Positive effects of neuromuscular shoulder exercises with or without EMG-biofeedback, on pain and function in participants with subacromial pain syndrome – A randomised controlled trial

In recent years there has been a rapid growth of interest in exploring the relationship between nutritional therapies and the maintenance of cognitive function in adulthood. Emerging evidence reveals an increasingly complex picture with respect to the benefits of various food constituents on learning, memory and psychomotor function in adults. However, to date, there has been little consensus in human studies on the range of cognitive domains to be tested or the particular tests to be employed. To illustrate the potential difficulties that this poses, we conducted a systematic review of existing human adult randomised controlled trial (RCT) studies that have investigated the effects of 24 d to 36 months of supplementation with flavonoids and micronutrients on cognitive performance. There were thirty-nine studies employing a total of 121 different cognitive tasks that met the criteria for inclusion. Results showed that less than half of these studies reported positive effects of treatment, with some important cognitive domains either under-represented or not explored at all. Although there was some evidence of sensitivity to nutritional supplementation in a number of domains (for example, executive function, spatial working memory), interpretation is currently difficult given the prevailing ‘scattergun approach’ for selecting cognitive tests. Specifically, the practice means that it is often difficult to distinguish between a boundary condition for a particular nutrient and a lack of task sensitivity. We argue that for significant future progress to be made, researchers need to pay much closer attention to existing human RCT and animal data, as well as to more basic issues surrounding task sensitivity, statistical power and type I error.

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Comparison of weight bearing functional exercise and non-weight bearing quadriceps strengthening exercise on pain and function for people with knee osteoarthritis and obesity: protocol for the TARGET randomised controlled trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2662-5 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Kim L. Bennell ◽

Rachel K. Nelligan ◽

Alexander J. Kimp ◽

Tim V. Wrigley ◽

Ben Metcalf ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Knee Osteoarthritis ◽

Controlled Trial ◽

Weight Bearing ◽

Strengthening Exercise ◽

Functional Exercise ◽

Randomised Controlled ◽

And Function

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Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-008625 ◽

2019 ◽

Vol 29 (2) ◽

pp. 122-134 ◽

Cited By ~ 7

Author(s):

Erik Lenguerrand ◽

Cathy Winter ◽

Dimitrios Siassakos ◽

Graeme MacLennan ◽

Karen Innes ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Apgar Score ◽

Professional Training ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Stepped Wedge ◽

Unit Level ◽

Positive Effects ◽

Training Package ◽

Randomised Controlled

ObjectiveTo assess whether the implementation of an intrapartum training package (PROMPT (PRactical Obstetric Multi-Professional Training)) across a health service reduced the proportion of term babies born with Apgar score <7 at 5 min (<75mins).DesignStepped-wedge cluster randomised controlled trial.SettingTwelve randomised maternity units with ≥900 births/year in Scotland. Three additional units were included in a supplementary analysis to assess the effect across Scotland. The intervention commenced in March 2014 with follow-up until September 2016.InterventionThe PROMPT training package (Second edition), with subsequent unit-level implementation of PROMPT courses for all maternity staff.Main outcome measuresThe primary outcome was the proportion of term babies with Apgar<75mins.Results87 204 eligible births (99.2% with an Apgar score), of which 1291 infants had an Apgar<75mins were delivered in the 12 randomised maternity units. Two units did not implement the intervention. The overall Apgar<75mins rate observed in the 12 randomised units was 1.49%, increasing from 1.32% preintervention to 1.59% postintervention. Once adjusted for a secular time trend, the ‘intention-to-treat’ analysis indicated a moderate but non-significant reduction in the rate of term babies with an Apgar scores <75mins following PROMPT training (OR=0.79 95%CI(0.63 to 1.01)). However, some units implemented the intervention earlier than their allocated step, whereas others delayed the intervention. The content and authenticity of the implemented intervention varied widely at unit level. When the actual date of implementation of the intervention in each unit was considered in the analysis, there was no evidence of improvement (OR=1.01 (0.84 to 1.22)). No intervention effect was detected by broadening the analysis to include all 15 large Scottish maternity units. Units with a history of higher rates of Apgar<75mins maintained higher Apgar rates during the study (OR=2.09 (1.28 to 3.41)) compared with units with pre-study rates aligned to the national rate.ConclusionsPROMPT training, as implemented, had no effect on the rate of Apgar <75mins in Scotland during the study period. Local implementation at scale was found to be more difficult than anticipated. Further research is required to understand why the positive effects observed in other single-unit studies have not been replicated in Scottish maternity units, and how units can be best supported to locally implement the intervention authentically and effectively.Trial registration numberISRCTN11640515.

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