scholarly journals Oral Magnesium Supplementation for Insomnia in Older Adults: A Systematic Review & Meta-Analysis

2021 ◽  
Author(s):  
Jasmine Mah ◽  
Tyler Pitre
Keyword(s):  
Older Adults ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Risk Of Bias ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Magnesium Supplementation ◽  
Quality Of Evidence ◽  
Oral Magnesium

Abstract Background: Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. The aim was to assess the effectiveness and safety of magnesium supplementation for older adults with insomnia. Methods: A search was conducted in three databases comparing magnesium supplementation to placebo or no treatment. Outcomes were sleep quality, quantity, and adverse events. Risk of bias and quality of evidence assessments were carried out using the RoB 2.0 and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Data was pooled and treatment effects were quantified using mean differences. For remaining outcomes, a modified effects direction plot was used for data synthesis. Results: Three trials were identified comparing oral magnesium to placebo in 151 older adults in three countries. Pooled analysis showed that post-intervention sleep onset latency time was 17.36 minutes less after magnesium supplementation compared to placebo (95% CI -27.27 to -7.44, p=0.0006). Total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant. All trials were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence. Conclusion: This review confirms that the quality of literature is substandard for physicians to make well-informed recommendations on usage of oral magnesium for older adults with insomnia. However, given that oral magnesium is very cheap and widely available, there is weak evidence supporting improved sleep parameters after magnesium supplementation for insomnia symptoms.

scholarly journals Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jasmine Mah ◽  
Tyler Pitre
Keyword(s):  
Older Adults ◽  
Grey Literature ◽  
Sleep Onset ◽  
Risk Of Bias ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Magnesium Supplementation ◽  
Quality Of Evidence ◽  
Oral Magnesium

Abstract Background Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. The aim was to assess the effectiveness and safety of magnesium supplementation for older adults with insomnia. Methods A search was conducted in MEDLINE, EMBASE, Allied and Complementary Medicine, clinicaltrials.gov and two grey literature databases comparing magnesium supplementation to placebo or no treatment. Outcomes were sleep quality, quantity, and adverse events. Risk of bias and quality of evidence assessments were carried out using the RoB 2.0 and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Data was pooled and treatment effects were quantified using mean differences. For remaining outcomes, a modified effects direction plot was used for data synthesis. Results Three randomized control trials (RCT) were identified comparing oral magnesium to placebo in 151 older adults in three countries. Pooled analysis showed that post-intervention sleep onset latency time was 17.36 min less after magnesium supplementation compared to placebo (95% CI − 27.27 to − 7.44, p = 0.0006). Total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant. All trials were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence. Conclusion This review confirms that the quality of literature is substandard for physicians to make well-informed recommendations on usage of oral magnesium for older adults with insomnia. However, given that oral magnesium is very cheap and widely available, RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to three times a day) for insomnia symptoms.

scholarly journals The Effects of Green Exercise on Physical and Mental Wellbeing: A Systematic Review

2019 ◽  
Vol 16 (8) ◽  
pp. 1352 ◽  
Author(s):  
Ian Lahart ◽  
Patricia Darcy ◽  
Christopher Gidlow ◽  
Giovanna Calogiuri
Keyword(s):  
Perceived Exertion ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Mental Wellbeing ◽  
Affective Valence ◽  
Post Intervention ◽  
Green Exercise ◽  
Quality Of Evidence ◽  
Exercise Condition

We aimed to examine the evidence for the proposed additive effect of exercise in the presence of nature (green exercise) by systematically reviewing studies that investigated the effects of outdoor or virtual green exercise compared with indoor exercise. Our review updates an earlier review, whose searches were conducted in April 2010. Trials were eligible if: (a) participants in an outdoor or virtual exercise condition were exposed to views of nature (green exercise); (b) green exercise was compared with indoor exercise with no exposure to nature; (c) included an outcome related to physical or mental health; (d) used comparative or crossover trial design. We searched the following databases from 1st January 2010 to 28th June 2018: PubMed, CENTRAL, EMBASE, PsycINFO, GreenFile, and Sports DISCUS. We assessed risk of bias using the Cochrane “risk of bias” tool. Where possible we conducted a meta-analysis using the inverse variance random-effects method, and where this approach was not possible we presented the results qualitatively and in harvest plots. We identified 28 eligible trials. In a meta-analysis of just three longitudinal trials, the only statistical finding was slightly lower post-intervention perceived exertion with green versus indoor exercise (mean difference: −1.02; 95% confidence intervals: −1.88, −0.16). Compared with indoor exercise, acute bouts of outdoor green exercise may favorably influence affective valence and enjoyment, but not emotion, perceived exertion, exercise intensity, and biological markers. No other consistent statistical differences were observed, apart from a higher enjoyment of outdoor green versus virtual green exercise. We found a high risk of bias across trials and an overall low quality of evidence. In conclusion, there was limited evidence to support the view that green exercise offers superior benefits to exercise without exposure to nature. The low quality of evidence prohibits clear interpretation of trial findings. Future robust and rigorously designed trials are needed to evaluate the effects of long-term and multiple-bout exposure to nature during exercise compared with exercise indoors.

scholarly journals Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Allen Abbing ◽  
Vasiliki Koretsi ◽  
Theodore Eliades ◽  
Spyridon N. Papageorgiou
Keyword(s):  
Treatment Duration ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Comprehensive Treatment ◽  
Orthodontic Appliances ◽  
Duration Of Treatment ◽  
Quality Of Evidence ◽  
Fixed Appliances

Abstract Objectives Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. Materials and methods Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. Conclusions While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. Trial registration PROSPERO: (CRD42019148169)

Outpatient total hip arthroplasty does not increase complications and readmissions: a meta-analysis

2020 ◽  
pp. 112070002094879
Author(s):  
Vittorio Bordoni ◽  
Niccolò Marelli ◽  
Davide Previtali ◽  
Paolo Gaffurini ◽  
Giuseppe Filardo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Moderate Risk ◽  
Readmission Rates ◽  
Quality Of Evidence ◽  
Total Hip

Background: There is no consensus about the safety of outpatient total hip arthroplasty (THA). Therefore, the purpose of this meta-analysis was to quantitatively evaluate and compare outpatient and inpatient THA studies in terms of complication and readmission rates. Methods: A systematic search of the literature was performed on 26 July 2019 on PubMed, Web of Science, Cochrane library, and on the grey literature databases. The papers thus collected were used for a meta-analysis comparing outpatient and inpatient THA in terms of complication and readmission rates. Risk of bias and quality of evidence were defined according to Cochrane guidelines. The PRISMA guidelines were used to determine which papers to include in this study. Results: The literature search resulted in 2317 articles; of these, 8 articles were used for the meta-analysis. A total of 66,971 patients were included, of which 1428 were THA outpatients. The overall complication rate for outpatient THAs was 3.0%, while inpatient THAs had an overall complication rate of 4.7%. The readmission rate was 1.4% in outpatient THAs and 3.0% in inpatient THAs. Only 6 studies reported the number of deaths, which ranged from 0% to 0.01%. The included studies present a moderate risk of bias and, according to GRADE guidelines, the level of evidence for complications and readmissions is very low. Conclusions: This meta-analysis documented that outpatient THA is a feasible approach since it does not increase complications or readmissions with respect to inpatient THA, but the available studies present a moderate risk of bias and the quality of evidence of these findings is very low. Future high-level studies are needed to confirm results and indications for outpatient THA.

scholarly journals Traction Therapy for Cervical Radicular Syndrome is Statistically Significant but not Clinically Relevant for Pain Relief. A Systematic Literature Review with Meta-Analysis and Trial Sequential Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3389
Author(s):  
Claudio Colombo ◽  
Stefano Salvioli ◽  
Silvia Gianola ◽  
Greta Castellini ◽  
Marco Testa
Keyword(s):  
Sequential Analysis ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Treatment Modalities ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Quality Of Evidence ◽  
Radicular Syndrome

Aim: We aimed to investigate the effectiveness of traction therapy in reducing pain by performing a systematic review with meta-analysis. We also explore the best modality for administering traction to patients with cervical radicular syndrome (CRS). Methods: We searched the Medline, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) electronic databases. Two reviewers independently selected randomized controlled trials (RCTs) that compared traction in addition to other treatments versus the effectiveness of other treatments alone for pain outcome. We calculated the mean differences (MDs) and 95% confidence intervals (CIs). We used Cochrane’s tool to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the quality of evidence and summarize the study conclusions. Results: A total of seven studies (589 patients), one with low risk of bias, were evaluated. An overall estimate of treatment modalities showed low evidence that adding traction to other treatments is statistically significant (MD −5.93 [95% CI, −11.81 to −0.04] P = 0.05 and I2 = 57%) compared to other treatments alone. The subgroup analyses were still statistically significant only for mechanical and continuous modalities. Conclusions: Overall analysis showed that, compared to controls, reduction in pain intensity after traction therapy was achieved in patients with cervical radiculopathy. However, the quality of evidence was generally low and none of these effects were clinically meaningful.

scholarly journals Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Guoying Gao ◽  
Siu-wai Leung ◽  
Yongliang Jia
Keyword(s):  
Chinese Medicine ◽  
Angina Pectoris ◽  
Traditional Chinese Medicine ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Quality Of Evidence ◽  
Randomized Controlled ◽  
Grade Approach

Abstract Background: The efficacy of traditional Chinese medicine injections (TCMIs) for angina pectoris has never been well investigated for lacking quality assessment of evidence. This study aimed to conduct a comprehensive and rigorous network meta-analysis and assess the quality of evidence according to the Grading of Recommendations and Assessment, Development, and Evaluation (GRADE) approach to compare the efficacy of all TCMIs in treating angina pectoris.Methods: Following the protocol (reference: CRD42018117720), randomized controlled trials (RCTs) which compared one TCMI with another TCMI or conventional treatments on anginal outcome measures (i.e. symptomatic improvement, electrocardiography improvement, symptomatic recovery, and electrocardiography recovery) were included. The risk of bias among included RCTs was assessed with the revised Cochrane’s risk of bias tool 2. Frequentist statistical analyses including subgroup analysis, sensitivity analysis, meta-regression and publication bias analysis were performed. The certainty of evidence was assessed with the GRADE approach.Results: Totally, 475 RCTs including all 24 TCMIs were identified, while the quality of all but two included RCTs was poor. According to the network meta-analysis, Honghua (Safflower) injection were preferable both in improving symptoms and electrocardiography. However, significant inconsistency showed the intransitivity among indirect comparisons, results in network meta-analysis seemed thus not trustworthy. The quality of evidence was assessed as low or very low.Conclusions: The low-quality evidence reduced the confidence in the efficacious results. Current evidence hardly supports the beneficial effects of TCMIs in treating angina pectoris.

Systematic review and meta-analysis of smart-technology vs. face-to-face physical activity interventions in older adults (Preprint)

2022 ◽  
Author(s):  
Cassandra D'Amore ◽  
Julie C Reid ◽  
Matthew Chan ◽  
Samuel Fan ◽  
Amanda Huang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Smart Technology ◽  
Face To Face ◽  
Meta Analyses ◽  
Community Dwelling Older Adults

BACKGROUND This is a systematic review of randomized controlled trials and a meta-analysis comparing smart-technology to face-to-face physical activity (PA) interventions, in community-dwelling older adults, mean age greater than or equal 60 years. OBJECTIVE To determine the effect of smart-technology interventions compared to face-to-face PA interventions on PA and physical function in older adults. Our secondary outcomes were depression, anxiety, and health-related quality of life. METHODS We searched four electronic databases from inception to February 2021. Two independent reviewers screened titles/abstracts, full texts, and performed data extraction and risk of bias assessments using the Cochrane risk of bias tool. GRADE was used to evaluate the quality of the evidence. We provided a narrative synthesis on all included studies and, where possible, we performed meta-analyses for similar outcomes. RESULTS 19 studies with a total of 3455 patients were included. Random-effects meta-analyses showed that smart-technology interventions resulted in improved step count (mean difference 1440 steps, 95% confidence interval (CI) 500, 2390) and total PA (standardized mean difference 0.17, 95% CI 0.02, 0.32) compared to face-face interventions. The quality of the evidence for the effects of smart-technology interventions was very low based on GRADE criteria. There was no difference between groups for measures of physical function. CONCLUSIONS Interventions that include smart-technology may improve daily step counts by an average of 1440 steps in community dwelling older adults, however the quality of the evidence was very low. Future studies are needed to improve the certainty of results.

scholarly journals Prevalence of postural deviations in the spine in schoolchildren: a systematic review with meta-analysis

2017 ◽  
Vol 27 (1) ◽  
pp. 99 ◽  
Author(s):  
Ana Paula Kasten ◽  
Bruna Nichele da Rosa ◽  
Emanuelle Francine Detogni Schmit ◽  
Matias Noll ◽  
Claudia Tarragô Candotti
Keyword(s):  
Methodological Quality ◽  
Web Of Science ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Positive Events ◽  
Quality Of Evidence ◽  
Strength Of Evidence ◽  
Study Selection ◽  
Thoracic And Lumbar Spine

Objective: To estimate the prevalence of spine postural deviations in Brazilian schoolchildren. Method: Searches were conducted in databases EMBASE, LILACS, PubMed, SCOPUS, SciELO, Science Direct, and Web of Science, as well as manual searches to identify studies that evaluated the prevalence of spine postural deviations in Brazilian schoolchildren. Two independent reviewers realized the study selection, evaluated the methodological quality and the risk of bias and extracted data. The homogeneity between the studies was evaluated and the quality of evidence level using the GRADE system. Results: 29 studies were included, of which extracted the frequency of positive events to changes in cervical, thoracic and lumbar spine, as well as the frequency of scoliosis between schoolchildren. Even performing the meta-analysis separated by subgroups according to the spine region, the heterogeneity level it was up to 90%, it is not possible to perform the meta-analysis to estimate the prevalence of spine postural deviations in Brazilian schoolchildren. Conclusion: There is low strength of evidence to establish a consensus about the values of the prevalence of spine postural deviations in Brazilian schoolchildren.

scholarly journals Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (17) ◽  
pp. 6401
Author(s):  
Juan Vega-Escaño ◽  
Ana María Porcel-Gálvez ◽  
Rocío de Diego-Cordero ◽  
José Manuel Romero-Sánchez ◽  
Manuel Romero-Saldaña ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Publication Date ◽  
The Impact

The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and the Insomnia Severity Index were used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD −2.08, CI 95%: [−2.68, −1.47]) and a non-significant degree of heterogeneity were obtained (p = 0.64; I2 = 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers’ health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout.

scholarly journals Occupational risk factors for meniscal lesions: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Carolin Bahns ◽  
Ulrich Bolm-Audorff ◽  
Andreas Seidler ◽  
Karla Romero Starke ◽  
Elke Ochsmann
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Occupational Risk ◽  
Hard Coal ◽  
Occupational Risk Factors ◽  
Quality Of Evidence ◽  
Meniscal Lesions

Abstract Background Meniscal lesions are common and are associated with the development of knee osteoarthritis. Knee-straining activities at work such as kneeling or squatting cause high biomechanical stresses on the knee joints that can lead to acute or chronic injuries. The objective of this systematic review is to update the evidence on the potential relationship between occupational risk factors and meniscal lesions. Methods We searched the Medline, Embase and Web of Science databases until August 2021 to identify epidemiological observational studies on the association between occupational risk factors and meniscal lesions. Study selection, data extraction and risk of bias assessment were performed independently by two reviewers. Effect measures were extracted from individual studies and pooled with random effects meta-analysis. Heterogeneity analyses were conducted. We used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the overall quality of evidence. Results The database search resulted in 11,006 references, and 46 additional studies were identified through hand search. Twenty-two studies (represented in 25 publications) met the predefined eligibility criteria and nine records were included in the meta-analysis. There was only one study with an overall low risk of bias. Significant associations between occupational risk factors and the development of meniscal lesions were found for kneeling (effect size (ES) 2.15, 95% CI 1.67–2.76), squatting (ES 2.01, 95% CI 1.34–3.03), climbing stairs (ES 2.28, 95% CI 1.58–3.30), lifting and carrying weights ≥ 10 kg (ES 1.63, 95% CI 1.35–1.96), lifting and carrying weights ≥ 25 kg (ES 1.56, 95% CI 1.08–2.24), playing football on a professional level (ES 5.22, 95% CI 3.24–8.41), working as a hard coal miner (ES 5.23, 95% CI 2.16–12.69) and floor layers (ES 1.99, 95% CI 1.43–2.78). The overall quality of evidence according GRADE was moderate to low. Conclusion We found consistent evidence of an increased risk of meniscal lesions by occupational knee-straining exposures. Our findings are important for the development of preventive strategies to reduce work-related knee disorders and work absence. Trial registration PROSPERO (registration no. CRD42020196279).

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