scholarly journals Effect of backward walking training on knee osteoarthritis: protocol of a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040726
Author(s):  
Yuxuan Wu ◽  
Cheng Lei ◽  
Zhimin Huangfu ◽  
Kejimu Sunzi ◽  
Changmei Yang

IntroductionBackward walking (BW) is otherwise known as retrowalking. As opposed to forward walking, BW is a countersequential exercise and is a common method of rehabilitation training and disease-assisted treatment. Studies have shown that BW has a helpful effect on improving lower limb proprioception, gait synergy and improving limb balance. Many studies have concluded that BW can improve the symptoms of patients with knee osteoarthritis (KOA) and can be used for rehabilitation and adjunctive treatment of KOA, but there is a lack of evidence-based medical evidence.This research aims to provide an update to the most recent available evidence on the effect of BW on patients with KOA .Methods and analysesElectronic databases, such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed, will be searched by us. We will include studies identified from citation until 12 May 2020 and will not be restricted by geographical setting. The search will not be limited to the language of the publication, but the study of human subjects. Randomised controlled trials (RCTs) on the BW training of KOA will be included, with outcome measures including pain, knee function or balance function. The quality of included RCTs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. A meta-analysis or systematic review will be performed to summarise the effects of BW training. We will perform sensitivity analysis on the sample size of RCTs, meta-regression analysis of the follow-up periods, dosages and baselines of outcome measures, and publication bias analysis.Ethics and disseminationEthical approval is not required as this study will not involve confidential personal data. The results of this study will be disseminated through a peer-reviewed journal.PROSPERO registration numberCRD42020185694.

2017 ◽  
Vol 35 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Jinhuan Yue ◽  
Ming Liu ◽  
Jun Li ◽  
Yuming Wang ◽  
E-Sing Hung ◽  
...  

Objectives To assess the effectiveness and safety of acupuncture for hiccups following stroke. Methods Medline, Embase, CENTRAL, CINAHL, and four Chinese medical databases were searched from their inception to 1 June 2015. The dataset included randomised controlled trials (RCTs) with no language restrictions that compared acupuncture as an adjunct to medical treatment (effectiveness) or acupuncture versus medical treatment (comparative effectiveness) in stroke patients with hiccups. The Cochrane risk of bias tool was used to assess the methodological quality of the trials. Results Out of 436 potentially relevant studies, five met the inclusion criteria. When acupuncture was compared with other interventions (as sole or adjunctive treatment), meta-analysis revealed a significant difference in favour of cessation of hiccups within a specified time period (CHWST) following intervention when used as an adjunct (risk ratio (RR) 1.59, 95% CI 1.16 to 2.19, I2=0%), but not when used alone (RR 1.40, 95% CI 0.79 to 2.47, I2=65%, ie, high heterogeneity). No safety information was reported in these studies. Conclusions Our systematic review and meta-analysis suggests that acupuncture may be an effective treatment for patients suffering from hiccups following stroke when used as an adjunct to medical treatment. However, due to the limited number of RCTs and poor methodology quality, we cannot reach a definitive conclusion, hence further large, rigorously designed trials are needed.


2020 ◽  
Author(s):  
Zhiqiang Wang ◽  
Ambrish Singh ◽  
Benny Antony

AbstractTurmeric extracts have been used as a remedy for treating arthritis in traditional medicine. Recent years have witnessed the rise of different extracts from turmeric and randomised clinical trials (RCTs) evaluating the efficacy and safety of these extracts for the treatment of knee osteoarthritis (OA). This planned systematic review and meta-analysis aims to assess the efficacy and safety of turmeric extracts for the treatment of knee OA. Biomedical databases such as PubMed, Scopus, and Embase will be searched for RCTs reporting safety and efficacy of turmeric extracts for the treatment of knee OA. Cochrane risk of bias tool will be used to assess the methodological quality of the included studies, and a meta-analysis will be performed to pool the effect estimates.


2019 ◽  
Vol 54 (5) ◽  
pp. 263-271 ◽  
Author(s):  
Andrew Craig Hislop ◽  
Natalie J Collins ◽  
Kylie Tucker ◽  
Margaret Deasy ◽  
Adam Ivan Semciw

ObjectivesTo determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises and ii) the type of hip strengthening exercise with the greatest evidence for improving pain, function and quality of life.DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, Cochrane, CINAHL and SportDiscus databases were searched from inception to January 2018.Eligibility criteria for selecting studiesRandomised controlled trials investigating the effect of adding hip exercises to quadriceps exercises in people with KOA on pain, function and/or quality of life were included. Three subgroups of hip exercises were included: resistance, functional neuromuscular or multimodal exercise.ResultsEight studies were included. Pooled data provide evidence that combined hip and quadriceps exercise is significantly more effective than quadriceps exercise alone for improving walking function (standardised mean difference −1.06, 95% CI −2.01 to −0.12), but not for outcomes of pain (−0.09, 95% CI –0.96 to 0.79), patient-reported function (−0.74, 95% CI –1.56 to 0.08) or stair function (−0.7, 95% CI –1.67 to 0.26). Subgroup analyses reveal that hip resistance exercises are more effective than functional neuromuscular exercises for improving pain (p<0.0001) and patient-reported function (p<0.0001). Multimodal exercise is no more effective than quadriceps strengthening alone for pain (0.13, 95% CI –0.31 to 0.56), patient-reported function (−0.15, 95% CI –0.58 to 0.29) or stair function (0.13, 95% CI –0.3 to 0.57).ConclusionWalking improved after the addition of hip strengthening to quadriceps strengthening in people with KOA. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function.


Author(s):  
Mun Leng Lee ◽  
Patrick Chakravarty ◽  
David Ellul

Objectives: Rhinitis affects up to 40% of the population worldwide and can significantly reduce quality of life. Some patients remain symptomatic despite maximal medical therapy. In refractory cases, posterior nasal neurectomy (PNN - the division of the intranasal nerve branches containing postganglionic parasympathetic fibres) is postulated to reduce symptom burden. The objectives of this paper were to review the literature to establish whether the procedure is effective and safe in the management of allergic and non-allergic rhinitis. Design: A systematic review of Pubmed, EMBASE and MEDLINE was undertaken. Studies were excluded if not available in English or undertaken in non-human subjects. Participants: Seventeen articles satisfied the inclusion criteria studying in total 2029 patients. Sample size ranged from 8-1056. Main Outcome Measures: Patient-reported objective and subjective outcomes and post-operative complications were reviewed Results: There were two randomised controlled trials, two case control studies, and the remaining thirteen were case series using both objective and subjective outcome measures. All but one study found improved patient reported outcomes following PNN. Complications were reported in 10 studies - haemorrhage was the most common complication and was observed in 28 patients (1.6% of subjects). Conclusions: Endoscopic posterior nasal neurectomy is safe and appears to be effective in the treatment of intractable rhinitis but the level of the available evidence was generally poor. Larger, well designed studies are needed to clarify its role in the management of difficult-to-treat rhinitis.


2017 ◽  
Vol 210 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Francesco Bartoli ◽  
Cristina Crocamo ◽  
Massimo Clerici ◽  
Giuseppe Carrà

BackgroundSince bipolar disorder seems to be associated with purinergic system dysfunction, allopurinol might be effective in treating symptoms of mania.AimsTo estimate the efficacy and tolerability of allopurinol as adjunctive treatment for mania symptoms in people with bipolar affective disorder.MethodWe conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effects of adjunctive allopurinol and placebo on mania symptom changes.ResultsFive RCTs were included in the meta-analysis. Participants with allopurinol augmentation had a significantly greater decrease in mania symptoms than those with placebo (SMD= −0.34, P = 0.007), especially in people with the most severe forms of mania. Remission rates, although based on only two studies (n = 177), were significantly higher among individuals receiving allopurinol, whereas for discontinuation and side-effects no difference was found.ConclusionsOur finding of a small to moderate effect size and overall low evidence for add-on allopurinol in reducing mania symptoms indicate that its use in routine practice needs further elucidation.


2020 ◽  
Author(s):  
Abdulmalik Alsaif ◽  
Mohammad Alazemi ◽  
Narvair Kahlar ◽  
Mohammad Karam ◽  
Ahmad Abul ◽  
...  

Introduction There is no consensus on the most superior tonsillectomy technique in adult patients. Recent trials involving coblation technique have shown promising results. Aim The study aims to compare the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy. Methods A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and a search of electronic information was conducted to identify all Randomised Controlled Trials (RCTs) as well as non-randomised studies comparing the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy. Reactionary haemorrhage, delayed haemorrhage and postoperative pain were primary outcome measures. Secondary outcome measures included a return to theatre, administration of analgesia, intraoperative bleeding, diet, the effect on tonsils (degree of healing of tonsillar fossae) and operation time. Fixed effects modelling was used for the analysis. Results Four RCTs and two non-randomised studies were identified enrolling a total of 1824 patients. There were no significant differences between the coblation and bipolar groups in terms of reactionary haemorrhage (Odds Ratio [OR] = 1.81, P = 0.51), delayed haemorrhage (OR = 0.72, P = 0.20) or post-operative pain by day 7 (standardised Mean Difference [MD] = -0.15, P = 0.45). For secondary outcomes, there were no differences noted in terms of intraoperative blood loss, diet and the number of cases returned to theatre. Administration of analgesia was reported to be either insignificant between the two groups or higher in the coblation group Also, the coblation group had longer operation time and greater healing effect on tonsillar tissue. Conclusions Coblation is neither a superior or inferior option when compared to bipolar diathermy used in the current clinical practice for adult patients undergoing tonsillectomy as both techniques have similar haemorrhage rates and post-operative pain whilst also lengthening the operative time in coblation.


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