What are the risk factors for injuries and injury prevention strategies for skiers and snowboarders in terrain parks and half-pipes? A systematic review

ObjectiveTo synthesise the current evidence regarding the risk factors, the injury prevention strategies and the profile of injured skiers and snowboarders in terrain parks (TPs) and half-pipes (HPs).DesignSystematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Data sourcesLiterature searches from six electronic databases and manual searches were performed.Eligibility criteria for selecting studiesInclusion criteria were: (1) publication based on original data; (2) injuries sustained in TPs or HPs; (3) recreational skiing or snowboarding injuries; (4) observational or experimental study design with a comparison group.ResultsNo study explored the risk factors in HPs or the prevention strategies in TPs or HPs. From the literature retrieved, there is strong evidence that skiing or snowboarding in a TP is a risk factor for head, neck, back and severe injuries. Two papers assessed the risk factors for injuries in TPs, mainly demonstrating that features promoting aerial manoeuvres or a large drop to the ground were associated with higher feature-specific injury rates. The profile of injured skiers and snowboarders in TPs described in the literature suggested some evidence of associations between factors including activity, sex, skill level, helmet use, age and TP injuries.Summary/conclusionsThis systematic review demonstrates the need for studies identifying the risk factors for injuries to skiers and snowboarders and on interventions to reduce the risk of injury in TPs and HPs. Studies addressing the issue of TP design should be considered.PROSPERO registration numberCRD42016045206.

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Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2015-094639 ◽

2015 ◽

Vol 49 (13) ◽

pp. 865-870 ◽

Cited By ~ 80

Author(s):

Carolyn A Emery ◽

Thierry-Olivier Roy ◽

Jackie L Whittaker ◽

Alberto Nettel-Aguirre ◽

Willem van Mechelen

Keyword(s):

Systematic Review ◽

Injury Prevention ◽

Meta Analysis ◽

Youth Sport ◽

Neuromuscular Training ◽

Prevention Strategies

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Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017868 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017868

Author(s):

Joey S.W. Kwong ◽

Sheyu Li ◽

Wan-Jie Gu ◽

Hao Chen ◽

Chao Zhang ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Adverse Outcomes ◽

Coronary Revascularisation ◽

Eligibility Criteria ◽

Registration Number ◽

Collection Form ◽

Randomised Controlled ◽

Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099934 ◽

2019 ◽

Vol 53 (17) ◽

pp. 1070-1077 ◽

Cited By ~ 15

Author(s):

Myles Calder Murphy ◽

Mervyn J Travers ◽

Paola Chivers ◽

James Robert Debenham ◽

Sean Iain Docking ◽

...

Keyword(s):

Systematic Review ◽

Natural History ◽

Small Sample Size ◽

Meta Analysis ◽

Achilles Tendinopathy ◽

Small Sample ◽

Current Evidence ◽

Eligibility Criteria ◽

Exercise Interventions ◽

And Function

ObjectiveTo assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy.DesignA systematic review and meta-analysis were conducted as per the PRISMA guidelines.Data sourcesPUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018.Eligibility criteriaRandomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles.ResultsSeven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of −5.65 (-10.51 to −0.79, three studies). However, this difference is unlikely to be clinically significant.ConclusionCurrent evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different.Systematic review registryPROSPERO registration number: CRD4201804493Protocol referenceThis protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? Systematic Reviews 2018; 7: 58

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Effectiveness of Electronic Cigarettes in Smoking Cessation: A Systematic Review and Meta-analysis

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa181 ◽

2020 ◽

Cited By ~ 4

Author(s):

Igor Grabovac ◽

Moritz Oberndorfer ◽

Jismy Fischer ◽

Winfried Wiesinger ◽

Sandra Haider ◽

...

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Random Effects ◽

Electronic Cigarettes ◽

Meta Analysis ◽

Current Evidence ◽

Quality Of Evidence ◽

Registration Number ◽

Meta Analyses

Abstract Introduction Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to assess the current evidence regarding effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo, and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy [NRT] and or counseling) published between 1 January 2014 and 27 June 2020. Data from eligible studies were extracted and used for random-effects meta-analyses (PROSPERO registration number: CRD42019141414). Results The search yielded 13 950 publications with 12 studies being identified as eligible for systematic review (N = 8362) and 9 studies for random-effects meta-analyses (range: 30–6006 participants). The proportion of smokers achieving abstinence was 1.71 (95 CI: 1.02–2.84) times higher in nicotine EC users compared with non-nicotine EC users. The proportion of abstinent smokers was 1.69 (95 CI: 1.25–2.27) times higher in EC users compared with participants receiving NRT. EC users showed a 2.04 (95 CI: 0.90–4.64) times higher proportion of abstinent smokers in comparison with participants solely receiving counseling. Conclusions Our results suggest that nicotine ECs may be more effective in smoking cessation when compared with placebo ECs or NRT. When compared with counseling alone, nicotine ECs are more effective short term, but its effectiveness appears to diminish with later follow-ups. Given the small number of studies, heterogeneous design, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. Implications The results of this study do not allow for a conclusive argument. However, pooling current evidence points toward a potential for ECs as a smoking cessation tool. Though, given the overall quality of evidence, future studies should aim for more clarity in terms of interventions and larger study populations.

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Efficacy, immunogenicity and safety of a recombinant tetravalent dengue vaccine (CYD-TDV) in children aged 2–17 years: systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-019368 ◽

2019 ◽

Vol 9 (3) ◽

pp. e019368 ◽

Cited By ~ 3

Author(s):

Bruno Rodrigues Rosa ◽

Antonio José Ledo Alves da Cunha ◽

Roberto de Andrade Medronho

Keyword(s):

Systematic Review ◽

Incomplete Data ◽

Meta Analysis ◽

Randomised Trials ◽

Dengue Vaccine ◽

Eligibility Criteria ◽

Registration Number ◽

Randomised Controlled

BackgroundRandomised controlled trials have evaluated the recombinant tetravalent dengue vaccine (CYD-TDV). However, individual results may have little power to identify differences among the populations studied.ObjectiveTo evaluate efficacy, immunogenicity and safety of CYD-TDV in the prevention of dengue in children aged 2–17 years.DesignSystematic review and meta-analysis.Data sourcesMEDLINE (from 1950 to 5 December 2018), EMBASE (from 1947 to 5 December 2018) and Cochrane (from 1993 to 5 December 2018).Eligibility criteria of studiesRandomised trials comparing efficacy, immunogenicity and safety of CYD-TDV with placebo or other vaccines for preventing dengue cases in children aged 2–17 years.Outcome measuresEfficacy, immunogenicity and safety of CYD-TDV.Study appraisal and methodsCalculations were made of relative risk (RR) and mean difference (MD) for dichotomous and continuous outcomes, respectively. All estimates were calculated considering a 95% CI estimate. A p<0.05 was considered statistically significant.ResultsNine studies involving 34 248 participants were included. The overall efficacy of CYD-TDV was 60% (RR 0.40 (0.30 to 0.54)). Serotype-specific efficacy of the vaccine was 51% for dengue virus type-1 (DENV-1) (RR 0.49 (0.39 to 0.63)); 34% for DENV-2 (RR 0.66 (0.50 to 0.86)); 75% for DENV-3 (RR 0.25 (0.18 to 0.35)) and 77% for DENV-4 (RR 0.23 (0.15 to 0.34)). Overall immunogenicity (MD) of CYD-TDV was 225.13 (190.34 to 259.93). Serotype-specific immunogenicity was: DENV-1: 176.59 (123.36 to 229.83); DENV-2: 294.21 (181.98 to 406.45); DENV-3: 258.78 (146.72 to 370.84) and DENV-4: 189.35 (141.11 to 237.59). The most common adverse events were headache and pain at the injection site.LimitationsThe main limitation of this study was unclear or incomplete data.Conclusions and implications of key findingsCYD-TDV is considered safe and able to partially protect children and adolescents against four serotypes of DENV for a 1-year period. Despite this, research should prioritise improvements in vaccine efficacy, thus proving higher long-term protection against all virus serotypes.PROSPERO registration numberCRD42016043628.

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Is a low Functional Movement Screen score (≤14/21) associated with injuries in sport? A systematic review and meta-analysis

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000501 ◽

2019 ◽

Vol 5 (1) ◽

pp. e000501 ◽

Cited By ~ 1

Author(s):

Manuel Trinidad-Fernandez ◽

Manuel Gonzalez-Sanchez ◽

Antonio I Cuesta-Vargas

Keyword(s):

Systematic Review ◽

Female Athletes ◽

Meta Analysis ◽

Functional Movement Screen ◽

Eligibility Criteria ◽

Functional Movement ◽

Increased Risk ◽

Registration Number ◽

Definition Of ◽

Evidence Database

ObjectiveTo assess whether Functional Movement Screen (FMS) score is associated with subsequent injuries in healthy sportspeople.DesignSystematic review and meta-analysis.Data sourcesThe following electronic databases were searched to December 2017: Medline, PubMed, PsycINFO, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Scopus, Embase, and Physiotherapy Evidence Database.Eligibility criteria for selecting studiesEligibility criteria included (1) prospective cohort studies that examined the association between FMS score (≤14/21) and subsequent injuries, (2) a sample of healthy and active participants without restrictions in gender or age, and (3) the OR was the effect size and the main outcome.ResultsThirteen studies met the criteria for the systematic review and 12 were included in the meta-analysis. In 5 of the 12 studies, and among female athletes in 1 study, FMS score ≤14 out of 21 points was associated with subsequent injuries. The overall OR of the selected studies in the meta-analysis was 1.86 (95% CI 1.32 to 2.61) and showed substantial heterogeneity (I2=70%).Summary/ConclusionWhether or not a low FMS score ≤14 out of 21 points is associated with increased risk of injury is unclear. The heterogeneity of the study populations (type of athletes, age and sport exposure) and the definition of injury used in the studies make it difficult to synthesise the evidence and draw definitive conclusions.Trial registration numberCRD42015015579.

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Long-Term Growth in Phenylketonuria: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu11092070 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2070 ◽

Cited By ~ 1

Author(s):

Fatma Ilgaz ◽

Alex Pinto ◽

Hülya Gökmen-Özel ◽

Julio César Rocha ◽

Esther van Dam ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Normal Growth ◽

Optimal Growth ◽

Current Evidence ◽

Eligibility Criteria ◽

Dietary Practices ◽

Dietary Treatments ◽

The Impact

There is an ongoing debate regarding the impact of phenylketonuria (PKU) and its treatment on growth. To date, evidence from studies is inconsistent, and data on the whole developmental period is limited. The primary aim of this systematic review was to investigate the effects of a phenylalanine (Phe)-restricted diet on long-term growth in patients with PKU. Four electronic databases were searched for articles published until September 2018. A total of 887 results were found, but only 13 articles met eligibility criteria. Only three studies had an adequate methodology for meta-analysis. Although the results indicate normal growth at birth and during infancy, children with PKU were significantly shorter and had lower weight for age than reference populations during the first four years of life. Impaired linear growth was observed until the end of adolescence in PKU. In contrast, growth impairment was not reported in patients with mild hyperphenylalaninemia, not requiring dietary restriction. Current evidence indicates that even with advances in dietary treatments, “optimal” growth outcomes are not attained in PKU. The majority of studies include children born before 1990s, so further research is needed to show the effects of recent dietary practices on growth in PKU.

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Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-047273 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047273

Author(s):

Mei-Ying Kwan ◽

Kit-Lun Yick ◽

Joanne Yip ◽

Chi-Yung Tse

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Outcome Measurement ◽

Meta Analysis ◽

Outcome Data ◽

Risk Of Bias ◽

Eligibility Criteria ◽

Systematic Analysis ◽

Registration Number ◽

Mean Differences

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

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What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026037 ◽

2019 ◽

Vol 9 (8) ◽

pp. e026037 ◽

Cited By ~ 2

Author(s):

Gillian Sandra Gould ◽

Laura Twyman ◽

Leah Stevenson ◽

Gabrielle R Gribbin ◽

Billie Bonevski ◽

...

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Data Extraction ◽

Meta Analysis ◽

Self Report ◽

Health Providers ◽

Eligibility Criteria ◽

Reporting Practices ◽

Registration Number ◽

Meta Analyses

BackgroundPregnancy is an opportunity for health providers to support women to stop smoking.ObjectivesIdentify the pooled prevalence for health providers in providing components of smoking cessation care to women who smoke during pregnancy.DesignA systematic review synthesising original articles that reported on (1) prevalence of health providers’ performing the 5As (‘Ask’, ‘Advise’, ‘Assess’, ‘Assist’, ‘Arrange’), prescribing nicotine replacement therapy (NRT) and (2) factors associated with smoking cessation care.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO databases searched using ‘smoking’, ‘pregnancy’ and ‘health provider practices’.Eligibility criteria for selecting studiesStudies included any design except interventions (self-report, audit, observed consultations and women’s reports), in English, with no date restriction, up to June 2017.ParticipantsHealth providers of any profession.Data extraction, appraisal and analysisData were extracted, then appraised with the Hawker tool. Meta-analyses pooled percentages for performing each of the 5As and prescribing NRT, using, for example, ‘often/always’ and ‘always/all’. Meta-regressions were performed of 5As for ‘often/always’.ResultsOf 3933 papers, 54 were included (n=29 225 participants): 33 for meta-analysis. Health providers included general practitioners, obstetricians, midwives and others from 10 countries. Pooled percentages of studies reporting practices ‘often/always’ were: ‘Ask’ (n=9) 91.6% (95% CI 88.2% to 95%); ‘Advise’ (n=7) 90% (95% CI 72.5% to 99.3%), ‘Assess’ (n=3) 79.2% (95% CI 76.5% to 81.8%), ‘Assist (cessation support)’ (n=5) 59.1% (95% CI 56% to 62.2%), ‘Arrange (referral)’ (n=6) 33.3% (95% CI 20.4% to 46.2%) and ‘prescribing NRT’ (n=6) 25.4% (95% CI 12.8% to 38%). Heterogeneity (I2) was 95.9%–99.1%. Meta-regressions for ‘Arrange’ were significant for year (p=0.013) and country (p=0.037).ConclusionsHealth providers ‘Ask’, ‘Advise’ and ‘Assess’ most pregnant women about smoking. ‘Assist’, ‘Arrange’ and ‘prescribing NRT’ are reported at lower rates: strategies to improve these should be considered.PROSPERO registration numberCRD42015029989.

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Cycling is associated with a lower incidence of cardiovascular diseases and death: Part 1 – systematic review of cohort studies with meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099099 ◽

2019 ◽

Vol 53 (14) ◽

pp. 870-878 ◽

Cited By ~ 6

Author(s):

Solveig Nordengen ◽

Lars Bo Andersen ◽

Ane K Solbraa ◽

Amund Riiser

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Systematic Review ◽

Dose Response ◽

Meta Analysis ◽

Effect Estimate ◽

Cvd Risk ◽

Eligibility Criteria ◽

Relative Risks ◽

Quantitative Studies

ObjectivesPhysical inactivity is a risk factor for cardiovascular disease (CVD). Cycling as a physical activity holds great potential to prevent CVD. We aimed to determine whether cycling reduces the risk of CVD and CVD risk factors and to investigate potential dose-response relationships.DesignSystematic review and meta-analysis of quantitative studies.Eligibility criteria for selecting studiesWe searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD incidence, mortality or risk factors were reported. Studies were excluded when they reported continuous outcomes or when cycling and walking were combined in them. We pooled adjusted relative risks (RR) and OR. Heterogeneity was investigated using I.ResultsThe search yielded 5174 studies; 21 studies which included 1,069,034 individuals. We found a significantly lower association in combined CVD incidence, mortality and physiological risk factors with total effect estimate 0.78 (95% CI (CI): 0.74–0.82; P<0.001; I2=58%). Separate analyses for CVD incidence, mortality and risk factors showed estimates of RR 0.84 (CI, 0.80 to 0.88; P<0.001; I2=29%), RR 0.83 (CI, 0.76 to 0.90; P<0.001; I2=0%), and OR 0.75 (CI, 0.69 to 0.82; P<0.001; I2=66%), respectively. We found no dose-response relationship or sex-specific difference.ConclusionsAny form of cycling seems to be associated with lower CVD risk, and thus, we recommend cycling as a health-enhancing physical activity.Systematic review registrationProspero CRD42016052421.

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