Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis

2017 ◽  
Vol 31 (10) ◽  
pp. 1292-1304 ◽  
Author(s):  
Silvia GR Neri ◽  
Jefferson R Cardoso ◽  
Lorena Cruz ◽  
Ricardo M Lima ◽  
Ricardo J de Oliveira ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Fear Of Falling ◽  
Random Sequence ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Large Variability ◽  
Positive Effects

Objective: To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly. Data sources: An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials. Review method: Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias. Results: A total of 28 studies met the inclusion criteria and were appraised ( n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3–6 and 8–12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. Conclusion: Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.

scholarly journals Overuse and underuse of cardiovascular diagnostic and therapeutic procedures for community-dwelling adults: a protocol for a systematic review

2021 ◽  
Vol 4 ◽  
pp. 99
Author(s):  
Dominic Quinn ◽  
David Byrne ◽  
Tom Fahey ◽  
Rose Anne Kenny ◽  
Christine McGarrigle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Cost Effective ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Healthcare Intervention ◽  
Cross Sectional ◽  
International Guidelines

Background: Potentially inappropriate care can result from overuse or underuse of treatments, tests, or procedures. Overuse is defined as the use of health services with no clear benefit to the recipient or where harms outweigh benefits and/or costs of care. Underuse is defined as failure to deliver an effective and cost-effective healthcare intervention. Cardiovascular procedures such as coronary artery bypass grafting, carotid endarterectomy, coronary angiography, and coronary angioplasty (with/without stenting) are potentially both underused and overused. This systematic review aims to identify rates of potential overuse and underuse of these cardiovascular procedures and explore any associated patient or healthcare system factors. Methods: A systematic review and meta-analysis will be conducted in accordance with the PRISMA guidelines. A systematic search of MEDLINE (via Ovid), Embase, Cumulative Index to Nursing and Allied Health Literature and the Cochrane library will be conducted using a predefined search strategy.  Eligible studies for inclusion will examine rates of overuse and underuse of cardiovascular procedures, measured against national/international guidelines, for adults aged ≥18 years. Primary observational studies including cross-sectional and cohort studies will be included. Titles, abstracts, and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standardised form. Risk of bias for all included studies will be assessed using a modified version of the Hoy risk of bias tool. Where adequate data exists, and if statistically appropriate, meta-analyses will be conducted. If statistical pooling of the data is not possible, the findings will be narratively summarised focusing on the review’s objectives. Conclusion: This systematic review will examine overuse and underuse of cardiovascular procedures for adults.  The results will help inform policy makers, researchers, patients, and clinicians in the appropriate use of these procedures, in line with international guidelines. Registration: This protocol has been submitted for registration on PROSPERO (CRD42021239041).

scholarly journals Effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Positive Effects ◽  
Meta Analyses

Abstract Objectives To examine the effectiveness and safety of yoga for women with sleep problems by performing a systematic review and meta-analysis.Methods Medline/PubMed, Clincalkey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), or objective instruments, such as polysomnography, actigraphy, and safety of the intervention. For each outcome, standardized mean difference (SMD) and 95% confidence intervals (CIs) were determined. Results Nineteen studies including 1832 participants were included in this systematic review. Meta-analyses revealed positive effects of yoga using PSQI or ISI scores in 16 randomized control trials (RCTs) compared with the control group in improving sleep quality in women, PSQI (SMD = −0.54; 95% CI = −0.89 to −0.19 ; P = 0.003). However, three RCTs revealed no effects of yoga compared with the control group in reducing the severity of insomnia in women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = −0.15 ; 95% CI = −0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri-or postmenopausal women using PSQI (SMD = −0.31; 95% CI = −0.95 to 0.33; P = 0.34).Yoga was not associated with serious adverse events. Discussion This systematic review and meta-analysis found that yoga intervention in some groups of women was beneficial in managing sleep problems. Despite certain disadvantages in methodology in the included studies, yoga may be recommended as a complementary therapy to women.

scholarly journals The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Positive Effects ◽  
Meta Analyses

Abstract Background: To examine the effectiveness and safety of yoga of women with sleep problems by performing a systematic review and meta-analysis. Methods: Medline/PubMed, ClinicalKey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June, 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep QualityIndex (PSQI),Insomnia Severity Index (ISI), or objective instruments such as polysomnography, actigraphy, and safety of the intervention. For each outcome, a standardized mean difference (SMD) and confidence intervals (CIs) of 95% were determined. Results: Nineteen studies in this systematic review included 1832 participants. The meta-analysis of the combined data conducted according to Comprehensive Meta-Analysis showed a significant improvement in sleep (SMD =−0.327, 95% CI=−0.506 to −0.148,P<0.001).Meta-analyses revealed positive effects of yoga using PSQI scores in 16 randomized control trials (RCTs), compared with the control group in improving sleep quality among women usingPSQI (SMD = −0.54; 95% CI = −0.89 to −0.19; P = 0.003). However, three RCTs revealed no effects of yoga compared to the control groupin reducing insomnia among women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69).Yoga was not associated with any serious adverse events. Discussion: This systematic review and meta-analysis demonstrated that yoga intervention in women can be beneficial whencompared to non-active control conditions in term of managing sleep problems.The moderator analyses suggest that participants in the non-breast cancer subgroup and participants in the non-peri/postmenopausal subgroup were associated with greater benefits, with a direct correlation of total class time with quality of sleep among other related benefits.

scholarly journals Effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Meta Analysis ◽  
Complementary Therapy ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Positive Effects ◽  
Meta Analyses

Abstract Objectives To examine the effectiveness and safety of yoga for women with sleep problems by performing a systematic review and meta-analysis.Methods Medline/PubMed, Clincalkey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep qualityor the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), or objective instruments, such as polysomnography, actigraphy, and safety of the intervention. For each outcome, standardized mean difference (SMD) and 95% confidence intervals (CIs) were determined.Results Nineteen studies including 1832 participants were included in this systematic review. Meta-analyses revealed positive effects of yoga using PSQI or ISI scores in 16 randomized control trials (RCTs) compared with the control group in improving sleep quality in women, PSQI (SMD = −0.54; 95% CI = −0.89 to −0.19 ; P = 0.003). However, three RCTs revealed no effects of yoga compared with the control group in reducing the severity of insomnia in women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = −0.15 ; 95% CI = −0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri-or postmenopausal women using PSQI (SMD = −0.31; 95% CI = −0.95 to 0.33; P = 0.34).Yoga was not associated with serious adverse events.Discussion This systematic review and meta-analysis found that yoga intervention in some groups of women was beneficial in managing sleep problems. Despite certain disadvantages in methodology in the included studies, yoga may be recommended as a complementary therapy to women.

scholarly journals The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Positive Effects ◽  
Meta Analyses

Abstract Objectives: To examine the effectiveness and safety of yoga of women with sleep problems by performing a systematic review and meta-analysis. Methods: Medline/PubMed, ClinicalKey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June, 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep QualityIndex (PSQI),Insomnia Severity Index (ISI), or objective instruments such as polysomnography, actigraphy, and safety of the intervention. For each outcome, a standardized mean difference (SMD) and confidence intervals (CIs) of 95% were determined. Results: Nineteen studies in this systematic review included 1832 participants. The meta-analysis of the combined data conducted according to Comprehensive Meta-Analysis showed a significant improvement in sleep (SMD =−0.327, 95% CI=−0.506 to −0.148,P<0.001).Meta-analyses revealed positive effects of yoga using PSQI scores in 16 randomized control trials (RCTs), compared with the control group in improving sleep quality among women usingPSQI (SMD = −0.54; 95% CI = −0.89 to −0.19; P = 0.003). However, three RCTs revealed no effects of yoga compared to the control groupin reducing insomnia amongwomen using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69).Yoga was not associated with any serious adverse events. Discussion: This systematic review and meta-analysis demonstrated that yoga intervention in women can be beneficial whencompared to non-active control conditions in term of managing sleep problems.The moderator analyses suggest that participants in the non-breast cancer subgroup and participants in the non-peri/postmenopausal subgroup were associated with greater benefits, with a direct correlation of total class time with quality of sleep among other related benefits.

scholarly journals Fall Prevention in Community-Dwelling Adults with Mild to Moderate Cognitive Impairment: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Megan Racey ◽  
Maureen Markle-Reid ◽  
Donna Fitzpatrick-Lewis ◽  
Muhammad Usman Ali ◽  
Hélène Gagné ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Exercise Interventions ◽  
Prevention Interventions ◽  
Risk Of Falls

Abstract Background: Cognitive impairment (CI) increases an individual’s risk of falls due to the role cognition plays in gait control. Older adults with dementia fall 2-3 times more than cognitively healthy older adults and 60-80% of people with dementia fall annually. Practitioners require evidence-based fall prevention best practices to reduce the risk of falls in cognitively impaired adults living in the community. Methods: We conducted a systematic review and meta-analysis to identify the effectiveness of primary and secondary fall prevention interventions in reducing falls and fear of falling, and improving gait, balance, and functional mobility. We searched 7 databases for fall prevention interventions involving community-dwelling adults ≥50 years with mild to moderate CI. Reviewers screened citations, extracted data, and assessed risk of bias and certainty of evidence (GRADE). We assessed statistical and methodological heterogeneity and performed a meta-analysis of studies including subgroup analysis based on intervention and risk of bias groupings.Results: 509 community-dwelling adults (mean age 67.5 to 84.0 years) with mild to moderate CI from 12 randomized or clinical controlled trials (RCTs/CCTs) were included in this review. Eight studies were exercise interventions, 3 were multifactorial, and 1 provided medication treatment. Fall prevention interventions had significant effects of medium magnitude on fear of falling (standardized mean difference (SMD) -0.73 [-1.10, -0.36]), balance (SMD 0.66 [0.19, 1.12]), and functional mobility measured as Timed Up and Go test (SMD -0.56 [-0.94, -0.17]) and significant effects of small magnitude on gait control (SMD 0.26 [0.08, 0.43]) all with moderate certainty of evidence. The meta-analysis showed no significant effects for falls (number of events or falls incidence). Sub-analysis showed that exercise and low risk of bias studies remained significant for balance and perceived risk of falls.Conclusion: The effect of fall prevention interventions on direct outcomes, such as falls, remains unclear in cognitively impaired individuals. Exercise interventions are effective at improving fall risk factors, however, high quality studies with longer follow-up and adequate sample sizes are needed to determine their effectiveness on falls directly. There remains a gap in terms of effective fall prevention interventions for older adults with CI.

scholarly journals Non-pharmacological interventions for fatigue in older adults: a systematic review and meta-analysis

2020 ◽  
Vol 49 (3) ◽  
pp. 341-351
Author(s):  
Lily Y W Ho ◽  
Shamay S M Ng
Keyword(s):  
Older Adults ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Long Term Effects ◽  
Pharmacological Interventions ◽  
Post Intervention ◽  
Positive Effects ◽  
Community Dwelling Older Adults

Abstract Background Non-pharmacological interventions are widely used to treat fatigue in clients with specific diseases but the findings may not be applicable to older adults experiencing fatigue, which also relates to the physiological changes of ageing. Non-pharmacological interventions for fatigue alleviation in older adults have not been reviewed and meta-analysed. Objective To evaluate the immediate and long-term effects of non-pharmacological interventions on fatigue in community-dwelling older adults. Methods Randomised controlled trials published from 2008 to May 2018 were searched in CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PubMed and Web of Science databases. The reference lists of the publications, forward citation and clinical trial registries were also reviewed. Relevant data were extracted and meta-analysis was conducted using Cochrane Review Manager 5.3. Results Eight studies, with a total of 1093 participants, were identified. Non-pharmacological interventions included mindfulness meditation, a behavioural lifestyle programme, muscle relaxation, pet insect-assisted therapy, yoga, Tai Chi and cognitive behavioural therapy. Non-pharmacological interventions elicited significant immediate positive effects on fatigue (SMD: −0.40, 95% CI −0.62 to −0.18), although there was no lasting effect. Both physical and cognitive/mental interventions effectively alleviated fatigue. Conclusion Non-pharmacological interventions appear to be effective in alleviating fatigue at immediate post-intervention in community-dwelling older adults. More studies with robust designs and adequate sample sizes are needed in the future.

scholarly journals Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: A systematic review and meta- analysis

2021 ◽  
Author(s):  
Jialu Qian ◽  
Shiwen Sun ◽  
Lu Liu ◽  
Xiaoyan Yu
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Physical Therapy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Ongoing Research ◽  
Positive Effects ◽  
Postpartum Fatigue ◽  
Psychoeducational Interventions

Abstract Background: Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. However, postpartum fatigue is an ongoing research issue but is seldom treated. This systematic review and meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae.Methods: The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until February 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions for postpartum fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. The meta-analysis was conducted using Review Manager 5.3.Results: Seventeen published clinical trials matched the eligibility criteria for the systematic review, and thirteen studies involving 1686 participants were included in this meta-analysis. The results of the meta-analysis revealed that exercise (SMD= -1.74, 95% CI=-2.61 to -0.88), physical therapy (SMD= -0.50, 95% CI=-0.96 to -0.03) and drinking tea (MD= -3.12, 95% CI=-5.44 to -0.80) resulted in significant improvements in women’s postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD= -2.89, 95% CI=-4.30 to -1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed.Conclusions: This review provides evidence that exercise, physical therapy and drinking tea are effective nonpharmacological interventions for relieving postpartum fatigue. Detailed instructions for postpartum exercise should be offered to puerperae. Physical therapy could be used in combination to enhance the intervention efficacy. Multiple daily cups of tea may be recommended. Psychoeducational interventions were ineffective for postpartum fatigue, but they could be integrated with the internet or smartphones to improve their effectiveness in the future. Fatigue-related nonpharmacological interventions of psychological outcomes still need to be studied.

scholarly journals PROGRAM CHARACTERISTICS ASSOCIATED WITH REDUCED FEAR OF FALLING: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RCTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S19-S19
Author(s):  
Marlot Kruisbrink ◽  
Kim Delbaere ◽  
Gertrudis Kempen ◽  
Rik Crutzen ◽  
G A Rixt Zijlstra
Keyword(s):  
Older People ◽  
Contact Time ◽  
Fear Of Falling ◽  
Data Extraction ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Community Setting ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Future Research

Abstract Fear of falling (FOF) is common among older people and can result in activity avoidance and decreased physical functioning. Different types of interventions have demonstrated significant small reductions in FOF. To optimize effect sizes, we sought to identify characteristics of interventions that were associated with a change in FOF. Five scientific databases were searched for articles using randomized controlled trial designs in community-dwelling older people without medical conditions. Data extraction included intervention type, setting, group format, type of supervision, provider, delivery format, duration, number of sessions, contact time, and risk of bias (assessed with the Cochrane Collaboration’s Risk of Bias Tool). After screening of titles, abstracts, and full texts, 55 unique studies – reporting on 68 interventions – were systematically reviewed. The majority of interventions focused on exercise (n=50). Interventions were performed at home (n=21) or in a community setting (n=23), were delivered in a group (n=26) or individual (n=30) format, and were often supervised (n=60) and delivered face-to-face (n=56). Duration ranged from 1 to 52 weeks and total contact time with the provider from 2 to 56 hours. Results of 42 interventions were suitable for meta-analysis. Univariate meta-regressions to evaluate associations between intervention characteristics and intervention effects directly after the intervention yielded no significant results. Due to self-reported outcomes and difficulties with blinding, risk of bias was high in all studies. To conclude, intervention characteristics were not associated with changes in FOF in this study. Possible reasons for an absence of associations and future research directions will be discussed.

scholarly journals Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jialu Qian ◽  
Shiwen Sun ◽  
Lu Liu ◽  
Xiaoyan Yu
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Significant Risk ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Start Time ◽  
Positive Effects ◽  
Skin Contact ◽  
Postpartum Fatigue

Abstract Background Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. This meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae. Methods The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until June 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions conducted during 0 ~ 78 weeks postpartum for fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. Cohen’s kappa coefficient was used to measure inter-rater agreement. The meta-analysis was conducted using Review Manager 5.3. Results Seventeen published clinical trials matched the eligibility criteria and ten studies involving 1194 participants were included in this meta-analysis. The intervention start time varied from immediately postpartum care to 1 year after delivery, and duration ranged from 1 day to 3 months. The results revealed that exercise (SMD = − 1.74, 95% CI = -2.61 to − 0.88) and drinking tea (MD = − 3.12, 95% CI = -5.44 to − 0.80) resulted in significant improvements in women’s postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD = − 2.89, 95% CI = -4.30 to − 1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed. Physical therapies including mother-infant skin-to-skin contact, taking warm showers and breathing lavender oil aroma were used for reducing postpartum fatigue. No significant risk of publication bias was found. Small number of included studies and sample sizes, not time-matched conditions of control groups, high heterogeneity and the risk of bias within the included studies were the main limitations of our review. Conclusions This review provides evidence that exercise and drinking tea may be effective nonpharmacological interventions for relieving postpartum fatigue. More effective and targeted exercise programs need to be further studied. Rigorous RCTs of drinking tea are needed. Caution is required when interpreting the findings due to the limitations of our study. Further studies are still needed to validate our findings and increase confidence in the results.

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