scholarly journals Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis

2016 ◽  
Vol 52 (3) ◽  
pp. 176-183 ◽  
Author(s):  
Pieter Coenen ◽  
Lisa Willenberg ◽  
Sharon Parry ◽  
Joyce W Shi ◽  
Lorena Romero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Meta Analysis ◽  
Musculoskeletal Symptoms ◽  
Low Back ◽  
Potential Health ◽  
High Exposure ◽  
Meta Analyses ◽  
Upper Extremity Symptoms

ObjectiveGiven the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms.DesignA systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous.Data sourcesElectronic databases were systematically searched.Eligibility criteriaPeer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified.ResultsOf the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, ‘substantial’ (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms.ConclusionsThe evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing.

Associations of screen work with neck and upper extremity symptoms: a systematic review with meta-analysis

2019 ◽  
Vol 76 (7) ◽  
pp. 502-509 ◽  
Author(s):  
Pieter Coenen ◽  
Henk F van der Molen ◽  
Alex Burdorf ◽  
Maaike A Huysmans ◽  
Leon Straker ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Self Report ◽  
Musculoskeletal Symptoms ◽  
Tablet Computers ◽  
Increased Risk ◽  
Electronic Database Search ◽  
Meta Analyses ◽  
Upper Extremity Symptoms

ObjectivesIt has often been suggested that screen work (ie, work on desktop, laptop, notebook or tablet computers) is a risk factor for neck and upper extremity symptoms. However, an up-to-date overview and quantification of evidence are lacking. We aimed to systematically review the association of exposure to screen work with neck and upper extremity symptoms from prospective studies.MethodsAn electronic database search (PubMed, Embase, Cinahl and Scopus) for prospective studies on the association of exposure to screen work and musculoskeletal symptoms was conducted. Studies were synthesised regarding extracted data and risk of bias, and meta-analyses were conducted.ResultsAfter screening 3423 unique references, 19 articles from 12 studies (with 18 538 participants) were included for the current review, with the most recent exposure assessment reported in 2005. Studies described duration and input frequency of screen work (ie, computer, keyboard and mouse use, assessed using self-reports or software recordings) and musculoskeletal symptoms (ie, self-reported neck/shoulder and distal upper extremity symptoms and diagnosed carpal tunnel syndrome [CTS]). Although there was overall an increased occurrence of musculoskeletal symptoms with larger exposure to screen work (relative risk: 1.11 [1.03 1.19]), findings were rather inconsistent with weaker (and statistically non-significant) risks when screen work was assessed by software recording (1.05 [0.91 1.21]) compared to with self-report (1.14 [1.03 1.19]).ConclusionsWe found an increased risk of musculoskeletal symptoms with screen work. However, the evidence is heterogeneous, and it is striking that it lacks information from contemporary screen work using laptop, notebook or tablet computers.

Tapered and non-tapered prosthetic grafts in upper extremity dialysis access: A systematic review and meta-analysis

2020 ◽  
pp. 112972982097417
Author(s):  
Venkata Sai Jasty ◽  
David Haddad ◽  
Babu Mohan ◽  
Wei Zhou ◽  
Jeffrey J Siracuse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Meta Analysis ◽  
Primary Patency ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Significant Difference ◽  
Arteriovenous Grafts ◽  
Meta Analyses ◽  
Steal Syndrome

Objective: It is unclear whether tapered arteriovenous grafts (AVGs) are superior to non-tapered AVGs when it comes to preventing upper extremity ischemic steal syndrome. We aimed to evaluate the outcomes of tapered and non-tapered AVGs using systematic review and meta-analysis. Methods: A literature search was systemically performed to identify all English publications from 1999 to 2019 that directly compared the outcomes of upper extremity tapered and non-tapered AVGs. Outcomes evaluated were the primary patency at 1-year (number of studies ( n) = 4), secondary patency at 1-year ( n = 3), and risk of ischemic steal ( n = 5) and infection ( n = 4). Effect sizes of individual studies were pooled using random-effects model, and between-study variability was assessed using the I2 statistic. Results: Of 5808 studies screened, five studies involving 4397 patients have met the inclusion criteria and included in the analysis. Meta-analyses revealed no significant difference for the risk of ischemic steal syndrome (pooled odds ratio (OR) 0.92, 95% Confidence Incidence (CI) 0.29–2.91, p = 0.89, I2 = 48%) between the tapered and non-tapered upper extremity AVG. The primary patency (OR 1.33, 95% CI 0.93–1.90, p = 0.12, I2 = 10%) and secondary patency at 1-year (OR 1.49, 95% CI 0.84–2.63, p = 0.17, I2 = 13%), and rate of infection (OR 0.62, 95% CI 0.30–1.27, p = 0.19, I2 = 29%) were also similar between the tapered and non-tapered AVG. Conclusions: The risk of ischemic steal syndrome and patency rate are comparable for upper extremity tapered and non-tapered AVGs. This meta-analysis does not support the routine use of tapered graft over non-tapered graft to prevent ischemic steal syndrome in upper extremity dialysis access. However, due to small number of studies and sample sizes as well as limited stratification of outcomes based on risk factors, future studies should take such limitations into account while designing more robust protocols to elucidate this issue.

A Systematic Review and Meta-Analysis of Nutritional Supplementation in Chronic Lower Extremity Wounds

2016 ◽  
Vol 15 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Junna Ye ◽  
Raj Mani
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Sickle Cell ◽  
Meta Analysis ◽  
Nutritional Supplementation ◽  
Cochrane Library ◽  
Similar Data ◽  
Venous Ulcers ◽  
Study Characteristics ◽  
Meta Analyses

A systematic review and meta-analyses of nutritional supplementation to treat chronic lower extremity wounds was done in order to test the premise that impaired nutrition is implicated in healing. The databases of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and EBSCO CINAHL (1972-October 2014) were searched systematically. Only randomized controlled trials in adults with chronic lower extremity wounds were included. Both topical and systemic routes of supplementing nutrition were considered. The primary outcome was wound healing. Study characteristics, outcomes, and risk of bias were extracted by trained researchers and confirmed by the principal investigator. Twenty-three of 278 (8.3%) retrieved articles met the inclusion criteria and were selected. Most of the studies were of unclear or low risk. Overall, nutritional supplementation was favorable (risk ratio [RR] = 1.44, 95% confidence interval [CI] = 1.25-1.66). The systemic route was marginally better than the topical one (RR = 1.51, 95% CI = 1.36-1.67; RR = 1.14, 95% CI = 0.96-1.36, respectively). For venous ulcers, the data showed nutritional supplementation to be significantly beneficial compared to placebo (RR = 1.44, 95% CI = 1.31-1.59). Similar data were found for diabetic foot and sickle cell ulcers (RR = 1.17, 95% CI = 0.93-1.47; RR = 1.56, 95% CI = 0.94-2.60, respectively). These data permit the inferences that nutritional supplementation in the populations studied showed significant benefits in the healing of venous ulcers and tendency (nonsignificant trends) in the healing of diabetic and sickle cell ulcers.

scholarly journals Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 121-145 ◽  
Author(s):  
Joshua Robert Zadro
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Low Back ◽  
Pharmacological Interventions ◽  
Meta Analyses

Background: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBP and are prompting researchers to investigate alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti-inflammatory cytokines that reduce inflammation. These mechanisms might explain the increasing interest in the use of vitamin D supplementation for LBP. Objectives: To determine whether vitamin D supplementation improves pain more than a control intervention for individuals with LBP. Study Design: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Methods: We performed searches in numerous electronic databases combining key words relating to “vitamin D” and “LBP” until March 2017. Studies were included if they investigated vitamin D supplementation in participants with LBP, provided there was a comparison intervention. There was no restriction on the type of LBP, the intervention parameters investigated, or the type of clinical trial (e.g., randomized, non-randomized). Two reviewers independently performed the selection of studies, extracted data, rated the methodological quality of the included studies, and evaluated the overall quality of the evidence using the Grading of Recommendations Assessment, Delevopment, and Evaulation (GRADE) approach. Results: After screening 3,534 articles, 8 clinical trials were included in this systematic review. There is very low quality evidence (based on the GRADE approach) that vitamin D supplementation is not more effective than any intervention (including placebo, no intervention, and other conservative/ pharmacological interventions) (continuous pain measures [0–100]: mean difference [MD] = -2.65, 95% confidence interval [CI]: -10.42 to 5.12, P = 0.504, n = 5; self-reported reduction in pain: pooled odds ratio [OR] = 1.07, 95% CI: 0.35 to 3.26, P = 0.906, n = 5) or placebo/no intervention for individuals with LBP (continuous pain measures: MD = 1.29, 95% CI: -3.81 to 6.39, P = 0.620, n = 4; self-reported reduction in pain: pooled OR = 1.53, 95% CI: 0.38 to 6.20, P = 0.550, n = 4), where ‘n’ is the number of studies included in the meta-analysis. These results did not change when we stratified the meta-analyses by the type of vitamin supplementation (vitamin D3 vs. alfacalcidol) or the type of LBP (non-specific vs. LBP resulting from osteoporosis or vertebral fractures). Limitations: The overall quality of evidence was “very low” due to the poor methodological quality and small sample sizes of the included studies. Conclusions: Vitamin D supplementation is not more effective than placebo, no intervention, or other conservative/pharmacological interventions for LBP (based on very low quality evidence). These results are consistent, regardless of the type of LBP or vitamin D supplementation. Until well-designed and adequately powered clinical trials suggest otherwise, the prescription of vitamin D for LBP cannot be recommended. PROSPERO Registration No: CRD42016046874. www.crd.york.ac.uk/PROSPERO/display_record. asp?ID = CRD42016046874 Key words: Vitamin D, low back pain, chronic low back pain, alfacalcidol, osteoporosis, vertebral fractures, serum 25-hydroxyvitamin D, systematic review

scholarly journals Network meta-analysis for comparative effectiveness of treatments for chronic low back pain disorders: systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e057112
Author(s):  
Daniel L Belavy ◽  
Ashish D Diwan ◽  
Jon Ford ◽  
Clint T Miller ◽  
Andrew J Hahne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Individual Treatment ◽  
Low Back ◽  
Wide Range ◽  
Registration Number ◽  
Meta Analyses

IntroductionChronic low back pain disorders (CLBDs) present a substantial societal burden; however, optimal treatment remains debated. To date, pairwise and network meta-analyses have evaluated individual treatment modes, yet a comparison of a wide range of common treatments is required to evaluate their relative effectiveness. Using network meta-analysis, we aim to evaluate the effectiveness of treatments (acupuncture, education or advice, electrophysical agents, exercise, manual therapies/manipulation, massage, the McKenzie method, pharmacotherapy, psychological therapies, surgery, epidural injections, percutaneous treatments, traction, physical therapy, multidisciplinary pain management, placebo, ‘usual care’ and/or no treatment) on pain intensity, disability and/or mental health in patients with CLBDs.Methods and analysisSix electronic databases and reference lists of 285 prior systematic reviews were searched. Eligible studies will be randomised controlled/clinical trials (including cross-over and cluster designs) that examine individual treatments or treatment combinations in adult patients with CLBDs. Studies must be published in English, German or Chinese as a full-journal publication in a peer-reviewed journal. A narrative approach will be used to synthesise and report qualitative and quantitative data, and, where feasible, network meta-analyses will be performed. Reporting of the review will be informed by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, including the network meta-analysis extension (PRISMA-NMA). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for network meta-analysis will be implemented for assessing the quality of the findings.Ethics and disseminationEthical approval is not required for this systematic review of the published data. Findings will be disseminated via peer-reviewed publication.PROSPERO registration numberPROSPERO registration number CRD42020182039.

scholarly journals Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (22) ◽  
pp. 5327
Author(s):  
Gloria Gonzalez-Medina ◽  
Veronica Perez-Cabezas ◽  
Carmen Ruiz-Molinero ◽  
Gema Chamorro-Moriana ◽  
Jose Jesus Jimenez-Rejano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Pain Scale ◽  
Low Back ◽  
Scientific Databases ◽  
Patient Reported ◽  
Meta Analyses ◽  
And Function

Background: The aim of this systematic review and meta-analysis was to evaluate the global postural re-education (GPR) program’s effectiveness compared to other exercise programs in subjects with persistent chronic low back pain. Methods: A systematic review and meta-analysis were carried out using PRISMA2020. An electronic search of scientific databases was performed from their inception to January 2021. Randomized controlled trials that analyzed pain and patient-reported outcomes were included in this review. Four meta-analyses were performed. The outcomes analyzed were disability due to back pain and pain. The risk of bias and quality of evidence were evaluated. The final search was conducted in March. Results: Seven trials were included, totaling 334 patients. The results showed improvement in pain measured by Visual Analogue Scale (VAS) (Standardised Mean Difference (SMD) = −0.69; 95% Confidence Interval (CI), −1.01 to −0.37; p < 0.0001), Numerical Pain Scale (NRS) (SMD = −0.40; 95% CI, −0.87 to 0.06); p = 0.022), VAS + NRS (SMD = −1.32; 95% CI, −1.87 to −0.77; p < 0.0001) and function (Roland Morris Disability Questionnaire (RMDQ)) (SMD = −0.55; 95% CI, −0.83 to −0.27; p < 0.0001) after GPR treatment. Conclusion: This meta-analysis provides reliable evidence that GPR may be an effective method for treating LBP by decreasing pain and improving function, with strong evidence.

The Effects of Evening-Primrose Oil on Menopausal Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 16 (4) ◽  
pp. 265-276
Author(s):  
Karen Christelle ◽  
Maryam Mohd Zulkfili ◽  
Norhayati Mohd Noor ◽  
Nani Draman
Keyword(s):  
Systematic Review ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Menopausal Symptoms ◽  
Musculoskeletal Symptoms ◽  
Vasomotor Symptoms ◽  
Evening Primrose Oil ◽  
Evening Primrose ◽  
Meta Analyses

Background: Evening primrose oil (EPO) has been a treatment option for reducing menopausal symptoms, but evidence for its use is inadequate. Objective: The study aimed to determine the effectiveness of EPO in treating menopausal symptoms among peri and postmenopausal women. Study design: This is a systematic review with meta-analyses of randomised clinical trials (RCTs). Methods: We searched CENTRAL, Medline, Embase and trial registries for relevant RCTs. The methodology and reporting were carried out grounded on references from the Cochrane collaboration and the preferred reporting items for systematic reviews and meta-analyses statement. Review Manager version 5.3.5 was used to perform all the statistical analyses. Results: Five RCTs, recruiting a total of 402 peri and postmenopausal women were identified. EPO did not reduce the frequency of daily vasomotor symptoms (MD 0.01 episodes, 95% CI -0.54 to 0.57, P=0.960), frequency of daytime hot flash episodes (MD -0.51 episodes, 95% CI -2.05 to 1.03, P=0.510), frequency of night sweat episodes (MD 0.33 episodes, 95% CI -0.48 to 1.13, P=0.430) and severity of vasomotor symptoms (SMD -0.45, 95% CI -1.56 to 0.66, P=0.420) in comparison to control. EPO was associated with a minimal reduction in the severity of overall menopausal symptoms in comparison to control (SMD -1.18; 95% CI-2.18 to -0.18, P=0.02). There were insufficient data to pool results for musculoskeletal symptoms, mood, sexuality, sleeping disorders and quality of life. Conclusion: EPO may reduce the severity of overall menopausal symptoms but is not effective to reduce the frequency and severity of vasomotor symptoms. The evidence quality ranged from very low to moderate. Further research is needed to enhance related evidence.

Is Percutaneous Adhesiolysis Effective in Managing Chronic Low Back and Lower Extremity Pain in Post-surgery Syndrome: a Systematic Review and Meta-analysis

2020 ◽  
Vol 24 (6) ◽  
Author(s):  
Laxmaiah Manchikanti ◽  
Nebojsa Nick Knezevic ◽  
Satya P. Sanapati ◽  
Mahendra R. Sanapati ◽  
Alan D. Kaye ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Low Back ◽  
Post Surgery ◽  
Lower Extremity Pain

scholarly journals Systematic review and meta-analysis of outcomes in patients with suspected deep vein thrombosis

2020 ◽  
Vol 4 (12) ◽  
pp. 2779-2788 ◽  
Author(s):  
Payal Patel ◽  
Parth Patel ◽  
Meha Bhatt ◽  
Cody Braun ◽  
Housne Begum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract After deep vein thrombosis (DVT) is diagnosed, prompt evaluation and therapeutic intervention are of paramount importance for improvement in patient-important outcomes. We systematically reviewed patient-important outcomes in patients with suspected DVT, including mortality, incidence of pulmonary embolism (PE) and DVT, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, Ovid Medline, Embase for eligible studies, references lists of relevant reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data. Nine studies with 5126 patients were included for lower extremity DVT. Three studies with 500 patients were included for upper extremity DVT. Among patients with lower extremity DVT, 0.85% (95% confidence interval [CI], 0% to 2.10%) and 0% developed recurrent DVT and PE, respectively, at 3 months. Among patients with upper extremity DVT, 0.49% (95% CI, 0% to 1.16%) and 1.98% (95% CI, 0.62% to 3.33%) developed recurrent DVT and PE, respectively, at 3 months. No major bleeding events were reported for those anticoagulated, which is lower than in other systematic reviews. For both upper and lower extremity DVT, low pretest probability patients with a negative D-dimer had a comparable incidence of VTE at 3 months (∼1%) as patients with a negative ultrasound (US). At higher pretest probabilities, negative US testing with or without serial US appears to be the safer option. In this review, we summarized the outcomes of patients evaluated by various diagnostic pathways. In most instances, there was significant limitation due to small population size or lack of direct evidence of effects of using a specific pathway. This systematic review was registered at PROSPERO as CRD42018100502.

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