The effect of sensory discrimination training on sensorimotor performance in individuals with central neurological conditions: A systematic review

Objective The aim of this systematic review was to investigate the efficacy of sensory discrimination training (SDT) on sensorimotor performance in individuals with a neurological condition affecting the central nervous system. Methods MEDLINE, CINAHL, EMBASE, AMED, CENTRAL, PsychINFO, Scopus, OT Seeker, PEDro, ETHOS, Web of Science and OpenGrey were systematically searched for appropriate randomised controlled trials (RCTs). Included studies were assessed for risk of bias, and the quality of the evidence was rated using the GRADE approach. The protocol was registered on PROSPERO (CRD42017055237). Results Six RCTs met the inclusion/exclusion criteria. All studies used manual tactile discrimination to retrain somatosensation. Somatosensory effect sizes (0.12–0.92) and motor function effect sizes (0.12–10.39) ranged from trivial to large with narrative analysis revealing some between-group difference in favour of the intervention group. However, the total sample size ( n = 220) was relatively small, and the quality of the included studies was low. Conclusions SDT may have potential to be an efficacious treatment option for improving sensorimotor performance in individuals with neurological disease. However, at present there is limited evidence on which to base any firm clinical recommendations.

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Acupuncture for postprostatectomy incontinence: a systematic review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002450 ◽

2020 ◽

pp. bmjspcare-2020-002450

Author(s):

Huan Chen ◽

Yu Liu ◽

Jiani Wu ◽

Fanrong Liang ◽

Zhishun Liu

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Narrative Analysis ◽

Short Form ◽

Pelvic Floor Muscle ◽

Efficacy And Safety ◽

Postprostatectomy Incontinence ◽

International Consultation ◽

Randomised Controlled

BackgroundPostprostatectomy incontinence (PPI) is a clinically significant condition that is caused by surgery of prostate. Study showed that electroacupuncture can reduce urine leakage among women with stress urinary incontinence (SUI), but few was known about its efficacy and safety for men with PPI. This study aims to conduct a systematic review to evaluate efficacy and safety of acupuncture for men with PPI compared with other non-surgical treatment.MethodsSeven databases were searched for all randomised controlled trials (RCTs) on acupuncture for men with PPI up to August 2020. Risks of bias of included studies were assessed using RevMan V.5.3. Narrative analysis was conducted.ResultsSeven studies with 830 men with PPI were included in the review. Studies showed that acupuncture can significantly improve score of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form for men with urgent urinary incontinence (UUI) when compared with medicine (p<0.05). It showed a significant better overall response rate when acupuncture was combined with solifenacin for men with UUI (p<0.05), or with pelvic floor muscle training (PFMT) (p<0.001), or with PFMT and medicine together for men with UUI or SUI (p<0.01), compared with control groups. No adverse event was reported in the studies. However, the quality of evidences was considered low generally.ConclusionThe results showed that acupuncture could be beneficial for men with PPI when applied alone or as an adjunction to other conservative therapies and medicines, however, the quality of evidence was considered low and inconclusive in this review.PROSPERO registration numberThis study has been registered at PROSPERO system with ID No. CRD42019091164.

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Effects of wearable technology on patients with diabetes: A systematic review and meta-analysis (Preprint)

10.2196/preprints.24757 ◽

2020 ◽

Author(s):

Dongjun Wu ◽

Nicholas Buys ◽

Guandong Xu ◽

Jing Sun

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Relapse Prevention ◽

Diabetes Management ◽

Meta Analysis ◽

Intervention Group ◽

Wearable Technologies ◽

Patients With Diabetes ◽

Hba1c Levels

UNSTRUCTURED Aims: This systematic review and meta-analysis aimed to evaluate the effects of wearable technologies on HbA1c, blood pressure, body mass index (BMI), and fastening blood glucose (FBG) in patients with diabetes. Methods: We searched PubMed, Scopus, Embase, the Cochrane database, and the Chinese CNKI database from last 15 years until August 2021. The quality of the 16 included studies was assessed using the PEDro scale, and random effect models were used to estimate outcomes, with I2 used for heterogeneity testing. Results: A significant reduction in HbA1c (-0.475% [95% CI -0.692 to -0.257, P<0.001]) was found following telemonitoring. However, the results of the meta-analysis did not show significant changes in blood pressure, BMI, and glucose, in the intervention group (P>0.05), although the effect size for systolic blood pressure (0.389) and diastolic blood pressure may indicate a significant effect. Subgroup analysis revealed statistically significant effects of wearable technologies on HbA1c when supported by dietetic interventions (P<0.001), medication monitoring (P<0.001), and relapse prevention (P<0.001). Online messages and telephone interventions significantly affected HbA1c levels (P<0.001). Trials with additional online face-to-face interventions showed greater reductions in HbA1c levels. Remote interventions including dietetic advice (P<0.001), medication (P<0.001), and relapse prevention (P<0.001) during telemonitoring showed a significant effect on HbA1c, particularly in patients attending ten or more intervention sessions (P<0.001). Conclusion: Wearable technologies can improve diabetes management by simplifying self-monitoring, allowing patients to upload their live measurement results frequently and thereby improving the quality of telemedicine. Wearable technologies also facilitate remote medication management, dietetic interventions, and relapse prevention.

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The quality of intervention reporting in trials of therapeutic exercise for hip osteoarthritis: a secondary analysis of a systematic review

Trials ◽

10.1186/s13063-021-05342-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Louise C. Burgess ◽

Thomas W. Wainwright ◽

Khara A. James ◽

Johan von Heideken ◽

Maura D. Iversen

Keyword(s):

Systematic Review ◽

Secondary Analysis ◽

Internal Validity ◽

Hip Osteoarthritis ◽

Therapeutic Exercise ◽

Quality Of Reporting ◽

Effective Interventions ◽

Randomised Controlled ◽

Intervention Reporting

Abstract Background Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA. Methods Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT) to evaluate intervention reporting. Correlations between quality assessment scores and CERT and TIDieR scores evaluated the relationship between internal validity and external applicability. The year of publication was compared to the quality of reporting scores. Results Fourteen RCTs were included in the analysis. On average, studies were awarded 9.43 ± 1.95 out of 12 points for the TIDieR checklist (range 4–12) and 13.57 ± 4.01 out of 19 points for the CERT (range 5–19). Pearson’s correlation coefficient suggested that the quality of reporting had improved over time and that there was a fair, positive relationship between internal validity and external applicability. Discussion Whilst the quality of intervention reporting is improving, many RCTs of therapeutic exercise in HOA lack the detail necessary to allow accurate evaluation and replication. Researchers are encouraged to utilise the standardised reporting guidelines to increase the translation of effective interventions into clinical practice.

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Hysteroscopic management of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

QJM ◽

10.1093/qjmed/hcab115.005 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hatem Hussein El-Gamal ◽

Walid El-Basuony Mohammad ◽

Ahmed Samir Mohamed Zeerban

Keyword(s):

Quality Of Life ◽

Caesarean Section ◽

Controlled Trial ◽

Intervention Group ◽

Expectant Management ◽

Control Group ◽

Randomised Controlled ◽

Caesarean Scar Defect ◽

Interventional Group

Abstract Background Long-term complaints after caesarean section, such as postmenstrual spotting, dysmenorrhea, dyspareunia, or chronic pelvic pain, are frequently described in relation to the presence of a niche. A post-caesarean niche is defined as an indentation in the myometrium at the site of the uterine scar. Two independent prospective cohort studies reported that the presence of a niche after caesarean section increases the risk of postmenstrual spotting for more than 2 days from 15 to 30%. Postmenstrual spotting may be caused by a mechanical outflow problem, with the retention of menstrual blood in a niche, or by the accumulation of blood because of impaired uterine contractions at the site of the niche. Additionally, newly formed fragile vessels in the niche may play a role in the formation of blood or fluid in the niche and uterine cavity. Objective The aim of this study was to compare the effectiveness of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting and a uterine caesarean scar defect. Methods This trial is a randomised controlled trial that provides evidence for the (cost) effectiveness of hysteroscopic resection of a niche versus expectant management in women with niche related postmenstrual spotting. It was carried out on 28 cases divided into two equal group. The study was conducted at Ain Shams University on the women reporting postmenstrual spotting after a caesarean section. The primary outcome was the number of days of postmenstrual spotting 6 months after randomization. Secondary outcomes were spotting at the end of menstruation, intermenstrual spotting, dysuria, sonographic niche measurements, quality of life, women’s satisfaction, sexual function, and additional therapy. Outcomes were measured at 3 months and, also at 6 months after randomization. Results The results of this study show a significant improvement in interventional group after 3 months more than the control group in bleeding micturition characteristics which includes total days of spotting, spotting end of menstruation, intermenstral spotting, discomfort from spotting, dysmenorrhea and daily pain during micturition, after 6 months the two group improved but the interventional group was significantly higher than control group. Regarding the radiological assessment it was found that there was a significant improvement in intervention group more than the control group after 3 months, also the control group improved after 6 months also, but the intervention groups was significantly higher than the control group. The quality of life show a significant increasing in intervention group more than the control group after 3 months of intervention, at the end of follow up the intervention group was significantly higher in quality of life more than the control group. Conclusion A hysteroscopic niche resection reduces postmenstrual spotting, and the discomfort from spotting, compared with expectant management after 3 months of follow-up in women with a niche with a residual myometrium of at least 3 mm.

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Systematic Review of the Quality of Mindfulness-Based School Interventions

10.31234/osf.io/bfkjn ◽

2021 ◽

Author(s):

Mary Lynd Phan ◽

Tyler L Renshaw ◽

Julie Caramanico ◽

Jeffrey M. Greeson ◽

Elizabeth MacKenzie ◽

...

Keyword(s):

Systematic Review ◽

Physiological Stress ◽

Self Regulation ◽

Total Sample ◽

Attentional Focus ◽

Coding System ◽

Level Of Evidence ◽

School Interventions ◽

Youth Outcomes

We reviewed the effects of mindfulness-based school interventions (MBSIs) on youth outcomes. We evaluated seventy-three studies with a total sample a total of 11,906 students across five continents, assessing the quality of each study through a robust coding system for evidence-based guidelines. Coders rated studies as 1++ (systematic review) to 4 (expert opinion) for level of evidence. Outcomes were assigned a corresponding evidence quality letter grade, from strongest (A) to weakest (D) evidence. Outcomes fell into 11 categories: wellbeing, self-compassion, social functioning, mental health, self-regulation and emotionality, mindful awareness, attentional focus, psychological and physiological stress, problem behaviors, academic performance, and acceptability. Strongest evidence showed increased resilience and reduced anxiety. There was comparable improvement in depression and wellbeing across youth relative to control groups. We urge researchers interested in MBSIs to study their effectiveness using more rigorous designs to minimize bias and promote higher quality evidence to guide school-based practice.

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Stress Management in Elementary School Students: a Pilot Randomised Controlled Trial

EMBnet journal ◽

10.14806/ej.26.1.976 ◽

2021 ◽

Vol 26 (1) ◽

pp. e976

Author(s):

Katerina Sofianopoulou ◽

Flora Bacopoulou ◽

Dimitrios Vlachakis ◽

Ioulia Kokka ◽

Evaggelos Alexopoulos ◽

...

Keyword(s):

Quality Of Life ◽

Elementary School ◽

Randomised Controlled Trial ◽

Elementary School Students ◽

Controlled Trial ◽

Intervention Group ◽

School Students ◽

Pilot Randomised Controlled Trial ◽

Randomised Controlled

Research has shown that stress experiences begin in early stages of life. Stress management techniques have appeared to be beneficial for the development or enhancement of stress coping skills. The aim of this pilot randomised controlled trial was to assess the effect of a 12-week intervention, comprising training in diaphragmatic breathing and progressive muscular relaxation, on elementary school students’ stress levels. Outcomes on the quality of life and behavioural aspects of the students were also assessed. Standardised questionnaires were administered at baseline and after the 12-week intervention program. Fifty-two children aged 10 to 11 years were randomly assigned to intervention (n=24) and control groups (n=28). Children of the intervention group demonstrated lower levels of stress (in all three subscales of lack of well-being, distress, and lack of social support) and improved aspects of quality of life (physical, emotional, and school functioning). No significant differences were observed regarding the examined behavioural dimensions, in the intervention group. Larger randomised controlled trials with follow-up evaluations are needed to ascertain the positive outcomes of such programs on elementary school children.

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Inspiratory muscle training does not improve clinical outcomes in 3-week COPD rehabilitation: results from a randomised controlled trial

European Respiratory Journal ◽

10.1183/13993003.02000-2017 ◽

2018 ◽

Vol 51 (1) ◽

pp. 1702000 ◽

Cited By ~ 29

Author(s):

Konrad Schultz ◽

Danijel Jelusic ◽

Michael Wittmann ◽

Benjamin Krämer ◽

Veronika Huber ◽

...

Keyword(s):

Quality Of Life ◽

Pulmonary Rehabilitation ◽

Controlled Trial ◽

Intervention Group ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Chronic Obstructive ◽

Muscle Training ◽

Randomised Controlled

The value of inspiratory muscle training (IMT) in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) is unclear. The RIMTCORE (Routine Inspiratory Muscle Training within COPD Rehabilitation) randomised controlled trial examined the effectiveness of IMT added to pulmonary rehabilitation.In total, 611 COPD patients (Global Initiative for Chronic Obstructive Lung Disease stage II–IV) received a 3-week inpatient pulmonary rehabilitation, of which 602 patients were included in the intention-to-treat analyses. The intervention group (n=300) received highly intensive IMT and the control group (n=302) received sham IMT. The primary outcome was maximal inspiratory pressure (PImax). The secondary outcomes were 6-min walk distance, dyspnoea, quality of life and lung function. Outcomes were assessed pre- and post-pulmonary rehabilitation. ANCOVA was used.The intervention group showed higher effects in PImax (p<0.001) and forced inspiratory volume in 1 s (p=0.013). All other outcomes in both study groups improved significantly, but without further between-group differences. Sex and pulmonary rehabilitation admission shortly after hospitalisation modified quality of life effects.IMT as an add-on to a 3-week pulmonary rehabilitation improves inspiratory muscle strength, but does not provide additional benefits in terms of exercise capacity, quality of life or dyspnoea. A general recommendation for COPD patients to add IMT to a 3-week pulmonary rehabilitation cannot be made.

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Effectiveness of interventions for optimising adherence to treatments for the prevention and management of scars: A systematic review

Clinical Rehabilitation ◽

10.1177/0269215520978528 ◽

2020 ◽

pp. 026921552097852

Author(s):

Jessica Killey ◽

Megan Simons ◽

Zephanie Tyack

Keyword(s):

Grey Literature ◽

Intervention Group ◽

Original Data ◽

Theoretical Frameworks ◽

Burn Scar ◽

Clinical Trial Registries ◽

Core Components ◽

Adherence Interventions ◽

Randomised Controlled

Objectives: To identify the adherence interventions used with people receiving treatments to prevent or manage scarring, the effectiveness of these interventions, and the theoretical frameworks on which these interventions were based. Data sources: Databases (PubMed, Embase, Web of Science, CINAHL, PsychINFO and OTseeker) were searched (09.10.2020) with no date or language restrictions. Grey literature databases, clinical trial registries and references lists of key papers were also searched. Review methods: Eligible randomised controlled trials included people using treatments for scarring following skin wounds, interventions that may improve adherence, and outcomes measuring adherence. Risk of bias (selection, performance, detection, attrition, reporting) and certainty of evidence (inconsistency, imprecision, indirectness, publication bias) were assessed. Results: Four randomised trials were included with 224 participants (17 children) with burn scars. Interventions involved educational (three trials) or technology-based components (four trials) and ranged in length from two weeks to six months. All four trials reported greater adherence rates in the intervention group compared with standard practice [standardised mean difference = 1.50 (95% confidence interval (CI) = 0.91–2.08); 2.01 (95% CI 1.05–2.98); odds ratio = 0.28 (95% CI = 0.11–0.69)]. One trial did not report original data. The certainty of evidence was very low. Conclusion: Adherence interventions using education or technology for people receiving burn scar treatment may improve adherence. Further studies are needed particularly in children, with a focus on including outcomes of importance to patients (e.g. quality of life) and identifying core components of effective adherence interventions using theoretical frameworks.

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