Overuse syndrome of the hand and wrist in musicians: a systematic review

2020 ◽  
Vol 45 (6) ◽  
pp. 636-642
Author(s):  
Julia Betzl ◽  
Ursula Kraneburg ◽  
Kai Megerle

We systematically searched medical publication databases for articles in English on upper extremity overuse syndrome in musicians. We focused on non-specific pain disorders, including diagnostic definitions, epidemiology, pathophysiology, risk factors, symptoms, treatment, and prevention. We included 42 out of 156 identified articles. The point prevalence of playing-related musculoskeletal disorders ranges from 37% to 47% in musicians with the hand and wrist among the most commonly affected areas, and the lifetime prevalence is reported as high as 89%. Leading symptoms are pain, weakness, stiffness, and loss of control. Intense repetitive use during practice, or before an audition or concert, recent changes in conductors or teachers, psychological stress, the effort of holding a weighty instrument, wrong technique, and joint laxity have all been identified as risk factors. The need for prevention is highlighted. Today’s therapy is mostly based on individual rehabilitation programmes rather than on long-term rest. However, treatment remains predominantly based on beliefs rather than on evidence. The entire subject needs intensive future research.

2020 ◽  
Vol 77 (3) ◽  
pp. 1107-1115
Author(s):  
Robin van den Kieboom ◽  
Liselore Snaphaan ◽  
Ruth Mark ◽  
Inge Bongers

Background: Caring for patients with dementia at home is often a long-term process, in which the independence of the patient declines, and more responsibility and supervision time is required from the informal caregiver. Objective: In order to minimize and reduce caregiver burden, it is important to explore its trajectory and the accompanying risk factors as dementia progresses; the objective of this systematic review. Methods: PRISMA guidelines were followed in this systematic review. Three databases, PubMed, PsycINFO, and EMbase, were systematically searched in November 2019 using specific keywords. Results: 1,506 hits emerged during the systematic search but only eleven articles actually met the inclusion criteria for this review. The trajectory of caregiver burden is highly variable and depends on multiple factors. Important risk factors included: patients’ behavioral and neuropsychiatric symptoms, and their decline in functioning in (I)ADL; the caregiver’s age, gender, and physical and mental health; and, within the dyads (patient/caregiver), cohabitation and kinship. Conclusion: There is no one-size-fits-all for predicting how caregiver burden will change over time, but specific factors (like being a spouse and increased behavioral impairment and decline in functional status in the patient) may heighten the risk. Other factors, not yet comprehensively included in the published studies, might also prove to be important risk factors. Future research in the field of reducing caregiver burden is recommended to integrate the patient, caregiver, and context characteristics in the trajectory of caregiver burden, and to assess more clearly the phase of the dementia progression and use of external resources.


2021 ◽  
pp. 003232172110072
Author(s):  
Ramon van der Does ◽  
Vincent Jacquet

Deliberative minipublics are popular tools to address the current crisis in democracy. However, it remains ambiguous to what degree these small-scale forums matter for mass democracy. In this study, we ask the question to what extent minipublics have “spillover effects” on lay citizens—that is, long-term effects on participating citizens and effects on non-participating citizens. We answer this question by means of a systematic review of the empirical research on minipublics’ spillover effects published before 2019. We identify 60 eligible studies published between 1999 and 2018 and provide a synthesis of the empirical results. We show that the evidence for most spillover effects remains tentative because the relevant body of empirical evidence is still small. Based on the review, we discuss the implications for democratic theory and outline several trajectories for future research.


2014 ◽  
Vol 59 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Anke E. Kip ◽  
Manica Balasegaram ◽  
Jos H. Beijnen ◽  
Jan H. M. Schellens ◽  
Peter J. de Vries ◽  
...  

ABSTRACTRecently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to monitor and compare therapies specifically for visceral leishmaniasis, in which the primary recrudescence of parasites is a particularly long-term event that remains difficult to predict. We performed a systematic review of studies evaluating biomarkers in human patients with visceral, cutaneous, and post-kala-azar dermal leishmaniasis, which yielded a total of 170 studies in which 53 potential pharmacodynamic biomarkers were identified. In conclusion, the large majority of these biomarkers constituted universal indirect markers of activation and subsequent waning of cellular immunity and therefore lacked specificity. Macrophage-related markers demonstrate favorable sensitivity and times to normalcy, but more evidence is required to establish a link between these markers and clinical outcome. Most promising are the markers directly related to the parasite burden, but future effort should be focused on optimization of molecular or antigenic targets to increase the sensitivity of these markers. In general, future research should focus on the longitudinal evaluation of the pharmacodynamic biomarkers during treatment, with an emphasis on the correlation of studied biomarkers and clinical parameters.


2022 ◽  
pp. bjsports-2021-104858
Author(s):  
Carel Viljoen ◽  
Dina C (Christa) Janse van Rensburg ◽  
Willem van Mechelen ◽  
Evert Verhagen ◽  
Bruno Silva ◽  
...  

ObjectiveTo review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.DesignLiving systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.Data sourcesEight electronic databases were searched from inception to 18 March 2021.Eligibility criteriaStudies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.ResultsNineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.ConclusionLimited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.


2020 ◽  
Author(s):  
Ian Burton

Musculoskeletal disorders such as tendinopathy are having an increasing burden on society and health systems. Tendinopathy is responsible for up to 30% of musculoskeletal disorders, having a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness for treating lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are pre-determined and standardised, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles and do not consider individual factors or take the importance of individualised training into account. Resistance training programs in tendinopathy are currently not achieving required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualising and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite being found effective for increasing strength in healthy athletes, autoregulation methods have not been investigated in tendinopathy. The purpose of this article was threefold: first to give an overview of individual factors in tendinopathy and current resistance training protocols in tendinopathy and their limitations. Secondly, to give an overview of the history, methods and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a tendinopathy resistance training protocol with autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.


2018 ◽  
Vol 42 (3) ◽  
pp. 224-237 ◽  
Author(s):  
Rebecca Chau ◽  
David W. Kissane ◽  
Tanya E. Davison

2020 ◽  
Vol 11 ◽  
Author(s):  
Dominik Havsteen-Franklin ◽  
Megan Tjasink ◽  
Jacqueline Winter Kottler ◽  
Claire Grant ◽  
Veena Kumari

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis.


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