scholarly journals Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials

2017 ◽  
Vol 26 (4) ◽  
pp. 294-305 ◽  
Author(s):  
Koya Mine ◽  
Takashi Nakayama ◽  
Steve Milanese ◽  
Karen Grimmer
Keyword(s):  
Systematic Review ◽  
Evidence Synthesis ◽  
Japanese Language ◽  
Controlled Trials ◽  
Short Term ◽  
Randomized Controlled ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Shoulder ◽  
Young Subjects ◽  
Posterior Shoulder Tightness

Context:Posterior shoulder tightness (PST) and glenohumeral internal-rotation deficit (GIRD) can contribute to shoulder pain suffered by athletes engaged in overhead sporting activities. Stretching is a common intervention to resolve PST and GIRD, but it has weak evidence of effectiveness to date.Objective:This systematic review aimed to collect and synthesize effectiveness data from English- and Japanese-language randomized controlled trials (RCTs) investigating stretching interventions for PST and GIRD.Evidence Acquisition:7 English databases and 3 Japanese databases were searched from inception until December 5, 2015. Only English- and Japanese-language RCTs were considered. Risk of bias in the included studies was assessed using the Physiotherapy Evidence Database scale. Data were synthesized qualitatively.Evidence Synthesis:Eight English-language and 2 Japanese-language papers of low to high quality were included. There was moderate evidence for positive immediate and short-term effects of cross-body stretch on PST and GIRD in asymptomatic young subjects. Moderate evidence was found to suggest that active sleeper stretch might not be more effective than no intervention to improve PST and GIRD in the short term.Conclusions:Cross-body stretch can be effective to improve PST and GIRD in asymptomatic young subjects immediately or in the short term. Further study with methodological rigor is necessary to investigate the long-term effectiveness of stretching interventions on PST and GIRD in symptomatic patients.

scholarly journals Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

2013 ◽  
Vol 5 (1) ◽  
pp. 8 ◽  
Author(s):  
Ali Abdulkarim ◽  
Prasad Ellanti ◽  
Nicola Motterlini ◽  
Tom Fahey ◽  
John M. O’Byrne
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Implant Fixation ◽  
Short Term ◽  
Optimal Method ◽  
Radiographic Findings ◽  
Total Hip ◽  
Randomized Controlled ◽  
Significant Difference

The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

Effectiveness of Mechanical Traction for Lumbar Radiculopathy: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Carla Vanti ◽  
Alice Panizzolo ◽  
Luca Turone ◽  
Andrew A Guccione ◽  
Francesco Saverio Violante ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Physical Therapist ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Lumbar Radiculopathy ◽  
Short Term ◽  
Randomized Controlled ◽  
Lumbar Nerve Root ◽  
Mechanical Traction

Abstract Objective Lumbar radiculopathy is a pain syndrome caused by compression/irritation of the lumbar nerve root(s). Traction is a well-known and commonly used conservative treatment for lumbar radiculopathy, although its effectiveness is disputed. The purpose of this systematic review and meta-analysis of randomized controlled trials was to evaluate the effects of different types of traction added to or compared with conservative treatments on pain and disability. Methods Data were obtained from CENTRAL, PUBMED, CINAHL, Scopus, ISI Web of Science, and PEDro from their inception to April 2020. All randomized controlled trials on adults with lumbar radiculopathy, using mechanical traction, without any restriction regarding publication time or language, were considered. Two reviewers selected the studies, evaluated the quality assessment, and extracted the results. Meta-analysis used a random-effects model. Eight studies met the inclusion criteria, and 5 were meta-analyzed. Results Meta-analyses of results from low-quality studies indicated that supine mechanical traction added to physical therapist treatments had significant effects on pain (g = −0.58 [95% CI = −0.87 to −0.29]) and disability (g = −0.78 [95% CI = −1.45 to −0.11]). Analyses of results from high-quality studies of prone mechanical traction added to physical therapist intervention for pain and disability were not significant. These results were also evident at short-term follow-up (up to 3 months after intervention). Conclusions The literature suggests that, for pain and disability in lumbar radiculopathy, there is short-term effectiveness of supine mechanical traction when added to physical therapist intervention. Impact This systematic review may be relevant for clinical practice due to its external validity because the treatments and the outcome measures are very similar to those commonly used in a clinical context.

scholarly journals Modification of High-Density Lipoprotein Functions by Diet and Other Lifestyle Changes: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Vol 10 (24) ◽  
pp. 5897
Author(s):  
Albert Sanllorente ◽  
Camille Lassale ◽  
Maria Trinidad Soria-Florido ◽  
Olga Castañer ◽  
Montserrat Fitó ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fatty Acids ◽  
Cardiovascular Risk ◽  
Randomized Controlled Trials ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Healthy Individuals ◽  
Short Term ◽  
Randomized Controlled ◽  
Hdl Function

High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein, lecithin-cholesterol acyltransferase, HDL antioxidant capacity, HDL oxidation status, paraoxonase-1 activity, HDL anti-inflammatory and endothelial protection capacity, HDL-associated phospholipase A2, HDL-associated serum amyloid A, and HDL-alpha-1-antitrypsin. In mainly short-term clinical trials, the consumption of monounsaturated and polyunsaturated fatty acids (particularly omega-3 in fish), and dietary antioxidants showed benefits to HDL functionality, especially in subjects with cardiovascular risk factors. In this regard, antioxidant-rich dietary patterns were able to improve HDL function in both healthy individuals and subjects at high cardiovascular risk. In addition, in randomized trial assays performed mainly in healthy individuals, reverse cholesterol transport with ethanol in moderate quantities enhanced HDL function. Nevertheless, the evidence summarized was of unclear quality and short-term nature and presented heterogeneity in lifestyle modifications, trial designs, and biochemical techniques for the assessment of HDL functions. Such findings should therefore be interpreted with caution. Large-scale, long-term, randomized, controlled trials in different populations and individuals with diverse pathologies are warranted.

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