scholarly journals Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis

Cephalalgia ◽  
2018 ◽  
Vol 39 (4) ◽  
pp. 544-555 ◽  
Author(s):  
Dennis Anheyer ◽  
Matthew J Leach ◽  
Petra Klose ◽  
Gustav Dobos ◽  
Holger Cramer
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Cognitive Therapy ◽  
Stress Reduction ◽  
Tension Type Headache ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standardized Mean Difference ◽  
Mindfulness Based Stress Reduction

Background Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache. Data sources and study selection MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool. Results Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = −0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = −0.08; 95% confidence interval = −1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = −0.78; 95% confidence interval = −1.72,0.16). Conclusions Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.

scholarly journals The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials

2017 ◽  
Vol 31 (10) ◽  
pp. 883-894 ◽  
Author(s):  
Chong-Wen Wang ◽  
Amy YM Chow ◽  
Cecilia LW Chan
Keyword(s):  
Quality Of Life ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Well Being ◽  
Life Review ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standardized Mean Difference

Background: Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive. Aim: To evaluate the effects of therapeutic life review on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer. Design: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Data sources: Five databases were searched from their respective inception through February 2017 for relevant randomized controlled trials. The effects of therapeutic life review were pooled across the trials. Standardized mean differences were calculated for the pooled effects. Heterogeneity was assessed using the I2 test. Study quality was assessed using the Cochrane criteria. Results: Eight randomized controlled trials met the inclusion criteria. The pooled results suggested a desirable effect of therapeutic life review on the meaning of life domain of spiritual well-being (standardized mean difference = 0.33; 95% confidence interval, 0.12 to 0.53), general distress (standardized mean difference = −0.32; 95% confidence interval, −0.55 to −0.09), and overall quality of life (standardized mean difference = 0.35; 95% confidence interval, 0.15 to 0.56) when compared to usual care only. Of the three outcomes examined, only the pooled effect on overall quality of life remained statistically significant at follow-ups up to 3 months after the intervention (standardized mean difference = 0.82; 95% confidence interval, 0.47 to 1.18). Conclusions: Therapeutic life review is potentially beneficial for people near the end of life. However, the results should be interpreted with caution due to the limited number of randomized controlled trials and associated methodological weaknesses. Further rigorously designed randomized controlled trials are warranted.

Teledentistry and mHealth for Promotion and Prevention of Oral Health: A Systematic Review and Meta-analysis

2021 ◽  
pp. 002203452110038
Author(s):  
C.E. Fernández ◽  
C.A. Maturana ◽  
S.I. Coloma ◽  
A. Carrasco-Labra ◽  
R.A. Giacaman
Keyword(s):  
Systematic Review ◽  
Oral Health ◽  
Randomized Controlled Trials ◽  
Communication Systems ◽  
Text Messages ◽  
Mean Difference ◽  
Controlled Trials ◽  
Large Reduction ◽  
Randomized Controlled ◽  
Standardized Mean Difference

The dental profession has experienced a dramatic acceleration in the use of communication systems and information-based technologies over recent years, originating new paradigms for the prevention and promotion of oral health. The purpose of this systematic review was to determine the effect of teledentistry-based (telematic) strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion–related outcomes in patients of all ages. We searched Medline via PubMed, SCOPUS, and Web of Science from inception until August 2020, regardless of the language of publication. We selected studies for inclusion and conducted data extraction, assessed risk of bias (Cochrane tool), and evaluated the certainty of the evidence (GRADE approach) in duplicate and independently. Out of 898 potentially eligible references, we selected 43 for full-text screening, of which 19 studies proved eligible: 18 randomized controlled trials and 1 quasi-randomized study. Virtual interventions were mostly asynchronous via apps ( n = 9), text messages ( n = 9), or computer-aided learning ( n = 1). The use of teledentistry as compared with conventional strategies may result in a large reduction in the plaque index (standardized mean difference, −1.18; 95% CI, −1.54 to −0.82; I2 = 92%; low certainty) and will likely result in a large reduction in the gingival index (standardized mean difference, −2.17; 95% CI, −3.15 to −1.19; I2 = 97%; moderate certainty) and in the incidence of white spot lesions (risk ratio, 0.48; 95% CI, 0.35 to 0.66; I2 = 0%; moderate certainty), with an increased effect over time. Evidence suggests that teledentistry, particularly mHealth (messages and apps), is a promising clinical tool for preventing and promoting oral health, especially under the accelerated virtualization of dentistry. Future studies should include a broader spectrum of the population, including adults and elders, to better inform policy and implementation of teledentistry (PROSPERO: CRD42020192685).

Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials

Cephalalgia ◽  
2015 ◽  
Vol 35 (14) ◽  
pp. 1323-1332 ◽  
Author(s):  
Juan A Mesa-Jiménez ◽  
Cristina Lozano-López ◽  
Santiago Angulo-Díaz-Parreño ◽  
Ángel L Rodríguez-Fernández ◽  
Jose L De-la-Hoz-Aizpurua ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Manual Therapy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Tension Type Headache ◽  
Mean Difference ◽  
Controlled Trials ◽  
Weighted Mean ◽  
Randomized Controlled ◽  
Type Headache

Background Manual therapies are generally requested by patients with tension type headache. Objective To compare the efficacy of multimodal manual therapy vs. pharmacological care for the management of tension type headache pain by conducting a meta-analysis of randomized controlled trials. Methods PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, PEDro and SCOPUS were searched from their inception until June 2014. All randomized controlled trials comparing any manual therapy vs. medication care for treating tension type headache adults were included. Data were extracted and methodological quality assessed independently by two reviewers. We pooled headache frequency as the main outcome and also intensity and duration. The weighted mean difference between manual therapy and pharmacological care was used to determine effect sizes. Results Five randomized controlled trials met our inclusion criteria and were included in the meta-analysis. Pooled analyses found that manual therapies were more effective than pharmacological care in reducing frequency (weighted mean difference –0.8036, 95% confidence interval –1.66 to –0.44; three trials), intensity (weighted mean difference –0.5974, 95% confidence interval –0.8875 to –0.3073; five trials) and duration (weighted mean difference –0.5558, 95% confidence interval –0.9124 to –0.1992; three trials) of the headache immediately after treatment. No differences were found at longer follow-up for headache intensity (weighted mean difference –0.3498, 95% confidence interval –1.106 to 0.407; three trials). Conclusion Manual therapies were associated with moderate effectiveness at short term, but similar effectiveness at longer follow-up for reducing headache frequency, intensity and duration in tension type headache than pharmacological medical drug care. However, due to the heterogeneity of the interventions, these results should be considered with caution at this stage.

Effectiveness of N-acetylcysteine in autism spectrum disorders: A meta-analysis of randomized controlled trials

2020 ◽  
pp. 000486742095254
Author(s):  
Tsung-Min Lee ◽  
Kuan-Min Lee ◽  
Chuan-Ya Lee ◽  
Hsin-Chien Lee ◽  
Ka-Wai Tam ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Repetitive Behavior ◽  
Autism Spectrum ◽  
Mean Difference ◽  
Spectrum Disorder ◽  
Controlled Trials ◽  
Social Responsiveness ◽  
Randomized Controlled

Objective: Currently, pharmaceutical treatment options for autism spectrum disorder are limited. Brain glutaminergic dysregulation is observed in autism spectrum disorder. N-acetylcysteine, which can be converted to glutathione and subsequently release glutamate into the extracellular space, and thus reduce glutamatergic neurotransmission at synapses, is considered a potential drug for autism spectrum disorder treatment. Here, we analyzed the treatment effects of N-acetylcysteine on autism spectrum disorder in randomized controlled trials. Study design: Updated systematic review and meta-analysis. Data sources: By systematically searching the PubMed, Embase and Cochrane Library, we obtained five randomized controlled trials. Study selection: Meta-analyses were performed to examine the improvement in autistic behaviors as measured by the Aberrant Behavior Checklist, Social Responsiveness Scale and Repetitive Behavior Scale–Revised, using mean difference with a 95% confidence interval and a random-effects model. Data Synthesis: After 8–12 weeks of N-acetylcysteine supplementation, the pooled result of four trials revealed an improvement in Aberrant Behavior Checklist total score (mean difference = 1.31, 95% confidence interval = [0.42, 2.20]). When one trial was excluded, the sensitivity test result was stronger (mean difference = 1.88, 95% confidence interval = [0.92, 2.83]). The pooled results of three trials revealed significant improvements in hyperactivity (mean difference = 4.80, 95% confidence interval = [1.20, 8.40]) and irritability (mean difference = 4.07, 95% confidence interval = [1.13, 7.04]). Regarding Social Responsiveness Scale, the pooled result of two trials showed significant improvement in social awareness after 8–12 weeks of N-acetylcysteine supplementation (mean difference = 1.34, 95% confidence interval = [0.09, 2.59]). No differences were observed in the pooled results of two trials using Repetitive Behavior Scale, either in the total or the subscales. Conclusion: We concluded that N-acetylcysteine is safe and tolerable, reduces hyperactivity and irritability and enhances social awareness in children with autism spectrum disorder. However, further evidence should be sought before a general recommendation.

The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 44 (5) ◽  
pp. 341-354
Author(s):  
Saeed Shahabi ◽  
Kamran Bagheri Lankarani ◽  
Seyed Taghi Heydari ◽  
Maryam Jalali ◽  
Sulmaz Ghahramani ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Mean Difference ◽  
Controlled Trials ◽  
Short Term ◽  
Randomized Controlled ◽  
Lateral Elbow ◽  
Standardized Mean Difference ◽  
Lateral Elbow Tendinopathy

Background: Lateral elbow tendinopathy, also known as “tennis elbow” or “lateral epicondylitis,” is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive. Objectives: To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome. Study design: Systematic review and meta-analysis of randomized controlled trials. Methods: PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019. Results: Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference −0.02; 95% confidence interval: −0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference −0.86; 95% confidence interval: −2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95% confidence interval: −0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95% confidence interval: −0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95% confidence interval: −0.44 to 1.59) had better effects on pain improvement versus the brace. Conclusion: The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks). Clinical relevance The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness.

scholarly journals Effect of Spirulina Supplementation on Systolic and Diastolic Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3054
Author(s):  
Piotr Machowiec ◽  
Gabriela Ręka ◽  
Marcela Maksymowicz ◽  
Halina Piecewicz-Szczęsna ◽  
Agata Smoleń
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Lowering ◽  
Randomized Controlled

Spirulina is a microalga that presents various important pro-health properties, for instance lowering blood pressure in the research. The study aims to appraise the efficacy of Spirulina administration on systolic (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved by a systematic search of PubMed, Web of Science, and the Cochrane Library databases from inception to June 2021 according to a standardized protocol. The effect size of each study was counted from mean and standard deviation before and after the intervention and shown as Un-standardized mean difference and 95% confidence interval. Sensitivity analyses were performed. Meta-analysis on 5 RCTs with 230 subjects was eligible. The amount of Spirulina ranged from 1 to 8 g per day, and intervention durations ranged from 2 to 12 weeks. Data analysis indicated that Spirulina supplementation led to a significant lowering of SBP (Mean Difference (MD): −4.59 mmHg, 95% Confidence Interval (CI): −8.20 to −0.99, I square statistic (I2) = 65%) and significant lowering of DBP (MD: −7.02 mmHg, CI: −8.86 to −5.18, I2 = 11%), particularly in a subgroup of hypertensive patients. Spirulina administration might have a supportive effect on the prevention and treatment of hypertension. More exact randomized controlled trials are needed to clarify the effect of Spirulina supplementation on blood pressure.

scholarly journals Non-replication of structural brain changes from Mindfulness-Based Stress Reduction: Two combined randomized controlled trials

2021 ◽  
Author(s):  
Tammi RA Kral ◽  
Kaley Davis ◽  
Cole Korponay ◽  
Matthew J Hirshberg ◽  
Rachel Hoel ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Gray Matter ◽  
Stress Reduction ◽  
Gray Matter Volume ◽  
Controlled Study ◽  
Control Group ◽  
Controlled Trials ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Mindfulness Based Stress Reduction

Studies purporting to show changes in brain structure following the popular, eight-week Mindfulness-Based Stress Reduction (MBSR) course are widely referenced despite major methodological limitations. Here, we present findings from a large, combined dataset of two, three-arm randomized controlled trials with active and waitlist (WL) control groups. Meditation-naive participants (n=218) completed structural MRI scans during two visits: baseline and post-intervention period. After baseline, participants were randomly assigned to WL (n=70), an 8-week MBSR program (n=75), or a validated, matched active control (n=73). We assessed changes in gray matter volume, gray matter density, and cortical thickness. In the largest and most rigorously controlled study to date, we failed to replicate prior findings and found no evidence that MBSR produced neuroplastic changes compared to either control group, at either the whole-brain level or in regions of interest drawn from prior MBSR studies.

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