Dry Needling for the Treatment Of Tension-Type, Cervicogenic, or Migraine Headaches: a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mohammadreza Pourahmadi ◽  
Jan Dommerholt ◽  
César Fernández-de-Las-Peñas ◽  
Bart Willem Koes ◽  
Mohammad Ali Mohseni-Bandpei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Intensity ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Dry Needling ◽  
Short Term ◽  
Patient Will ◽  
Headache Pain ◽  
Better Than

Abstract Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. This systematic review's main objective was to assess the effectiveness of dry needling on headache pain intensity and related-disability in patients with TTH, CGH, or migraine. Methods Medline/PubMed, Scopus, Embase®, PEDro, WoS, Ovid, AMED/EBSCO, CENTRAL, Google Scholar, and trial registries were searched until April 1, 2020, along with reference lists of eligible studies and related reviews. Randomized clinical trials or observational studies that compared the effectiveness of dry needling with any other interventions were eligible for inclusion. Three reviewers independently selected studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were performed to produce pooled-effect estimates (Morris’s dppc2) and their respective confidence intervals. Results Of 2715 identified studies, 11 randomized clinical trials were eligible for qualitative synthesis and 9 for meta-analysis. Only four trials were of high quality. Very low-quality evidence suggested that dry needling is not statistically better than other interventions for improving headache pain intensity at short-term in patients with TTH (SMD −1.27, 95% CI −3.56 to 1.03, n = 230), CGH (SMD −0.41, 95% CI −4.69 to 3.87, n = 104), or mixed headache (TTH and migraine; SMD 0.03; 95% CI −0.42 to 0.48, n = 90). Dry needling provided significantly greater improvement in related-disability at short-term in patients with TTH (SMD −2.28, 95% CI −2.66 to −1.91, n = 160) and CGH (SMD −0.72, 95% CI −1.09 to −0.34, n = 144). The synthesis of results showed that dry needling could significantly improve headache frequency, health-related quality of life, trigger point tenderness, and cervical range of motion in TTH and CGH. Conclusions Dry needling produces similar effects to other interventions for short-term headache pain relief, whereas dry needling seems to be better than other therapies for improvement in related-disability in the short-term. Impact Although further high methodological quality studies are warranted to provide a more robust conclusion, our systematic review suggested that for every one to two patients with TTH treating by dry needling, one patient will likely show decreased headache intensity (NNT = 2; large effect) and improved related-disability (NNT = 1; very large effect). In CGH, for every three to four patients treating by dry needling, one patient will likely exhibit decreased headache intensity (NNT = 4; small effect) and improved related-disability (NNT = 3; medium effect).

Effects of Trigger Point Dry Needling for Nontraumatic Shoulder Pain of Musculoskeletal Origin: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Marcos J Navarro-Santana ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
Jose L Arias-Buría ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Trigger Point ◽  
Meta Analysis ◽  
Dry Needling ◽  
Short Term ◽  
Positive Effects ◽  
Evidence Level ◽  
Quality Evidence

Abstract Objective The purpose of this study was to evaluate the effects of trigger point (TrP) dry needling alone or as an adjunct to other interventions on pain intensity and related disability in nontraumatic shoulder pain. Methods Ten databases were searched from inception to January 2020 for randomized clinical trials in which at least 1 group received TrP dry needling for shoulder pain of musculoskeletal origin with outcomes collected on pain intensity and related disability. Data extraction including participant and therapist details, interventions, blinding strategy, blinding assessment outcomes, and results were extracted by 2 reviewers. The risk of bias (RoB, Cochrane Guidelines), methodological quality (PEDro score), and evidence level (GRADE approach) were assessed. The search identified 551 publications with 6 trials eligible for inclusion. Results There was moderate quality evidence that TrP dry needling reduces shoulder pain intensity with a small effect (MD = −0.49 points, 95% CI = −0.84 to −0.13; SMD = −0.25, 95% CI = −0.42 to −0.09) and low quality evidence that TrP dry needling improves related disability with a large effect (MD = −9.99 points, 95% CI -15.97 to −4.01; SMD = −1.14, 95% CI -1.81 to −0.47) as compared to a comparison group. The effects on pain were only found at short-term. The RoB was generally low, but the heterogenicity of the results downgraded the evidence level. Conclusions Moderate- to low-quality evidence suggests positive effects of TrP dry needling for pain intensity (small effect) and pain-related disability (large effect) in nontraumatic shoulder pain of musculoskeletal origin, mostly at short term. Future clinical trials investigating long-term effects are needed. Impact Dry needling is commonly used for the management of musculoskeletal pain. This is the first meta-analysis to examine the effects of dry needling on nontraumatic shoulder pain.

scholarly journals Effects of intradialytic exercise on cardiopulmonary capacity in chronic kidney disease: systematic review and meta-analysis of randomized clinical trials

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Francini Porcher Andrade ◽  
Patrícia de Souza Rezende ◽  
Tatiane de Souza Ferreira ◽  
Gabrielle Costa Borba ◽  
Alice Mânica Müller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Clinical Trials ◽  
Kidney Disease ◽  
Exercise Tolerance ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Exercise Group ◽  
Intradialytic Exercise ◽  
Better Than

AbstractPatients with chronic kidney disease show poorer functional and cardiorespiratory capacity than healthy individuals, and these impairments result in sedentarism. The aim of this study was to conduct a systematic review and meta-analysis of randomized clinical trials on the effects of different intradialytic exercise protocols on cardiopulmonary capacity in chronic kidney disease patients. The primary outcome was peak oxygen consumption (VO2peak) and the secondary outcomes were exercise duration and ventilation in the cardiopulmonary test. The quality of the evidence was evaluated using the GRADE guidelines. Seven studies with a total of 124 participants met the inclusion criteria. Compared to the non-exercise group, the exercise group improved in mean VO2peak (MD 4.06 [IC 0.81; 7.31]). In a separate analysis according to exercise modality, aerobic exercise plus strength training performed better than aerobic exercise alone (MD 5.28 [IC 3.90; 6.66]). In the exercise group, both exercise tolerance values (MD 3.10 [IC 1.70; 4.51]) and ventilation values in the cardiopulmonary test were better than those of the control group (MD 13.10 [IC 7.12; 19.09]). Thus, intradialytic exercise protocols can improve cardiopulmonary function, exercise tolerance and ventilatory efficiency in chronic kidney disease patients.

Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 15 (4) ◽  
pp. 232-237
Author(s):  
Mir Hadi Musavi ◽  
Behzad Jodeiri ◽  
Keyvan Mirnia ◽  
Morteza Ghojazadeh ◽  
Zeinab Nikniaz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Apgar Score ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Intravenous Fentanyl ◽  
Neonatal Effect ◽  
Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

scholarly journals Effect of photobiomodulation in secondary intention gingival wound healing—a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pooya Ebrahimi ◽  
Mahdi Hadilou ◽  
Ferdos Naserneysari ◽  
Amirmohammad Dolatabadi ◽  
Rana Tarzemany ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Healing Process ◽  
Adjunctive Treatment ◽  
Control Groups ◽  
Secondary Intention ◽  
Post Operative Pain

Abstract Background Photobiomodulation is widely being used to improve the wound healing process in dentistry and a vast majority of studies have proven its benefits. But there are plenty of knowledge gaps according to the optimal laser characteristics which should be used to maximize the healing effects of lasers. The goal of this systematic review and meta-analysis was to determine the effect of photobiomodulation (PBM) as an adjunctive treatment to periodontal therapies to evaluate secondary intention gingival wound healing and post-operative pain. Methods Five databases (PubMed, Embase, Scopus, ProQuest, and Web of Sciences) were searched up to November 30, 2020, for clinical trials that reported the result of the application of PBM on secondary gingival healing wounds and post-operative pain and discomfort after periodontal surgeries. Two independent reviewers selected the eligible studies and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results Ultimately, twelve studies were included in this review. The application of PBM as an adjunct to periodontal surgeries resulted in a significant improvement in wound healing indices. The Landry wound healing index at the 7th post-operative day was significantly improved (SMD = 1.044 [95% CI 0.62–1.46]; p < 0.01) in PBM + surgery groups compared to the control groups. There was also a statistically significant increase in the complete wound epithelialization (RR = 3.23 [95% CI 1.66–6.31]; p < 0.01) at the 14th post-operative day compared to the control groups. The methods used to assess the post-operative pain were heterogeneous, and therefore the results were limited which made the meta-analysis for post-operative pain assessment not possible. Conclusion Based on the results of this review, PBM can be effectively used as a method to improve secondary intention wound healing. High-quality randomized clinical trials, however, are needed in the future to identify the optimal PBM irradiation parameters and the effect of PBM on post-operative pain.

Carotenoids supplementation and inflammation: a systematic review and meta-analysis of randomized clinical trials

2021 ◽  
pp. 1-17
Author(s):  
Fatemeh Hajizadeh-Sharafabad ◽  
Elham Sharifi Zahabi ◽  
Mahsa Malekahmadi ◽  
Rasoul Zarrin ◽  
Mohammad Alizadeh
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis
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