scholarly journals Virtual and augmented reality in the vestibular rehabilitation of peripheral vestibular disorders: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Austin Heffernan ◽  
Mohammed Abdelmalek ◽  
Desmond A. Nunez
Keyword(s):  
Side Effects ◽  
Augmented Reality ◽  
Meta Analysis ◽  
Vestibular Rehabilitation ◽  
Vestibular Dysfunction ◽  
Symptom Improvement ◽  
Vestibular Disorders ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Bias Assessment

AbstractVestibular rehabilitation therapy is an established treatment for patients with vestibular dysfunction. Virtual reality (VR) and augmented reality (AR) can be utilised in vestibular rehabilitation. Evidence of the efficacy of VR and AR delivered rehabilitation in patients with peripheral vestibular disorders is reviewed. MEDLINE, EMBASE, CENTRAL, CINAHL, PsychInfo, PsychBITE, OTSeeker, Ei Compendex, IEE, Clinical trials.gov and WebofScience databases were searched. Reduction in vestibular dysfunction symptoms 0–3 months post-intervention was the primary outcome. Secondary outcomes included long-term symptom improvement and side effects. Risk of bias assessment and meta analyses were planned. Five studies meeting eligibility criteria were included. Dizziness Handicap Inventory (DHI) scores 0–3 months post-intervention were reported by four studies. Meta-analysis identified a 1.13 (95% CI, − 1.74, − 0.52) standardized mean difference reduction in DHI in VR and AR treated patients compared to controls. Side effects reported by two studies were reduced by week four of VR intervention. Bias assessment identified DHI scores and side effects to be at high risk or of some concern. Adjunct VR interventions reduced patient DHI significantly more than vestibular rehabilitation alone 0–3 months post-intervention in adult patients diagnosed with unilateral vestibular disease. High quality studies are needed.

scholarly journals HIIT is not superior to MICT in altering blood lipids: a systematic review and meta-analysis

2019 ◽  
Vol 5 (1) ◽  
pp. e000647 ◽  
Author(s):  
Gina Wood ◽  
Anna Murrell ◽  
Tom van der Touw ◽  
Neil Smart
Keyword(s):  
Systematic Review ◽  
Athletic Training ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Moderate Intensity ◽  
Continuous Training ◽  
Intervention Component ◽  
Post Intervention ◽  
Eligibility Criteria

ObjectiveTo compare the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on adult lipid profiles; to identify training or participant characteristics that may determine exercise-induced change in total cholesterol (TC), triglycerides (TRG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).DesignSystematic review and meta-analysis.Data sourcesEnglish language searches of several databases were conducted from inception until September 2019.Eligibility criteria for excluding studiesInclusion: (1) published randomised controlled human trials with group population n≥5; (2) intervention duration ≥4 weeks; (3) comparing HIIT with MICT; and (4) reporting pre–post intervention lipid measurements. Exclusion: subjects with chronic disease, <18 years, pregnant/lactating, in elite athletic training; and studies with a dietary or pharmaceutical intervention component.ResultsTwenty-nine data sets (mmol/L) of 823 participants were pooled and analysed. Neither HIIT nor MICT was better in decreasing TC (0.10 (−0.06 to 0.19), p=0.12, I2=0%), TRG (−0.05 (−0.11 to 0.01), p=0.10, I2=0%), LDL-C (0.05 (−0.06 to 0.17), p=0.37, I2=0%), or TC/HDL-C (−0.03 (−0.36 to 0.29), p=0.85, I2=0%). HIIT significantly raised HDL-C (0.07 (0.04 to 0.11), p<0.0001, I2=0%) compared with MICT.ConclusionNeither HIIT nor MICT is superior for altering TC, TRG, or LDL-C, or TC-HDL-C ratio. Compared with MICT, HIIT appeared to significantly improve HDL-C. Clinicians may prescribe either protocol to encourage participation in exercise and reduce cardiovascular risk. To raise HDL-C, HIIT may result in a larger effect size compared with MICT.PROSPERO registration numberCRD42019136722.

scholarly journals How to prepare and manage a systematic review and meta-analysis of clinical studies

2019 ◽  
Vol 4 (5) ◽  
pp. 213-220 ◽  
Author(s):  
James R. Berstock ◽  
Michael R. Whitehouse
Keyword(s):  
External Validity ◽  
Literature Search ◽  
Search Strategy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Clinical Question ◽  
Eligibility Criteria ◽  
Bias Assessment ◽  
Review Protocol

Use the PICO framework to formulate a specific clinical question. Formulate a search strategy. Prospectively register the review protocol. Execute the literature search. Apply eligibility criteria to exclude irrelevant studies. Extract data and appraise each study for risk of bias and external validity. Provide a narrative review. If appropriate data are available, perform a meta-analysis. Report the review findings in the context of the risk of bias assessment, any sensitivity analyses and the analysis of risk of publication bias. Useful resources include the Cochrane Handbook, PROSPERO, GRADE and PRISMA. Cite this article: EFORT Open Rev 2019;4:213-220. DOI: 10.1302/2058-5241.4.180049

scholarly journals Protocol for a Randomised Controlled Feasibility Study of Psychologically Informed Vestibular Rehabilitation for People With Persistent Dizziness (INVEST Trial)

2020 ◽  
Author(s):  
David Rhys Herdman ◽  
Sam Norton ◽  
Marousa Pavlou ◽  
Louisa Murdin ◽  
Rona Moss-Morris
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Vestibular Rehabilitation ◽  
Self Report ◽  
Power Calculation ◽  
Efficacy Trial ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Randomised Controlled ◽  
Post Randomisation

Abstract Background: Dizziness is a common complaint that often persists and leads to disability and distress. Several cognitive and behavioural responses may contribute to the neurobiological adaptations that maintain persistent vestibular symptoms. This paper will present the protocol of a two-arm parallel group feasibility randomised controlled trial designed to determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of an integrated cognitive behavioural therapy and vestibular rehabilitation (CBT-VR) treatment for people with persistent dizziness. Methods: Forty adult patients will be recruited from a tertiary vestibular clinic with persistent movement triggered dizziness for three months or longer who have moderate-high levels of dizziness handicap. Participants will be 1:1 randomised, using a minimisation procedure, to six sessions (12-14 weeks’) of either CBT-VR (intervention arm) or VR only (control arm). Measures will be collected at baseline and 4 months post randomisation. The primary feasibility outcomes include descriptive data on numbers meeting eligibility criteria, rates of recruitment, numbers retained post randomisation, treatment adherence and an acceptability questionnaire. Treatment effects on self-report outcomes will be estimated to determine that 95% confidence intervals for the effects are consistent with anticipated effects and minimum clinically important differences, and to provide information needed for the power calculation of an efficacy trial. A nested qualitative study will be conducted post-intervention (intervention group only) to explore the acceptability of the intervention and identify any areas in need of improvement. Discussion: If a trial of CBT-VR is feasible, acceptability data will be used to enhance the intervention if needed and refine the multicentre RCT protocol. Future studies will need to consider the training required for other physiotherapists to deliver the intervention.Trial registration: ISRCTN 10420559

scholarly journals Protocol for a randomised controlled feasibility study of psychologically informed vestibular rehabilitation for people with persistent dizziness: INVEST trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
David Herdman ◽  
Sam Norton ◽  
Marousa Pavlou ◽  
Louisa Murdin ◽  
Rona Moss-Morris
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Vestibular Rehabilitation ◽  
Self Report ◽  
Power Calculation ◽  
Efficacy Trial ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Randomised Controlled ◽  
Post Randomisation

Abstract Background Dizziness is a common complaint that often persists and leads to disability and distress. Several cognitive and behavioural responses may contribute to the neurobiological adaptations that maintain persistent vestibular symptoms. This paper will present the protocol of a two-arm parallel group feasibility randomised controlled trial designed to determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of an integrated cognitive behavioural therapy and vestibular rehabilitation (CBT-VR) treatment for people with persistent dizziness. Methods Forty adult patients will be recruited from a tertiary vestibular clinic with persistent movement–triggered dizziness for 3 months or longer who have moderate–high levels of dizziness handicap. Participants will be 1:1 randomised, using a minimisation procedure, to six sessions of either CBT-VR (intervention arm) or VR only (control arm). Measures will be collected at baseline and 4 months post randomisation. The primary feasibility outcomes include descriptive data on numbers meeting eligibility criteria, rates of recruitment, numbers retained post randomisation, treatment adherence and an acceptability questionnaire. Treatment effects on self-report outcomes will be estimated to determine that 95% confidence intervals for the effects are consistent with anticipated effects and minimum clinically important differences, and to provide information needed for the power calculation of an efficacy trial. A nested qualitative study will be conducted post-intervention (intervention group only) to explore the acceptability of the intervention and identify any areas in need of improvement. Discussion If a trial of CBT-VR is feasible, acceptability data will be used to enhance the intervention if needed and refine the multicentre RCT protocol. Future studies will need to consider the training required for other physiotherapists to deliver the intervention. Trial registration ClinicalTrials.gov, ISRCTN 10420559

scholarly journals Is tepid sponging more effective than paracetamol at relieving fever in febrile children in hot tropical climates? a mini review

2021 ◽  
Vol 55 (1) ◽  
pp. 60-68
Author(s):  
Samuel Akyirem ◽  
Irene F. Bossman
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Outcome Data ◽  
Systematic Review Methodology ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Randomised Controlled ◽  
Tropical Climates ◽  
New Evidence ◽  
Significant Health

Background: Childhood fever remains a significant health problem because of the convulsion risk it poses to the child as well as the parental anxiety it provokes. Tepid sponging of such children remains commonplace in tropical climates despite the lack of evidence to support it.Objective: To evaluate the effectiveness of tepid sponging in hot tropical climatesMethods: NICE systematic review methodology was used. Medline and EMBASE were searched from their inception to date. Eligibility criteria included a) studies of randomised controlled trial (RCT) design b) children aged 2 to 120 months c) the use of tepid sponging alone in one arm and paracetamol in the other arm of the experiment. Eligible studies were critically appraised with NICE risk of bias tool. The outcome of interest was the number of afebrile children 2 hours after intervention. The outcome data from eligible studies were pooled for meta-analysis using random effects.Findings: Out of the 201 papers retrieved from the electronic search, two studies met the inclusion criteria. The meta-analysis found that tepid sponging was less effective than paracetamol at relieving fever two hours post-intervention (RR=0.25, 95% CI 0.08-0.79]).Conclusion: Tepid sponging was not effective against fever. There is the need to modify existing local clinical protocols to reflect the new evidence and international guidelines.

scholarly journals Does advance contact with research participants increase response to questionnaires: A Systematic Review and meta-Analysis

2021 ◽  
Author(s):  
Benjamin Woolf ◽  
Phil Edwards
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Bias Assessment ◽  
Response Data ◽  
Randomised Control Trials ◽  
Study Participants ◽  
The Impact

AbstractBackgroundQuestionnaires remain one of the most common forms of data collection in epidemiology, psychology and other human-sciences. However, results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. The last systematic review to examine the effect of questionnaire pre-notification on response is ten years old, and lacked a risk of bias assessment.ObjectivesUpdate Edwards et al. (2009) to include 1) recently published studies, 2) an assessment of risk of bias.MethodsData sources: Edwards et al. (2009); 13 data-bases; the references in, and citations of included studies. Eligibility criteria: Randomised control trials examining the impact of pre-notification on response. Data extraction: data extraction was done twice by a single unblinded reviewer. Risk of bias was assessed using the Cochrane Risk of Bias tool and funnel plots.Results103 trials were included. Over-all pre-notification increased response, OR = 1.38 (95%CI: 1.25-1.53). However, when studies at high or unclear risk of bias were excluded the effect was greatly reduced (OR = 1.11, 95% CI: 1.01-1.21).ConclusionsThe evidence implies that while pre-notification does increase response rates, this may not be of clinical utility.

Financial incentives for physical activity in adults: systematic review and meta-analysis

2019 ◽  
Vol 54 (21) ◽  
pp. 1259-1268 ◽  
Author(s):  
Marc S Mitchell ◽  
Stephanie L Orstad ◽  
Aviroop Biswas ◽  
Paul I Oh ◽  
Melanie Jay ◽  
...  
Keyword(s):  
Physical Activity ◽  
Financial Incentives ◽  
Meta Analysis ◽  
Daily Step ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Step Counts ◽  
Technological Advances ◽  
The Impact ◽  
Vote Counting

ObjectiveThe use of financial incentives to promote physical activity (PA) has grown in popularity due in part to technological advances that make it easier to track and reward PA. The purpose of this study was to update the evidence on the effects of incentives on PA in adults.Data sourcesMedline, PubMed, Embase, PsychINFO, CCTR, CINAHL and COCH.Eligibility criteriaRandomised controlled trials (RCT) published between 2012 and May 2018 examining the impact of incentives on PA.DesignA simple count of studies with positive and null effects (‘vote counting’) was conducted. Random-effects meta-analyses were also undertaken for studies reporting steps per day for intervention and post-intervention periods.Results23 studies involving 6074 participants were included (64.42% female, mean age = 41.20 years). 20 out of 22 studies reported positive intervention effects and four out of 18 reported post-intervention (after incentives withdrawn) benefits. Among the 12 of 23 studies included in the meta-analysis, incentives were associated with increased mean daily step counts during the intervention period (pooled mean difference (MD), 607.1; 95% CI: 422.1 to 792.1). Among the nine of 12 studies with post-intervention daily step count data incentives were associated with increased mean daily step counts (pooled MD, 513.8; 95% CI:312.7 to 714.9).ConclusionDemonstrating rising interest in financial incentives, 23 RCTs were identified. Modest incentives ($1.40 US/day) increased PA for interventions of short and long durations and after incentives were removed, though post-intervention ‘vote counting’ and pooled results did not align. Nonetheless, and contrary to what has been previously reported, these findings suggest a short-term incentive ‘dose’ may promote sustained PA.

Vestibular Disorders following Concussion

2014 ◽  
Author(s):  
Kathryn J. Schneider
Keyword(s):  
Head Trauma ◽  
Vestibular Rehabilitation ◽  
Vestibular Dysfunction ◽  
Vestibular Disorders ◽  
Persistent Symptoms

Individuals with persistent symptoms following a sport-related concussion sometimes report dizziness and/or vertigo. These symptoms may occur secondary to vestibular dysfunction. A variety of vestibular conditions have been reported following head trauma and may result in persistent dizziness. Vestibular rehabilitation has demonstrated functional and symptomatic improvements in a variety of vestibular disorders and may be of benefit in individuals with persistent symptoms of dizziness following sport-related concussion. In the case of ongoing dizziness, further assessment to delineate the cause of the dizziness may reveal vestibular involvement. In this case, vestibular rehabilitation may be of benefit.

scholarly journals Effects of Variations in Resistance Training Frequency on Strength Development in Well-Trained Populations and Implications for In-Season Athlete Training: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Matthew Cuthbert ◽  
G. Gregory Haff ◽  
Shawn M. Arent ◽  
Nicholas Ripley ◽  
John J. McMahon ◽  
...  
Keyword(s):  
Resistance Training ◽  
Meta Analysis ◽  
Secondary Analysis ◽  
Potential Method ◽  
Risk Of Bias ◽  
Strength Development ◽  
Maximal Strength ◽  
Post Intervention ◽  
Bias Assessment ◽  
Training Frequency

Abstract Background In-season competition and tournaments for team sports can be both long and congested, with some sports competing up to three times per week. During these periods of time, athletes need to prepare technically, tactically and physically for the next fixture and the short duration between fixtures means that, in some cases, physical preparation ceases, or training focus moves to recovery as opposed to progressing adaptations. Objective The aim of this review was to investigate the effect of training frequency on muscular strength to determine if a potential method to accommodate in-season resistance training, during busy training schedules, could be achieved by utilizing shorter more frequent training sessions across a training week. Methods A literature search was conducted using the SPORTDiscus, Ovid, PubMed and Scopus databases. 2134 studies were identified prior to application of the following inclusion criteria: (1) maximal strength was assessed, (2) a minimum of two different training frequency groups were included, (3) participants were well trained, and finally (4) compound exercises were included within the training programmes. A Cochrane risk of bias assessment was applied to studies that performed randomized controlled trials and consistency of studies was analysed using I2 as a test of heterogeneity. Secondary analysis of studies included Hedges’ g effect sizes (g) and between-study differences were estimated using a random-effects model. Results Inconsistency of effects between pre- and post-intervention was low within-group (I2 = 0%), and moderate between-group (I2 ≤ 73.95%). Risk of bias was also low based upon the Cochrane risk of bias assessment. Significant increases were observed overall for both upper (p ≤ 0.022) and lower (p ≤ 0.008) body strength, pre- to post-intervention, when all frequencies were assessed. A small effect was observed between training frequencies for upper (g ≤ 0.58) and lower body (g ≤ 0.45). Conclusion Over a 6–12-week period, there are no clear differences in maximal strength development between training frequencies, in well-trained populations. Such observations may permit the potential for training to be manipulated around competition schedules and volume to be distributed across shorter, but more frequent training sessions within a micro-cycle rather than being condensed into 1–2 sessions per week, in effect, allowing for a micro-dosing of the strength stimuli.

scholarly journals Effects of Ramadan and Non-ramadan Intermittent Fasting on Body Composition: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 7 ◽  
Author(s):  
Joana M. Correia ◽  
Inês Santos ◽  
Pedro Pezarat-Correia ◽  
Analiza M. Silva ◽  
Goncalo V. Mendonca
Keyword(s):  
Systematic Review ◽  
Body Composition ◽  
Body Weight ◽  
Fat Mass ◽  
Meta Analysis ◽  
Fat Free Mass ◽  
Intermittent Fasting ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Comprehensive Search

Intermittent fasting (IF) has gained popularity for body-composition improvement purposes. The aim of this systematic review and meta-analysis was to summarize the effects of Ramadan vs. non-Ramadan IF on parameters of body composition. We conducted a comprehensive search of peer-reviewed articles in three electronic databases: PubMed, Scopus, and Web of Science (published until May 2020). Studies were selected if they included samples of adults (≥18 years), had an experimental or observational design, investigated any type of IF and included body composition outcomes. Meta-analytical procedures were conducted when feasible. Sixty-six articles met the eligibility criteria. We found that non-Ramadan IF is effective for decreasing body weight (−0.341 (95% CI [−0.584, −0.098], p = 0.006), body mass index (−0.699, 95% CI [−1.05, −0.347], p &lt; 0.001), and absolute fat mass (−0.447, 95% CI [−0.673, −0.221], p &lt; 0.001). When contrasting pre- post-intervention data on fat-free mass between treatments and controls, group-differences were non-significant (p &gt; 0.05). Conversely, we observed a significant increase in fat-free mass when comparing pre- to post-intervention in a within design fashion (0.306, 95% CI [0.133, 0.48], p = 0.001). Finally, despite being accompanied by dehydration, Ramadan IF is effective in decreasing body weight (−0.353; 95% CI [−0.651, −0.054], p = 0.02) and relative fat mass (−0.533; 95% CI [−1.025, −0.04], p = 0.034). Ramadan IF seems to implicate some beneficial adaptations in weight management, although non-Ramadan IF appears to be more effective in improving overall body composition.

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