scholarly journals Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis

2020 ◽  
pp. 026921552097510
Author(s):  
Xin Li ◽  
Jie Shen ◽  
Juping Liang ◽  
Xuan Zhou ◽  
Yuqi Yang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cobb Angle ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Trunk Rotation ◽  
Serious Adverse Events ◽  
Scoliosis Research Society ◽  
Significant Difference

Objective: To systematically assess the effectiveness of core-based exercise for correcting a spinal deformity and improving quality of life in people with scoliosis. Data sources: The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science databases were searched from inception up to September 30, 2020. Methods: Clinical controlled trials were eligible if they compared the effectiveness of core-based exercise to other nonsurgical interventions in people with scoliosis. The revised Cochrane risk of bias assessment tool for randomized trials and the methodological index for non-randomized studies scale were used to assess the risk of bias. The outcomes included the Cobb angle, the angle of trunk rotation and quality of life. RevMan 5.3 was used, and intergroup differences were determined by calculating mean differences (MD) and 95% confidence intervals (CIs). Results: After screening 1348 studies, nine studies with 325 participants met the inclusion criteria. The exercise group had significantly lower Cobb angles (MD = −2.08, 95% CI: −3.89 to −0.28, P = 0.02) and significantly better quality of life as measured by the Scoliosis Research Society-22 questionnaire (MD = 0.25, 95% CI: 0.02 to 0.49, P = 0.03) than the control groups. However, no significant difference was observed regarding the angle of trunk rotation between groups (MD = −0.69, 95% CI: −2.61 to 1.22, P = 0.48). Furthermore, no serious adverse events were reported. The overall quality of evidence ranged from low to very low. Conclusion: Core-based exercise may have a beneficial role in reducing the Cobb angle and improving quality of life in people with scoliosis in the short term. PROSPERO registration number: CRD42020160509 (Available at http://www.crd.york.ac.uk/prospero/ )

scholarly journals Tiotropium (SPIRIVA®) in mild COPD: Is it worth it?

2019 ◽  
Vol 46 (1) ◽  
Author(s):  
Lina Mahmoud ◽  
Hannah Ng ◽  
Jade Roberts
Keyword(s):  
Quality Of Life ◽  
Exercise Duration ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Serious Adverse Events ◽  
Main Trial ◽  
Copd Exacerbations ◽  
Increased Risk ◽  
Significant Difference

Purpose:Tiotropium (SPIRIVA®) is used in the treatment of moderate to severe chronic obstructive pulmonary disease (COPD) in patients with persistent dyspnea despite using a short acting bronchodilator (SABD).This paper explores the role of tiotropium in the treatment of mild COPD. Methods:The Cochrane Library, EMBASE, Pubmed, and Clinicaltrials.gov were searched on February 2018.We included randomized controlled trials (RCTs) that evaluated tiotropium in patients with mild COPD.Three authors assessed studies for eligibility. Outcomes included symptoms, quality of life, exercise duration, lung function, COPD exacerbations and hospitalizations, and serious adverse events. Results: Three RCTs were selected as the best available evidence. Based on the results of the main trial, quality of life and symptoms were improved with tiotropium as compared to placebo with a difference between groups at 24 months to be 1.2 (95% CI: 0.5 to 1.9; p=0.0011) using the COPD Assessment test (CAT) score. Frequency of acute exacerbations of COPD (AECOPD) requiring hospitalization was reduced by 10.3% (28.9% with tiotropium vs 39.2% with placebo) in patients receiving tiotropium. One RCT reported no statistically significant difference in exercise duration (27 ± 27 secs) in the tiotropium group vs 50 ± 21 secs in the placebo group; (p=0.4153). Oropharyngeal discomfort was more common with tiotropium (number needed to harm of 12) compared to placebo. Conclusions: Evidence suggests that tiotropium may reduce COPD exacerbations and hospitalizations and improve quality of life in patients with mild COPD.There is an increased risk of oropharyngeal discomfort with tiotropium.

Complementary therapies in controlling side-effects during cancer treatment

2021 ◽  
Vol 9 (7) ◽  
pp. 238-265
Author(s):  
Vinicius Teixeira Botelho ◽  
MELINE ROSSETTO RODRIGUES ◽  
Guilherme Augusto Rago Ferraz ◽  
Cassiana Mendes Bertoncello Fontes ◽  
Maria Helena Borgato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Side Effects ◽  
Randomized Clinical Trials ◽  
Care Center ◽  
Tertiary Care ◽  
Risk Of Bias ◽  
Anxiety Control ◽  
Significant Difference

This systematic review evaluated whether reiki had an impact on patients undergoing chemo-therapy, with possible improvement of the following outcomes: fatigue, pain, anxiety and quality of life. Method: Systematic review study with meta-analysis conducted at a tertiary care center. The following databases were searched until July 2020: MEDLINE, LILACS and CENTRAL. Two re-viewers independently examined eligible articles, extracted data and assessed the risk of bias using the Cochrane tool. Results: The analyzes included eight studies and showed that there was a sta-tistically significant for anxiety control (MD = -2-09; 95% CI: -3.00 to -1.19; I2 = 51%) and Quality of life (MD = -5.97; 95% CI: -10.70 to -1.25; I2 = 97%) but no statistically significant difference was found for the other outcomes analyzed. An analysis of the risk of bias has uncertain methodological limitations in the studies. Conclusions: Although there is anxiety control and improved quality of life, there is a need for the elaboration of randomized clinical trials with larger populations to verify their real performance in controlling some side effects during chemotherapy.

scholarly journals Exercise and Quality of Life in Women with Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 17 (19) ◽  
pp. 7049
Author(s):  
Thi Mai Nguyen ◽  
Thi Thanh Toan Do ◽  
Tho Nhi Tran ◽  
Jin Hee Kim
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trials ◽  
Risk Of Bias ◽  
Menopausal Symptoms ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Study Objective ◽  
Positive Effects ◽  
Randomized Controlled

Menopausal symptoms are associated with deterioration in physical, mental, and sexual health, lowering women’s quality of life (QoL). Our study objective is to examine the effect of exercise on QoL in women with menopausal symptoms. After initially identifying 1306 studies published on PubMed, Web of Science, Scopus, and Cochrane Library before June 2020, two researchers independently selected nine randomized controlled trials (RCTs) in which any type of exercise was compared with no active treatment. We assessed the risk of bias in the included studies using the Cochrane risk-of-bias 2.0 tool for RCTs and computed the converged standardized mean difference with a 95% confidence interval. We found evidences for the positive effects of exercise on physical and psychological QoL scores in women with menopausal symptoms. However, there was no evidence for the effects of exercise on general, social, and menopause-specific QoL scores. The most common interventions for women with menopausal and urinary symptoms were yoga and pelvic floor muscle training (PFMT), respectively. In our meta-analyses, while yoga significantly improved physical QoL, its effects on general, psychological, sexual, and vasomotor symptoms QoL scores as well as the effect of PFMT on general QoL were not significant. Our findings suggest that well-designed studies are needed to confirm the effect of exercise on QoL in women with menopausal symptoms.

The use of posture-correcting shirts for managing musculoskeletal pain is not supported by current evidence – a scoping review of the literature

2019 ◽  
Vol 19 (4) ◽  
pp. 659-670
Author(s):  
Thorvaldur Skuli Palsson ◽  
Mervyn J. Travers ◽  
Trine Rafn ◽  
Stian Ingemann-Molden ◽  
J.P. Caneiro ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Scoping Review ◽  
Management Strategy ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Cochrane Library ◽  
Management Approach ◽  
Clinical Populations

Abstract Background and aims The concept of bad posture being a dominant driver of pain is commonly held belief in the society. This may explain the significant attention supportive clothing such as posture-correcting shirts has recently gained in Scandinavia and the USA. The aim of this scoping review was to present an overview and synthesis of the available evidence for the use of posture-correcting shirts aimed at reducing pain or postural discomfort and optimising function/posture. Methods A systematic search was conducted for literature investigating the effect of posture-correcting shirts on musculoskeletal pain or function. PubMed, Embase, CINAHL, PEDro and the Cochrane Library were searched for relevant literature. Results of the searches were evaluated by two independent reviewers in three separate steps based on title, abstract and full text. For data synthesis, the population, intervention, comparator and outcome were extracted. The quality of the literature was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the risk of bias was assessed using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool or the RoB 2.0 tool for individually randomized, parallel group trials. The overall confidence in the literature was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results A total of 136 articles were identified and six of these were included in the review. These studies were heterogeneous with regards to aims, outcomes and methods, presenting contrasting results. The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity. The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence. An important limitation of all studies was that they were conducted in pain-free individuals. Conclusions The contrasting findings and the low quality of current literature, questions the intended effect of posture-correcting shirts and whether the changes it creates are in fact useful for clinical practice. Moreover, the findings are contrasted by the available evidence regarding posture and pain with a particular focus on whether this management strategy may have a detrimental effect on people living with musculoskeletal pain. A major limitation to the existing literature on the effect of posture-correcting shirts is that no studies have investigated their effect in clinical populations. Implications Based on the available literature and the major limitation of no studies investigating clinical populations, there is no good quality evidence to support recommendation of posture-correcting shirts as a management strategy for musculoskeletal pain. Promotion of this product may reinforce the inaccurate and unhelpful message that poor posture leads to pain. The efficacy of such garments should be tested in clinical populations and not only in pain-free individuals, to assess whether there is any meaningful benefit of this management approach. Until then, the use of posture-correcting shirts for musculoskeletal pain is not supported by current evidence.

416 A NARRATIVE SYSTEMATIC REVIEW OF POSTOPERATIVE REHABILITATION FOLLOWING SURGERY FOR ESOPHAGEAL CANCER

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
P Prasad ◽  
K Hardy ◽  
J Chmelo ◽  
M Navidi ◽  
A Phillips
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Positive Impact ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Risk Of Bias ◽  
Moderate Intensity ◽  
Cochrane Library ◽  
The Impact

Abstract   Esophagectomy is a complex procedure with associated high levels of morbidity. Rehabilitation programmes are being developed and increasingly utilised in the perioperative period and comprise a variety of physical, nutritional and psychological interventions. Such strategies may help reduce the incidence of postoperative complications, mitigate sarcopenia, prevent progressive frailty and restore quality of life. This systematic review aimed to identify and analyse studies reporting outcomes of post-esophagectomy rehabilitative interventions. Methods Major reference databases (PubMed, Medline, EMBASE, Cochrane Library and Google scholar) were interrogated and a systematic search with a pre-defined search strategy was performed up until January 2020. All eligible articles were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria for cohort studies and the Cochrane risk of bias tool for randomised studies. Results Three studies (n = 1 pilot study; n = 1 feasibility study and n = 1 randomised controlled trial) including some 108 patients were included in this narrative review, of whom 64 patients had undergone esophagectomy. Rehabilitative strategies utilised included a combination of physical activities such as walking and low- to moderate-intensity exercises, dietary counselling, psychological support and occupational therapy input. There was wide variation in the outcomes assessed between studies. Postoperative physical activity with exercises consistently demonstrated maximum positive impact upon cardiopulmonary fitness. The median MINORS score for included studies was 9 (8-10) and the risk of bias in the included randomised trial was low. Conclusion There is a paucity of data currently to help determine the impact that rehabilitation may have on clinical outcomes and quality of life following esophagectomy. While improved physical function has been demonstrated, there is a need to determine which interventions patients deem most important and acceptable to help them return to as close to baseline as possible. Additionally, there is a need to further understand the impact rehabilitation may have upon long-term outcomes.

Self-evaluation of Trunk Aesthetics in Conservatively Treated Children and Adolescents with Idiopathic Scoliosis

2018 ◽  
Vol 20 (5) ◽  
pp. 371-382
Author(s):  
Maciej Lendzion ◽  
Ewa Łukaszewicz ◽  
Jakub Waś ◽  
Dariusz Czaprowski
Keyword(s):  
Quality Of Life ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Trunk Rotation ◽  
Self Evaluation ◽  
Trunk Deformity ◽  
Polish Version ◽  
Scoliosis Treatment ◽  
The Impact

Background. Trunk deformity is an important manifestation of idiopathic scoliosis (IS). Patients’ perception of spinal deformity and its impact on their quality of life (QoL) are important aspects of scoliosis treatment. The aim of this study was to determine the correlation between radiographic parameters (Cobb angle), clinical parameters (angle of trunk rotation, ATR), and the type of conservative treatment used vs the perception of trunk aesthetics as well as QoL in IS patients. Material and methods. The study enrolled 90 subjects (68 females, 22 males) diagnosed with IS (age: 9-18 years, 14.3± 2.1; Cobb angle 10-66°, 22.2°±12.2; ATR 2-20°, 7.6°±3.9). The study group was divided into (1) patients treated with bracing and physiotherapy (n=35) and (2) subjects undergoing physiotherapy alone (n=55). The perception of trunk deformity was analysed with the TAPS visual scale. QoL was measured with the Polish version of the SRS-22 questionnaire. Results. The study showed that the patients’ perception of their trunk aesthetics significantly worsened with increasing Cobb angle (TAPS, rS= -0.327, p<0.01) and ATR (TAPS, rS= -0.228, p<0.05) values. Moreover, higher ATR values sig­ni­ficantly decreased the patients’ QoL (SRS-22, rS= -0.232, p<0.05). Bracing significantly worsened the patients’ perception of aesthetics and QoL (TAPS, 3.2±0.8 vs 3.8±0.6, p<0.05; SRS-22, 3.9±0.4 vs 4.0±0.4, p<0.05 for patients treated with bracing and physiotherapy alone, respectively). Conclusions. 1. The magnitude of scoliosis, angle of trunk rotation, and bracing leads to worsen perception of trunk aesthetics and quality of life. 2. The curvature angle, angle of trunk rotation, brac­ing, female sex, and age are all associated with a worse perception of trunk aesthetics and quality of life. Self-evaluation of trunk aesthetics and qua­lity of life do not depend on the type of scoliosis. 3. In planning the management of idiopathic sco­lio­sis, one should take into account the impact of spi­nal deformity on worse patient-rated body aes­thetics.

scholarly journals Effects of neuromuscular electrical stimulation on exercise capacity and quality of life in COPD patients: a systematic review and meta-analysis

2020 ◽  
Vol 40 (5) ◽  
Author(s):  
Xu Wu ◽  
Xianglin Hu ◽  
Weiping Hu ◽  
Guiling Xiang ◽  
Shanqun Li
Keyword(s):  
Quality Of Life ◽  
Electrical Stimulation ◽  
Exercise Capacity ◽  
Neuromuscular Electrical Stimulation ◽  
Walking Distance ◽  
Cochrane Library ◽  
Control Group ◽  
Copd Patients ◽  
Significant Difference

Abstract Neuromuscular electrical stimulation (NMES) has been shown to produce benefits in the muscle function of chronic obstructive pulmonary disease (COPD) patients. The definite effectiveness of NMES, applied in isolation or concurrently with conventional pulmonary rehabilitation (PR) or exercise training, remains unclear. This review was to determine the effects of NMES on exercise capacity, functional performance, symptoms, and health-related quality of life (HRQoL) in COPD patients. Electronic databases (PubMed, Embase, Web of Science, the Cochrane Library) were searched for relevant randomized controlled trials (RCTs). Two investigators independently screened the eligible studies up to February 2020 that used NMES as the intervention group. The outcome measures were 6-min walking distance (6MWD), peak rate of oxygen uptake (VO2 peak), St George’s Respiratory Questionnaire (SGRQ), and symptoms of dyspnoea and fatigue. Data were extracted using a predefined table and papers were appraised using Downs and Black tool. We analyzed 13 RCTs with 447 COPD patients. In the analysis of 6MWD, pooled estimates showed a significant increase in the NMES group, compared with the control group (mean difference (MD) = 27.05, 95% confidence interval (CI): 8.46–45.63, P&lt;0.001). There were also improvements in symptoms of dyspnea or leg fatigue, and reduction in London Chest Activity of Daily Living (LCADL) scores. No statistically significant difference was observed in VO2 peak, peak power, and SGRQ. NMES could improve exercise capacity and reduce perceived sensation of dyspnea during exercise in patients with COPD, but not to be recommended as an effective alternative training modality in the rehabilitation of stable COPD patients.

scholarly journals Rationale and Design of Different Self-care Models for Adults With Heart Failure: a Systematic Review and Network Meta-analysis

2021 ◽  
Author(s):  
Mingzhi Hu ◽  
Hengheng Dai ◽  
Kehua Zhou ◽  
Jingjing Zhang ◽  
Ying Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Meta Analysis ◽  
Self Care ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Intervention Model ◽  
Care Intervention ◽  
Credible Intervals

Abstract Background: Active self-care improves quality of life, lowers hospital readmission risks, and decreases mortality from heart failure. Different self-care intervention models for these patients involve a variety of care contributions from healthcare professionals and caregivers, and little is known about which self-care intervention model is the most effective.Methods: We will search the MEDLINE/PubMed, the Cochrane Library, CINAHL, ClinicalTrials.gov, Embase and PsycINFO databases from January, 2000 to April, 2021. The gray literature will also be searched to ensure randomized controlled trials are included as comprehensively as possible. Summary standardized mean differences and 95% credible intervals will be calculated via Bayesian random-effects network meta-analysis. Heterogeneity will be evaluated, and risk of bias will be assessed using the Cochrane Risk of Bias tool.Discussion: This network meta-analysis will analyze outcomes including quality of life, healthcare use, readmission rate, and mortality to identify the most effective intervention model.Impact: We will analyze self-care interventions and determine which is most effective through this meta‐analysis.Registration number: PROSPERO CRD42021253179

scholarly journals Effectiveness of Resilience Interventions on Psychosocial Outcomes for Persons With Neurocognitive Disorders: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Ying Wang ◽  
Iris Chi ◽  
Yuning Zhan ◽  
Wenjang Chen ◽  
Tongtong Li
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Psychosocial Outcomes ◽  
Well Being ◽  
Neurocognitive Disorders ◽  
Risk Of Bias ◽  
Significant Benefit ◽  
Cochrane Library

Background: Neurocognitive disorders, such as mild cognitive impairment (MCI), dementia, and Alzheimer's disease, not only harm people's cognitive function but also lead to negative emotions, poor quality of life (QOL), and unsatisfactory level of well-being. Resilience can be defined as a dynamic and amendable process, which maintains or improves life satisfaction and quick recovery from own dilemma. However, no meta-analysis of randomized controlled trials (RCTs) has thus far examined the effectiveness of resilience interventions among persons with neurocognitive disorders, and the results of RCTs were inconsistent. This systematic review aimed to assess the effectiveness of resilience interventions on psychosocial outcomes among persons with neurocognitive disorders.Methods: Nine electronic Chinese and English databases (the Cochrane Library, PsycINFO, Web of Science, PubMed, Medline, Eric, JSTOR, CNKI, and WANGFANG) were searched through April 2021. Only RCTs were included, and the quality of the included studies was assessed by the Cochrane “Risk of Bias” tool. Meta-analysis was carried out on psychosocial outcomes, and heterogeneity was investigated by subgroup and sensitivity analysis. RevMan 5.4 was used for meta-analysis.Results: Fourteen RCT studies were identified, representing a total of 2,442 participants with neurocognitive disorders. The risk of bias was high or unclear for most included studies in the domains of allocation concealment, blinding participants, and interventionists. Meta-analysis showed that heterogeneity was low or moderate. There were significant differences in favor of resilience interventions compared with control on the outcome of QOL, using the Quality of Life-Alzheimer Disease scale (QOL-AD) [I2 = 36%, standardized mean difference (SMD) = 0.14, 95% CI (0.02, 0.26), p = 0.02], and no significant differences on depression, using the Cornell Scale for Depression in Dementia (CSDD) [I2 = 41%, SMD = −0.14, 95% CI (−0.34, 0.05), p = 0.16], and neuropsychiatric symptoms using the Neuropsychiatric Inventory Questionnaire (NPI-Q) [I2 = 62%, SMD = −0.10, 95% CI (−0.37, −0.16), p ≤ 0.46].Conclusions: Resilience interventions had a significant benefit on QOL but no significant benefit on depression and neuropsychiatric behavioral symptoms. More evidence is needed to answer questions about how to implement resilience interventions and how to evaluate their effectiveness.

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