Physical performance outcome measures used in exercise interventions for adults with childhood-onset disabilities: A scoping review

2020 ◽  
Vol 47 (4) ◽  
pp. 359-380
Author(s):  
Jessica Z. Song ◽  
Margot Catizzone ◽  
Kelly P. Arbour-Nicitopoulos ◽  
Dorothy Luong ◽  
Laure Perrier ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Physical Performance ◽  
Outcome Measures ◽  
Scoping Review ◽  
Brain Injuries ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Childhood Onset ◽  
Exercise Interventions ◽  
Performance Outcome

BACKGROUND: People with childhood-onset disabilities face unique physical and social challenges in adulthood. Exercise interventions may improve physical performance in children, but there is a lack of research on adults. OBJECTIVE: To describe studies that investigate exercise interventions and to evaluate the quality of physical performance outcome measures for adults with childhood-onset disabilities. METHODS: Eligible studies reported on exercise interventions for adults (ages 16+) with cerebral palsy, spina bifida, or acquired brain injuries. Only randomized controlled trials published in English from 2008 to 2019 were included. MEDLINE, CINAHL, PEDro, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Two reviewers independently screened studies and abstracted data. RESULTS: This scoping review included 4 trials reporting on cerebral palsy only. Three strength training programs found significant improvements in gait, and one mixed training program found significant improvements in strength and fitness. Only two outcome measures used are valid/reliable for adults (6 Minute Walk Test and Borg-20 Grades). CONCLUSION: Certain interventions may improve physical performance, but there is a lack of research on appropriate exercise interventions and physical performance outcome measures for adults with childhood-onset disabilities. Different exercise interventions should be investigated using larger sample sizes and outcome measures should be standardized.

scholarly journals Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures

2014 ◽  
Vol 121 (3) ◽  
pp. 665-673 ◽  
Author(s):  
Weiming Liu ◽  
Nicolaas A. Bakker ◽  
Rob J. M. Groen
Keyword(s):  
Outcome Measures ◽  
Surgical Procedures ◽  
Subdural Hematoma ◽  
Meta Analysis ◽  
Chronic Subdural Hematoma ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Twist Drill ◽  
Recurrence Rates ◽  
Postoperative Drainage

Object In this paper the authors systematically evaluate the results of different surgical procedures for chronic subdural hematoma (CSDH). Methods The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other databases were scrutinized according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, after which only randomized controlled trials (RCTs) and quasi-RCTs were included. At least 2 different neurosurgical procedures in the management of chronic subdural hematoma (CSDH) had to be evaluated. Included studies were assessed for the risk of bias. Recurrence rates, complications, and outcome including mortality were taken as outcome measures. Statistical heterogeneity in each meta-analysis was assessed using the T2 (tau-squared), I2, and chi-square tests. The DerSimonian-Laird method was used to calculate the summary estimates using the fixed-effect model in meta-analysis. Results Of the 297 studies identified, 19 RCTs were included. Of them, 7 studies evaluated the use of postoperative drainage, of which the meta-analysis showed a pooled OR of 0.36 (95% CI 0.21–0.60; p < 0.001) in favor of drainage. Four studies compared twist drill and bur hole procedures. No significant differences between the 2 methods were present, but heterogeneity was considered to be significant. Three studies directly compared the use of irrigation before drainage. A fixed-effects meta-analysis showed a pooled OR of 0.49 (95% CI 0.21–1.14; p = 0.10) in favor of irrigation. Two studies evaluated postoperative posture. The available data did not reveal a significant advantage in favor of the postoperative supine posture. Regarding positioning of the catheter used for drainage, it was shown that a frontal catheter led to a better outcome. One study compared duration of drainage, showing that 48 hours of drainage was as effective as 96 hours of drainage. Conclusions Postoperative drainage has the advantage of reducing recurrence without increasing complications. The use of a bur hole or twist drill does not seem to make any significant difference in recurrence rates or other outcome measures. It seems that irrigation may lead to a better outcome. These results may lead to more standardized procedures.

scholarly journals Musculoskeletal Injuries Among Females in the Military: A Scoping Review

2020 ◽  
Author(s):  
Pauline Barbeau ◽  
Alan Michaud ◽  
Candyce Hamel ◽  
Danielle Rice ◽  
Becky Skidmore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Stress Fractures ◽  
Musculoskeletal Injuries ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Increased Risk ◽  
Military Members ◽  
The Military

ABSTRACT Introduction Musculoskeletal injuries (MSKi) are a common challenge for those in military careers. Compared to their male peers, reports indicate that female military members and recruits are at greater risk of suffering MSKi during training and deployment. The objectives of this study were to identify the types and causes of MSKi among female military personnel and to explore the various risk factors associated with MSKi. Materials and Methods A scoping review was conducted over a 4-month time frame of English language, peer-reviewed studies published from 1946 to 2019. Search strategies for major biomedical databases (e.g., MEDLINE; Embase Classic + Embase; and the following EBM Reviews—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment, and the NHS Economic Evaluation Database) were developed by a senior medical information specialist and included 2,891 titles/abstracts. Study selection and data collection were designed according to the Population, Concept, and Context framework. Studies were included if the study population provided stratified data for females in a military context. Results From a total of 2,287 citations captured from the literature searches, 168 peer-reviewed publications (144 unique studies) were eligible for inclusion. Studies were identified from across 10 countries and published between 1977 and 2019. Study designs were primarily prospective and retrospective cohorts. Most studies assessed both prevalence/incidence and risk factors for MSKi (62.50%), with few studies assessing cause (13.69%). For MSKi of female recruits compared to active female members, the prevalence was higher (19.7%-58.3% vs. 5.5%-56.6%), but the incidence (0.02%-57.7% vs. 13.5%-71.9%) was lower. The incidence of stress fractures was found to be much higher in female recruits than in active members (1.6%-23.9% vs. 2.7%). For anthropometric risk factors, increased body fat was a predictor of MSKi, but not stress fractures. For physiological risk factors for both female military groups, being less physically fit, later menarche, and having no/irregular menses were predictors of MSKi and stress fractures. For biomechanical risk factors, among female recruits, longer tibial length and femoral neck diameter increased the risk of stress fractures, and low foot arch increased risk of an ankle sprain. For female active military members, differences in shoulder rotation and bone strength were associated with risk of MSKi. For biological sex, being female compared to male was associated with an increased risk of MSKi, stress fractures, and general injuries. The consequences of experiencing MSKi for active military included limited duties, time off, and discharge. For recruits, these included missed training days, limited duty days, and release. Conclusions This scoping review provides insight into the current state of the evidence regarding the types and causes of MSKi, as well as the factors that influence MSKi among females in the military. Future research endeavors should focus on randomized controlled trials examining training paradigms to see if women are more susceptible. The data presented in the scoping review could potentially be used to develop training strategies to mitigate some of the identified barriers that negatively impact women from pursuing careers in the military.

scholarly journals The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034846 ◽  
Author(s):  
Rutger MJ de Zoete ◽  
James H McAuley ◽  
Nigel R Armfield ◽  
Michele Sterling
Keyword(s):  
Physical Exercise ◽  
Neck Pain ◽  
Meta Analysis ◽  
Network Effect ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Meta Analyses

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.

scholarly journals Effect of Exercise on Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kui Chen ◽  
Yan Tan ◽  
You Lu ◽  
Jiayan Wu ◽  
Xueyuan Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Aerobic Exercise ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions

Background. Exercise has an integral impact on the physical and mental wellbeing of patients with Parkinson’s disease (PD), yet no comprehensive and quantitative analysis has been conducted on the effect of exercise on quality of life (QoL) in these patients. This study aimed to evaluate the effect of exercise on overall QoL and different domains of QoL in people with PD, as well as investigating the influence of factors such as the exercise type and intervention period. Methods. Databases, such as PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched since inception to August 14, 2018 to identify randomized controlled trials that compare the effect of exercise versus no intervention on QoL in PD patients. Following the subgroup analysis, heterogeneity was further explored. The quality of eligible studies was assessed according to PRISMA guidelines. Results. 20 studies were included with 1,143 participants in total. A meta-analysis showed a significant improvement in QoL after exercise intervention in PD patients (SMD = −0.24, 95% CI = −0.36 to −0.12, P<0.001). A subgroup analysis of exercise types revealed significant QoL improvement with aerobic exercise, martial arts, and dance, but not anaerobic exercise and combined exercise. Interventions lasting 12 weeks or longer improved QoL significantly. Conclusions. Exercise interventions, especially aerobic exercise, dance, and Tai Chi, significantly improve QoL in PD patients. At least 12 weeks of exercise is needed to bring about significant benefits.

scholarly journals Effects of Nonpharmacological Interventions for Dizziness in Older People: Systematic Review

2016 ◽  
Vol 96 (5) ◽  
pp. 641-649 ◽  
Author(s):  
Julie C. Kendall ◽  
Jan Hartvigsen ◽  
Michael F. Azari ◽  
Simon D. French
Keyword(s):  
High Risk ◽  
Older People ◽  
Outcome Measures ◽  
Postural Balance ◽  
Comparison Group ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Significant Difference

Background Nonpharmacological interventions have been shown to have some effectiveness in adults with dizziness; however, the effectiveness of these interventions in older people is unknown. Purpose The aim of this study was to determine the effects of conservative nonpharmacological interventions for dizziness in older people. Data Sources The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, SCOPUS, CINAHL, AMED, Index to Chiropractic Literature, PsycINFO, and MANTIS were searched from inception to May 2014. Study Selection Two investigators independently screened controlled trials with participants who were more than 60 years old and experienced dizziness. Studies of participants with dizziness from a specific diagnosis, such as Ménière disease and benign paroxysmal positional vertigo, were excluded. Outcome measures from the selected studies included self-reported dizziness and postural balance. Data Extraction Two investigators independently extracted data on participants, interventions, comparison group, outcome measures, and results. The risk of bias of the included studies was assessed with Cochrane guidelines. Data Synthesis Seven articles consisting of 7 controlled trials were included. All studies involved some form of exercise, including vestibular rehabilitation exercises, postural balance exercises, and tai chi exercise, as the main intervention. The studies had a high risk of bias because of the lack of adequate randomization and allocation concealment, the lack of reporting on cointerventions, the lack of reporting on reasons for dropouts, and the lack of reporting on participant adherence. Limitations Heterogeneity among the included studies in interventions and outcome measures prohibited a meta-analysis. Only 2 studies reported a significant difference between the intervention group and the comparison group for self-reported dizziness. Conclusions There is insufficient evidence to determine the effectiveness of nonpharmacological treatments for dizziness in older people. Current evidence is hampered by a high risk of bias, and well-designed trials with adequate masking, randomization, and adherence are needed.

scholarly journals Reporting of “dialysis adequacy” as an outcome in randomised trials conducted in adults on haemodialysis: a systematic review

2018 ◽  
Author(s):  
Sanne Steyaert ◽  
Els Holvoet ◽  
Evi Nagler ◽  
Simon Malfait ◽  
Wim Van Biesen
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Outcome Measures ◽  
Health Care Professionals ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Structured Interviews ◽  
Dialysis Adequacy ◽  
Registration Number ◽  
Randomised Controlled

ABSTRACTBackgroundClinical trials are most informative for evidence-based decision-making when they consistently measure and report outcomes of relevance to stakeholders, especially patients, clinicians, and policy makers. However, sometimes terminology used is interpreted differently by different stakeholders, which might lead to confusion during shared decision making. The construct dialysis adequacy is frequently used, suggesting it is an important outcome both for health care professionals as for patients.ObjectiveTo assess the scope and consistency of the construct dialysis adequacy as reported in randomised controlled trials in hemodialysis, and evaluate whether these align to the insights and understanding of this construct by patients.MethodsTo assess scope and consistency of dialysis adequacy by professionals, we performed a systematic review searching the Cochrane Central Register of Controlled Trials (CENTRAL) up to July 2017. We identified all randomised controlled trails (RCT) including patients on hemodialysis and reporting dialysis adequacy, adequacy or adequacy of dialysis and extracted and classified all reported outcomes. To explore interpretation and meaning of the construct of adequacy by patients, we conducted 10 semi-structured interviews with HD patients using thematic analysis. Belgian registration number B670201731001.FindingsFrom the 31 included trials, we extracted and classified 98 outcome measures defined by the authors as adequacy of dialysis, of which 94 (95%) were biochemical, 3 (3%) non-biochemical surrogate and 2 (2%) patient-relevant. The three most commonly reported measures were all biochemical. None of the studies defined adequacy of dialysis as a patient relevant outcome such as survival or quality of life.Patients had a substantially different understanding of the construct dialysis adequacy than the biochemical interpretation reported in the literature. Being alive, time spent while being on dialysis, fatigue and friendliness of staff were the most prominent themes that patients linked to the construct of dialysis adequacy.Conclusion Adequacy of dialysis as reported in the literature refers to biochemical outcome measures, most of which are not related with patient relevant outcomes. For patients, adequate dialysis is a dialysis that enables them to spend as much quality time in their life as possible.

scholarly journals Effectiveness of eccentric-biased exercise interventions in reducing the incidence of falls and improving functional performance in older adults: a systematic review

2021 ◽  
Author(s):  
Durga Kulkarni ◽  
Sarah Gregory ◽  
Michelle Evans
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Eccentric Exercise ◽  
Functional Performance ◽  
Risk Of Bias ◽  
Walking Distance ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions

Abstract Background Exercise has been known to preserve and enhance functional performance in older adults. Eccentric exercise involves muscle contractions characterised by unique features such as lengthening of the muscle–tendon complex by a greater opposing force. Aims To systematically review randomised-controlled trials (RCTs) investigating the effectiveness of eccentric exercises in reducing the incidence of falls and improving the functional performance in older adults. Key methods We conducted a systematic review of RCTs following the PRISMA-P guidelines. Searches were completed in the Cochrane Central Register of Controlled Trials, Embase, CINAHL, Medline, and Global Health CABI. We included RCTs reporting at least one of the following outcomes—falls, Berg balance scale, timed-up and go test, chair stand test, stair climb test, maximal walking speed, and minute walking distance. Two reviewers screened papers for eligibility and assessed the quality of included papers using the Cochrane Collaborative risk-of-bias tool for randomised trials. Data were extracted by a single reviewer and cross-checked by the second reviewer. A narrative synthesis was undertaken, given the high level of heterogeneity across studies. Results Ten studies were assessed as eligible for inclusion in the review. Overall, eccentric exercises were as effective as conventional resistance exercises in improving the selected outcomes by most studies. Additionally, when pre-exercise and post-eccentric exercise functional performance measures were compared, there was a statistically significant improvement in nearly all measures. The quality of trials was mixed (one high, four moderate, two low–moderate, and three low risk of bias). Conclusions Our systematic review suggests that eccentric exercises can be as effective as conventional exercises in older adults. Evidence suggests that such exercise interventions can lead to an improvement in geriatric function.

Using Biological Feedback to Promote Health Behavior Change in Adults: Protocol for a Scoping Review (Preprint)

2021 ◽  
Author(s):  
Kelli Marie Richardson ◽  
Ahlam A Saleh ◽  
Michelle R Jospe ◽  
Yue Liao ◽  
Susan Schembre
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Scoping Review ◽  
Health Behavior Change ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Biological Feedback ◽  
Design And Implementation ◽  
Behavior Change Interventions ◽  
Wide Range

BACKGROUND Many health conditions can be prevented, managed, or improved through behavioral interventions. Biological feedback, as a component of health behavior change interventions, is of particular interest given recent advances in wearable biosensing technology, digital health apps, and personalized health and wellness. Yet, there is a paucity of literature to guide the design and implementation of interventions that incorporate biological feedback to motivate health behavior change. OBJECTIVE The goal of this scoping review is to deeply explore the use of biological feedback as a component of health behavior change interventions that target adults. Objectives of the review include: (1) mapping the domains of research that incorporate biological feedback and (2) describing the operational characteristics of using biological feedback in the context of health behavior change. METHODS A comprehensive list of search terms was developed to capture studies from a wide range of domains. Studies to be included are randomized controlled trials targeting adults ≥18 years old that use biological feedback to change a health-related behavior, and are published as primary research articles, theses, or dissertations. The following electronic databases were searched: Ovid MEDLINE, Embase.com Embase, Cochrane Central Register of Controlled Trials, EBSCOhost PsycINFO, and ProQuest Dissertations & Theses Global. The screening and data extraction process will be guided by the Joanna Briggs Institute Manual for Evidence Synthesis and conducted by trained reviewers. RESULTS Database searches were completed in June 2021. A total of 50,459 unique records were returned after the removal of 48,634 duplicate records. The scoping review is planned for completion in 2022. CONCLUSIONS To our knowledge, this will be the first scoping review to map the literature that uses biological feedback as a component of health behavior change interventions targeting adults. Findings will be used to develop a framework to guide the design and implementation of future health behavior change interventions that incorporate biological feedback. CLINICALTRIAL 10.17605/OSF.IO/YP5WA

scholarly journals What evidence is used to underpin the design of strength-based exercise interventions evaluated in randomised controlled trials for rheumatoid arthritis? A systematic review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e024127 ◽  
Author(s):  
Graham Boniface ◽  
Meriel Norris ◽  
Esther Williamson ◽  
Varsha Gandhi ◽  
Shona Kirtley ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ethical Issues ◽  
Risk Of Bias ◽  
Phase Iii ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Exercise Interventions ◽  
Strength Based ◽  
Randomised Controlled

IntroductionHealthcare researchers designing strength-based exercise interventions must choose an appropriate dose to test before evaluating its effect using a definitive/phase-III randomised controlled trial (RCT). Compared with early phase testing employed by pharmaceutical trials, it is questionable whether exercise-based trials employ the same rigour for establishing tolerated dosage. Consequently, it is unclear if participants are initially prescribed optimal doses of exercise, which may potentially impact on study outcomes. Using trials of strength-based exercise interventions in adults with rheumatoid arthritis (RA) as an exemplar, the aims of this review are to (1) identify the proportion of RCTs that use phase I/II trials with dose escalation methodology for setting prescription parameters, (2) determine type and level of evidence used to justify prescription parameters of strength-based exercise interventions evaluated by RCTs, (3) explore consistency and applicability of the evidence underpinning prescription parameters in RCTs and (4) explore if a relationship exists between risk of bias for RCTs evaluating strength-based interventions and the level of evidence used to underpin prescription parameters.Methods and analysisFocusing on RCT’s evaluating strength-based exercise interventions in adults with RA published after 2000, the following databases will be searched: Allied and Complementary Medicine Database, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica Database, Medline and Physiotherapy Evidence Database. For each RCT, we will identify the evidence used to underpin prescription parameters. Both trial and underpinning evidence will have key information about the intervention extracted using the template for intervention description and replication checklist. Risk of bias will be assessed according to Cochrane. Levels of evidence will be assessed against the Oxford Centre for Evidence-Based Medicine and relationships between RCT and underpinning evidence explored and described narratively. Two independent assessors will be involved throughout data selection and extraction with recourse to a third reviewer should agreement not be reached.Ethics and disseminationNo ethical issues are identified. Dissemination will be via publication.PROSPERO registration numberCRD42018090963.

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