A Systematic Review of the Effectiveness of Telerehabilitation Interventions for Therapeutic Purposes in the Elderly

Abstract Background Many elderly people suffer from chronic health conditions and mobility limitations. Therefore, they may benefit from traditional rehabilitation or telerehabilitation interventions as an alternative for this type of services. Objective The purpose of this study was to compare the effectiveness of telerehabilitation interventions with traditional rehabilitation services for therapeutic purposes in the elderly. Methods This systematic review was conducted in 2018. The searched databases were Cochrane Library, PubMed, Scopus, Web of Science, Embase, and ProQuest. The search was conducted with no time or language limitation. The selected papers included the randomized clinical trial studies in which elderly people aged 60 and over used telerehabilitation services for treatment purposes. The quality of the studies was evaluated by using the physiotherapy evidence database (PEDro) scale. Data were extracted by using a data extraction form and findings were narratively synthesized. Results After screening the retrieved papers, eight articles were selected to be included in the study. According to the findings, telerehabilitation was used for the elderly after stroke, chronic obstructive pulmonary disease (COPD), total knee replacement, and in patients with the comorbidity of COPD and chronic heart failure. Overall, in most studies, there was no significant difference between the intervention and control groups and the level of improvements was similar for most outcomes. Conclusion Telerehabilitation services can be regarded as an alternative to traditional rehabilitation approaches to reduce outpatient resource utilization and improve quality of life. However, more rigorous studies are suggested to investigate the effectiveness of telerehabilitation services for specific diseases or health conditions.

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Inclusion of patient-reported outcomes (PROs) in randomized controlled trials (RCTs) with elderly cancer patients: A systematic review.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18217 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18217-e18217

Author(s):

Francesco Sparano ◽

Neil K Aaronson ◽

Mirjam A.G. Sprangers ◽

Peter Fayers ◽

Andrea Pusic ◽

...

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Patient Reported Outcomes ◽

Data Extraction ◽

The Elderly ◽

Cochrane Library ◽

Elderly Cancer Patients ◽

Patient Reported ◽

Cancer Sample

e18217 Background: Inclusion of PROs in RCTs involving elderly cancer patients may be particularly important, as the elderly are often frail and vulnerable, and treatment decisions need to carefully balance potential burden against benefit. We aimed to determine how many RCTs involving elderly patients have included a PRO endpoint, and identified the most relevant PRO information available in this area. Methods: A systematic review in PubMed/Medline and Cochrane Library identified RCTs with PRO endpoint that enrolled a cancer sample (breast, colorectal, lung, prostate, gynaecological and bladder cancer) with a mean/ median age ≥70 years, published from January 2004 to June 2018. The quality of PRO reporting was evaluated using the ISOQOL-PRO recommended criteria. Two reviewers independently performed data extraction. RCTs meeting at least two-thirds of the recommended criteria were considered as “probably-robust” and therefore most likely to be able to inform patient care. Results: Out of the 610 RCTs with PRO endpoint identified, only 67 RCTs (11%) enrolled a sample that met the above criteria. In 19 RCTs (28.4%) PROs were the primary endpoint and 35 RCTs (52.2%) were conducted in a metastatic population. Less than one-third of these trials (n = 21) were considered as probably-robust. In 10 (47.6%) out of the 21 probably-robust RCTs, PROs favored the experimental arm and in 8 (38.1%) the arms did not differ. Overall survival (OS) was an endpoint in 13 of the probably-robust RCTs. In only 3 of these RCTs (23.1%) did OS improve in the experimental arm and in 10 (76.9%) there was no difference in OS between arms. In about half of the probably-robust trials evaluating OS (n = 7, 53.8%), PROs provided information that contrasted with survival findings. In two RCTs, OS improved in the experimental arm, while PROs either did not change between arms (n = 1) or favoured the control arm (n = 1). Conversely, in 5 RCTs (38.5%), OS did not differ between arms whereas PROs favoured the experimental arm. Conclusions: Among cancer RCTs including PROs, the proportion of those conducted in the elderly is low. However, PRO data may provide useful information for these type of patients and their clinicians.

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Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083991 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3991

Author(s):

Antonio Jose Martin-Perez ◽

María Fernández-González ◽

Paula Postigo-Martin ◽

Marc Sampedro Pilegaard ◽

Carolina Fernández-Lao ◽

...

Keyword(s):

Systematic Review ◽

Bone Metastasis ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Pharmacological Intervention ◽

Vertebral Metastasis ◽

Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

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Tiotropium (SPIRIVA®) in mild COPD: Is it worth it?

Dalhousie Medical Journal ◽

10.15273/dmj.vol46no1.9827 ◽

2019 ◽

Vol 46 (1) ◽

Author(s):

Lina Mahmoud ◽

Hannah Ng ◽

Jade Roberts

Keyword(s):

Quality Of Life ◽

Exercise Duration ◽

Cochrane Library ◽

Chronic Obstructive ◽

Serious Adverse Events ◽

Main Trial ◽

Copd Exacerbations ◽

Increased Risk ◽

Significant Difference

Purpose:Tiotropium (SPIRIVA®) is used in the treatment of moderate to severe chronic obstructive pulmonary disease (COPD) in patients with persistent dyspnea despite using a short acting bronchodilator (SABD).This paper explores the role of tiotropium in the treatment of mild COPD. Methods:The Cochrane Library, EMBASE, Pubmed, and Clinicaltrials.gov were searched on February 2018.We included randomized controlled trials (RCTs) that evaluated tiotropium in patients with mild COPD.Three authors assessed studies for eligibility. Outcomes included symptoms, quality of life, exercise duration, lung function, COPD exacerbations and hospitalizations, and serious adverse events. Results: Three RCTs were selected as the best available evidence. Based on the results of the main trial, quality of life and symptoms were improved with tiotropium as compared to placebo with a difference between groups at 24 months to be 1.2 (95% CI: 0.5 to 1.9; p=0.0011) using the COPD Assessment test (CAT) score. Frequency of acute exacerbations of COPD (AECOPD) requiring hospitalization was reduced by 10.3% (28.9% with tiotropium vs 39.2% with placebo) in patients receiving tiotropium. One RCT reported no statistically significant difference in exercise duration (27 ± 27 secs) in the tiotropium group vs 50 ± 21 secs in the placebo group; (p=0.4153). Oropharyngeal discomfort was more common with tiotropium (number needed to harm of 12) compared to placebo. Conclusions: Evidence suggests that tiotropium may reduce COPD exacerbations and hospitalizations and improve quality of life in patients with mild COPD.There is an increased risk of oropharyngeal discomfort with tiotropium.

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Association between sepsis and retinopathy of prematurity: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-025440 ◽

2019 ◽

Vol 9 (5) ◽

pp. e025440 ◽

Cited By ~ 3

Author(s):

Xiaofen Wang ◽

Kun Tang ◽

Ling Chen ◽

Sixiang Cheng ◽

Huilan Xu

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Premature Infants ◽

Retinopathy Of Prematurity ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Severe Stage

ObjectiveTo explore the association between sepsis and retinopathy of prematurity (ROP) in premature infants.DesignA systematic review and meta-analysis.Data sourcesWe performed a systematic search of PubMed, the Cochrane Library and Embase from 1 January, 2000, to 1 January, 2018, with no language restrictions and reported the relationship between sepsis and ROP.Eligibility criteriaOriginal observational studies, including cohort studies and case-control studies.Data extraction and synthesisTwo reviewers independently completed the study selection and data extraction. The OR and corresponding 95% CI were used to measure the risk of sepsis in patients with ROP. The heterogeneity between studies was evaluated using Cochran’s Q test and the I2statistic. The Newcastle-Ottawa Scale was adopted to evaluate the quality of each of the included studies, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the quality of the evidence.ResultsSixteen studies with a total sample size of 12 466 premature infants and 2494 cases of ROP were included in this meta-analysis. Adjusted analysis showed that sepsis was closely related to any stage of ROP (OR = 1.57, 95% CI 1.31 to 1.89) and severe stage of ROP (OR = 2.33, 95% CI 1.21 to 4.51) in premature infants, with 56.3% and 81.8% heterogeneity, respectively. Subgroup analyses showed that heterogeneity was obvious in prospective cohort studies (I2= 62.1%, p<0.001). In a sensitivity analysis, we found that removing any single study did not significantly change the overall effect value. The quality of the evidence was rated as low for both any stage of ROP and severe stage of ROP.ConclusionsSepsis increases the risk of ROP in preterm infants. However, considering that all included studies are observational and causality can rarely be established, additional evidence is needed to substantiate this finding and provide advice for practice.

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

10.21203/rs.3.rs-28796/v1 ◽

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

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Oral health and quality of life of the elderly.

Brazilian Journal of Implantology and Health Sciences ◽

10.36557/2674-8169.2020v2n6p04-11 ◽

2020 ◽

Vol 2 (6) ◽

pp. 04-11

Author(s):

Gabriela Furst Vaccarezza ◽

Raissa Lopes Fuga ◽

Stephanie Regiane Prata Ferreira

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Data Collection ◽

Elderly People ◽

Health Professionals ◽

Tooth Loss ◽

The Elderly ◽

Health Conditions ◽

Negative Impacts

Introduction: The Brazilian population has been aging rapidly since the early 1960s, when the age structure of the population began to change. In 1996, only 5% of the population was 60 years old or more, while today they are 9% of the population. Objective: The objective of this study is to assess oral health conditions of the elderly who live in Vila dos Idosos, collecting information about their condition of life, and trying to correlate how much oral health can compromise the quality of life and autonomy of these elderly people. Methods: Data collection was carried out through questionnaires and clinical examination; elderly people over 60 years old, of both sexes, were interviewed. All interviews were conducted in the Vila dos Idosos itself. Results: The results show that tooth loss or the use of inadequate prostheses has negative impacts on quality of life, especially with regard to worry, stress resulting from problems in the mouth and shame. It was obtained in the research that, in general, oral health in the elderly is fragile, requiring greater attention from health professionals; however, when self-perceived oral health is analyzed, the vast majority assess it as very good or good. Conclusion: The most important finding of the study was that, although the data obtained indicate a fragile oral health that reveals a commitment to quality of life, the vast majority of the elderly evaluated their own health positively. This may indicate that, for this population, health oral health is dissociated from health.

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The relationship between delivery mode and postpartum depression: a systematic review and meta-analysis

10.21203/rs.3.rs-30402/v1 ◽

2020 ◽

Author(s):

Yu-Xin Chen ◽

Pei Zhao ◽

ZhuLiduzi Jiesisibieke ◽

Pei-En Chen ◽

Tao-Hsin Tung ◽

...

Keyword(s):

Systematic Review ◽

Postpartum Depression ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Depression Symptoms ◽

Delivery Mode ◽

Significant Difference ◽

The Relationship

Abstract Background: To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreements were resolved by discussion with a third author. We used the Newcastle-Ottawa Scale and GRADE methods to assess the quality of the included studies and evidences. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results: The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio =1.29; 95% CI: 1.11-1.51). Conclusions: The findings supported a relationship between delivery mode and postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD.r Trial registration: The protocol of this systematic review was registered in the PROSPERO under the number CRD42019148154.

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Insomnia and Information and Communication Technologies (ICT) in Elderly People: A Systematic Review

Medical Sciences ◽

10.3390/medsci7060070 ◽

2019 ◽

Vol 7 (6) ◽

pp. 70 ◽

Cited By ~ 2

Author(s):

Arianna Salvemini ◽

Grazia D’Onofrio ◽

Filomena Ciccone ◽

Antonella Greco ◽

Anita Tullio ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Elderly People ◽

Information And Communication Technologies ◽

Data Extraction ◽

Institutional Care ◽

Communication Technologies ◽

Behavioural Therapy ◽

Information And Communication

Background: Insomnia seems to be related to disability, risk of injury, metabolic syndrome, risk for cardiovascular diseases, cognitive impairment, depression and impaired quality of life. Objectives: The goals in this paper was (1) to keep track of technological concepts and approaches to improve insomnia in elderly people, and (2) to define the effect that information and communication technologies (ICT) is having on patients’ care. Design: A systematic review was conducted from existing literature. Our selection criteria included: (1) age ≥ 60 years; (2) diagnosis of insomnia with the International Classification of Sleep Disorders (ICSD-II), (3) CBTi (cognitive behavioural therapy insomnia), (4) use of technological tools, and (5) associations between insomnia-related variables and indices of disability, quality of life, and global clinical assessments. Data analysis: 11 articles were included. An inductive content analysis was used for data extraction. Results: Our review revealed any technological systems that could purportedly rehabilitate elderly patients with insomnia. Three categories of research were identified from the review: (1) Internet Deliver-CBTi, (2) virtual coaches, and (3) sleep technologies. Conclusions: The potential for ICT to support insomnia care at home can improve the quality of life for families and reduce health care costs and premature institutional care.

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Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-021-01644-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiani Zhou ◽

Tingjun Liu ◽

Lihong Guo

Keyword(s):

Systematic Review ◽

Ethylenediaminetetraacetic Acid ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Eligibility Criteria ◽

Passive Ultrasonic Irrigation ◽

Significant Difference ◽

Ultrasonic Irrigation

Abstract Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

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Efficacy of Transparent vs. Pressure Dressing in Prevention of Post-Cardiac Catheterization Pain, Discomfort and Hematoma: A Systematic Review and Meta-analysis of RCTs

Journal of Caring Sciences ◽

10.34172/jcs.2021.019 ◽

2021 ◽

Vol 10 (2) ◽

pp. 103-110

Author(s):

Suresh K Sharma ◽

Kalpana Thakur ◽

Shiv K Mudgal ◽

Barun Kumar

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Cardiac Catheterization ◽

Odds Ratio ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Difference ◽

Pressure Dressing

ABSTRACT Introduction: There is lack consensus on superiority of transparent vs. pressure dressing for prevention of post-cardiac catheterization pain, discomfort and hematoma. Therefore, we conducted this systematic review and meta-analysis of available RCTs on this subject. Methods: We performed a systematic search of RCTs published between in 2000-2019 in English language using databases including PubMed Medline, EMBASE, CINAHL, Cochrane Library, ERMED Journals, Clinical trials database, DELNET, Google Scholar and Discovery Search. Studies conducted on adult patients with femoral dressing after cardiac catheterization measuring pain, discomfort, hematoma as intended outcomes have been included. Data extraction, critical appraisal, assessment of risk bias was done and decisions on quality were made on mutual consensus. Mantel-Haenszel (MH) and odds ratio for dichotomous variables was calculated by Review Manager 5.3 software. Results: Out of all identified studies, only 5 studies comprising 664 patients fulfilled the inclusion criteria and met the quality assessment. Incidence of discomfort (25, 333) were significantly less in transparent dressing group as compared to pressure dressing group (149, 331); odds ratio 0.10, 95% confidence interval [CI] 0.06-0.15; I2 = 0%, P= 0.00. Four studies reported significantly lower number of pain cases in transparent dressing (17, 203) as compared to pressure dressing (57, 201); odds ratio 0.13, 95% confidence interval [CI] 0.03-0.59; I2 = 47%, P= 0.01). However, incidence of hematoma did not reveal any significant difference between two groups. Conclusion: Transparent dressing is a better option in patients with femoral/groin dressing after cardiac catheterization as it is more effective in prevention of pain and discomfort.

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