction A random-effects meta-analysis was used to measure effects of the fruit supplements with 3 statistics; the QTotal value based on a χ2 distribution, τ2 value, and I2 value were used to determine homogeneity of variances on 22 studies (out of 807). Outliers were identified using a relative residual value. Results A small significant negative summary effect across the sum of all inflammatory marker outcomes (P < 0.001) and a moderate negative effect for the sum of all oxidative stress marker outcomes (P = 0.036) were found. Moderator analyses did not reveal significant (P > 0.05) differences between subgrouping variables. Conclusions Results indicate that consumption of whole fruit high in anthocyanins can be beneficial for reducing inflammation and oxidative stress.

Effect of laterality discrimination on joint position sense and cervical range of motion in patients with chronic neck pain: a randomized single-blind clinical trial

2019 ◽  
Vol 36 (2) ◽  
pp. 136-143
Author(s):  
Jose Vicente León-Hernández ◽  
David Marcos-Lorenzo ◽  
David Morales-Tejera ◽  
Ferran Cuenca-Martínez ◽  
Roy La Touche ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Range Of Motion ◽  
Chronic Neck Pain ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Cervical Range Of Motion ◽  
Single Blind
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