scholarly journals Efficacy of Exercise-Based Rehabilitation Programs for Improving Muscle Function and Size in People with Hip Osteoarthritis: A Systematic Review with Meta-Analysis

Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1251
Author(s):  
Zachary P. J. Rostron ◽  
Rodney A. Green ◽  
Michael Kingsley ◽  
Anita Zacharias

Objective: To determine the effect of exercise-based rehabilitation programs on hip and knee muscle function and size in people with hip osteoarthritis. Methods: Seven databases were systematically searched in order to identify studies that assessed muscle function (strength or power) and size in people with hip osteoarthritis after exercise-based rehabilitation programs. Studies were screened for eligibility and assessed for quality of evidence using the GRADE approach. Data were pooled, and meta-analyses was completed on 7 of the 11 included studies. Results: Six studies reported hip and/or knee function outcomes, and two reported muscle volumes that could be included in meta-analyses. Meta-analyses were conducted for four strength measures (hip abduction, hip extension, hip flexion, and knee extension) and muscle size (quadriceps femoris volume). For hip abduction, there was a low certainty of evidence with a small important effect (effect size = 0.28, 95% CI = 0.01, 0.54) favouring high-intensity resistance interventions compared to control. There were no other comparisons or overall meta-analyses that identified benefits for hip or knee muscle function or size. Conclusion: High-intensity resistance programs may increase hip abduction strength slightly when compared with a control group. No differences were identified in muscle function or size when comparing a high versus a low intensity group. It is unclear whether strength improvements identified in this review are associated with hypertrophy or other neuromuscular factors.

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022142
Author(s):  
Jun Wang ◽  
Yin Wang ◽  
Hui Zhang ◽  
Ming Lu ◽  
Weilu Gao ◽  
...  

IntroductionOsteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs.Methods and analysisWe will search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and PsycINFO databases as well as published and unpublished research in international registries and regulatory agency websites for osteoarthritis reports published prior to 5 January 2018. There will be no restrictions on the language. Randomised clinical trials that compare oral or transdermal opioids with other various opioids, placebo or no treatment for patients with knee or hip osteoarthritis will be included. The primary outcomes of efficacy will be pain and function. We will use pain and function scales to evaluate the main outcomes. The secondary outcomes of safety will be defined as the proportion of patients who have stopped treatment due to side effects. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. We will conduct subgroup analyses and sensitivity analyses to assess the robustness of our findings. The Grading of Recommendations, Assessment, Development and Evaluations framework will be used to assess the quality of the evidence contributing to each network assessment.Ethics and disseminationThis study does not require formal ethical approval because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations.PROSPERO registration numberCRD42018085503.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guozhong Zhou ◽  
Xin Xu ◽  
Yu Zhang ◽  
Peng Yue ◽  
Shiqi Luo ◽  
...  

Abstract Background In areas where Lyme disease is endemic, bites from ticks are common, but no vaccine is currently available against Lyme disease for humans. Therefore, the feasibility of using antibiotic prophylaxis to prevent Lyme disease after a tick bite is worth further exploration. Previous meta-analyses lack sufficient power to demonstrate the efficacy of about antibiotic prophylaxis for the prevention of Lyme disease following a tick bite. In this study, we explored more precise evidence and attempted to identify and update optimum treatment strategies. Methods We searched PubMed, Embase, and the Cochrane Library for studies until March 23, 2021. We included studies if the enrolled patients were randomly allocated to a treatment or control group within 72 h following a tick bite and had no clinical evidence of Lyme disease at enrolment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed for data abstraction. Two authors (GZZ and XX) independently reviewed the abstracts and identified articles for detailed assessment. We used a random-effects model to calculate the pooled results and reported the 95% confidence interval (CI). Study quality was assessed using a modified Jadad scale, and publication bias was assessed using Egger’s test. We calculated the risk ratio (RR) for the rates of unfavorable events in patients who received intervention versus the control group. This study is registered with PROSPERO, number CRD42021245002. Results Six studies (3,766 individuals) were included. The pooled rate of unfavorable events in persons receiving treatment and the control group were 0.4% (95%CI: 0.1–1.1%) and 2.2% (95%CI: 1.6–3.0%), respectively. The pooled RR was 0.38 (95%CI: 0.22–0.66). Subgroup analysis revealed that the pooled RR was 0.29 (95%CI: 0.14–0.60) in the single-use 200-mg doxycycline group; 0.28 (95%CI: 0.05–1.67) in a 10-day course group (Amoxicillin, Penicillin or tetracycline); and 0.73 (95%CI: 0.25–2.08) in a topical antibiotic treatment group (Azithromycin). Conclusions The available evidence supports the use of antibiotics for the prevention of Lyme disease, and reveals advantages of using single-dose; however, further confirmation is needed.


Author(s):  
Leizi Min ◽  
Dizhi Wang ◽  
Yanwei You ◽  
Yingyao Fu ◽  
Xindong Ma

Objectives: To use a quantitative approach to examine the effects of high-intensity interval training (HIIT) interventions on sleep for adults. Methods: PubMed, Ebsco, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, and Wanfang Data were searched from their inception to December 2020. Intervention studies with a control group that examined the effects of HIIT interventions on sleep were included in this meta-analysis. The risk of bias was assessed using the tool provided by the Cochrane Handbook for Systematic Reviews of Interventions. Effect sizes (ESs), calculated as weighted mean difference (WMD) and standardized mean difference (SMD), were used to examine the effects of objective outcomes and subjective outcomes separately. Results: A large increase in sleep quality (SQ) reflected by the Pittsburgh Sleep Quality Index global scores [WMD = −0.90, 95%CI (−1.72, −0.07), p = 0.03, n = 8] and a small-to-medium favorable effect on sleep efficiency (SE) [SMD = 0.43, 95%CI (0.20, 0.65), p = 0.0002, n = 10] were found after HIIT intervention. In addition, sub-analyses results suggest that ESs were moderated by the type, duration and frequency, as well as the length of the HIIT intervention. Conclusions: HIIT may be a promising way to improve overall subjective SQ and objective SE. PROSPERO, protocol registration number: CRD42021241734.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Thirumalaivasan Dhasakeerthi ◽  
Muhammad Ishfaq ◽  
Balaji Krishnaiah ◽  
Andrei Alexandrov ◽  
Georgios Tsivgoulis

Background: Post-stroke depression is common and it impedes rehabilitation and function recovery after stroke, and numerous trials evaluated SSRI’s for depression prophylaxis. The objective of this study is to assess the use of SSRI for prevention of poststroke depression and the potential effect on functional recovery after stroke. Methods: We searched electronic databases up to July 2019 for randomized controlled trials of SSRI’s for patients with stroke versus placebo. We calculated pooled odds ratios and 95% CIs by using random-effects models. The primary end points were depression and good functional outcome (modified Rankin Scale score of 0-2) at 90 days post-randomization. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Twelve randomized control trials assessing 4,887 patients have been included in the meta-analysis. SSRI treatment after stroke decreased the odds of depression compared to control group (OR = 0.48, 95% CI - 0.30 to 0.78, p=0.003). There was no heterogeneity between the trials (Cochran’s Q statistic 4.623, df 5; P = .337, I 2 =5.626%). The proportion of subjects who achieved mRS 0-2 at 90 days was similar between SSRI and control groups (OR= 3.471, 95% CI - 0.59 to 20.38, p=0.168). Conclusion: SSRI treatment for the stroke patients reduces the incidence of depression but it does not increase the odds of good functional recovery.


Lupus ◽  
2016 ◽  
Vol 26 (3) ◽  
pp. 282-288 ◽  
Author(s):  
Y H Lee ◽  
J H Jung ◽  
Y H Seo ◽  
J-H Kim ◽  
S J Choi ◽  
...  

Objective We aimed to evaluate the relationship between telomere length and systemic lupus erythematosus (SLE). Methods PUBMED and EMBASE databases were searched; meta-analyses were performed comparing telomere length in SLE patients and healthy controls, and on SLE patients in subgroups based on ethnicity, sample type, assay method and data type. Results Eight studies including 472 SLE patients and 365 controls were ultimately selected which showed that telomere length was significantly shorter in the SLE group than in the control group (standardized mean difference (SMD) = −0.835, 95% confidence interval (CI) = −1.291 to −0.380, p = 3.3 × 10−4). Stratification by ethnicity showed significantly shortened telomere length in the SLE group in Caucasian, Asian and mixed populations (SMD = −0.455, 95% CI = −0.763 to −0.147, p = 0.004; SMD = −0.887, 95% CI = −1.261 to −0.513, p = 3.4 × 10−4; SMD = −0.535, 95% CI = −0.923 to −0.147, p = 0.007; respectively). Furthermore, telomere length was significantly shorter in the SLE group than in the control group in whole blood and peripheral blood mononuclear cell groups (SMD = −0.361, 95% CI = −0.553 to −0.169, p = 2.3 × 10−4; SMD = −1.546, 95% CI = −2.583 to −0.510, p = 0.003; respectively); a similar trend was observed in leukocyte groups (SMD = −0.699, 95% CI = −1.511 to −0.114, p = 0.092). Meta-analyses based on assay method or data type revealed similar associations. Conclusions Our meta-analysis demonstrated that telomere length was significantly shorter in patients with SLE, regardless of ethnicity, sample type or assay method evaluated.


2019 ◽  
Author(s):  
Emma Norris ◽  
Tommy van Steen ◽  
Artur Direito ◽  
Emmanuel Stamatakis

Objective: This review provides the first meta-analysis of the effects of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared to a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible for inclusion in the systematic review and 37 of them were included across the six meta-analyses (n=12,663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95%CI 1.42, 3.25: k=16) and small, significant effects on overall PA (d= 0.32, 95%CI 0.18, 0.46: k=8). A large, significant effect was shown on lesson-time educational outcomes (d=0.81; 95%CI 0.47, 1.14: k=7) and a small, significant effect on overall educational outcomes (d=0.36, 95%CI [0.09, 0.63], k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least 2 domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had a positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool settings.


2019 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan

Abstract Objectives To examine the effectiveness and safety of yoga for women with sleep problems by performing a systematic review and meta-analysis.Methods Medline/PubMed, Clincalkey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), or objective instruments, such as polysomnography, actigraphy, and safety of the intervention. For each outcome, standardized mean difference (SMD) and 95% confidence intervals (CIs) were determined. Results Nineteen studies including 1832 participants were included in this systematic review. Meta-analyses revealed positive effects of yoga using PSQI or ISI scores in 16 randomized control trials (RCTs) compared with the control group in improving sleep quality in women, PSQI (SMD = −0.54; 95% CI = −0.89 to −0.19 ; P = 0.003). However, three RCTs revealed no effects of yoga compared with the control group in reducing the severity of insomnia in women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = −0.15 ; 95% CI = −0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri-or postmenopausal women using PSQI (SMD = −0.31; 95% CI = −0.95 to 0.33; P = 0.34).Yoga was not associated with serious adverse events. Discussion This systematic review and meta-analysis found that yoga intervention in some groups of women was beneficial in managing sleep problems. Despite certain disadvantages in methodology in the included studies, yoga may be recommended as a complementary therapy to women.


2020 ◽  
Vol 35 (14) ◽  
pp. 1004-1016 ◽  
Author(s):  
Bashar Hasan ◽  
Jehad Almasri ◽  
Bilal Marwa ◽  
Kelsey M. Klaas ◽  
Philip R. Fischer

Purpose: Postural orthostatic tachycardia syndrome has been recognized for decades, but treatment is largely based on anecdotal experience and expert opinion. Pharmacologic treatment is inconsistent and unstandardized. We did a systematic review to identify controlled studies from which informed treatment decisions can be made. Method: Through a standard systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified all English-language studies of a medication treatment for postural orthostatic tachycardia syndrome that included a comparison or control group and followed outcomes for at least 1 week of treatment. Results: A total of 626 studies were identified by the search criteria, and 8, involving a total of 499 patients, met the criteria. No studies were adequately similar to allow for meta-analysis. Of the identified 8 studies, 2 were randomized controlled trials and 4 had been subjected to peer review. In individual studies, there was some favorable effect with fludrocortisone, beta blockers, midodrine, and selective serotonin reuptake inhibitors. Conclusion: There is a paucity of high-quality data about effectiveness of medication in the treatment of postural orthostatic tachycardia syndrome. Nonetheless, 2 randomized trials and 6 other reports show some favorable effects of medication.


Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 458
Author(s):  
Duk-Han Ko ◽  
Yong-Chul Choi ◽  
Dong-Soo Lee

Badminton requires both aerobic fitness and anaerobic ability for high performance. High intensity interval training (HIIT) is a traditional training method for improving fitness. In this study, we investigated whether short-term Wingate-based HIIT is effective for improving anaerobic activity in youth badminton players. Participants included 32 total badminton players in middle school and high school. They were divided into two groups (HIIT and moderate continuous training (MCT)). Training occurred for 4 weeks in total, three times a week, for 30 min each session. A body composition test, isokinetic knee muscle function test (60°/s, 240°/s), Wingate anaerobic power test (30 s × 5 sets), and analysis of heart rate changes were undertaken before and after training. After 4 weeks, body fat decreased in the HIIT group (p = 0.019); they also showed superior anaerobic ability compared to the MCT group. Differences were statistically significant in 3–4 sets (three sets, p = 0.019; four sets, p = 0.021). Regarding fatigue, the HIIT group showed superior fatigue improvement after training and better fatigue recovery ability in 3~5 sets (three sets, p = 0.032; four sets, p = 0.017; five sets, p = 0.003) than the MCT group. Neither group exhibited changes in heart rate during the anaerobic power test after training. Both groups improved in terms of isokinetic knee muscle function at 60°/s with no differences. However, at 240°/s, the HIIT group showed a statistically significant improvement (p = 0.035). Therefore, HIIT for 4 weeks improved the athletes’ performance and physical strength.


2020 ◽  
Vol 9 (2) ◽  
pp. 493 ◽  
Author(s):  
Chang-Hoon Koo ◽  
Hyun-Jung Shin ◽  
Sung-Hee Han ◽  
Jung-Hee Ryu

The use of lidocaine in spinal anesthesia may increase the risk of transient neurological symptoms (TNS) according to previous meta-analyses. However, the previous meta-analyses lacked data on some other local anesthetics and thus, more evaluations are still needed to compare the effect of lidocaine on the development of TNS. The objective of this study was to compare the risk of TNS according to lidocaine versus other local anesthetics in patients undergoing spinal anesthesia. A total of 39 randomized controlled trials with 4733 patients were analyzed. The incidence of TNS was 10.8% in the lidocaine group and was 2.2% in the control groups (risk ratio (RR) 4.12, 95% confidence interval (CI) 3.13 to 5.43, p < 0.001). In subgroup analysis, lidocaine increased the incidence of TNS compared with other local anesthetics except mepivacaine, ropivacaine or sameridine. The risk of TNS was higher in the hyperbaric (p < 0.001) or isobaric lidocaine (p < 0.001) group compared with the control group, but there were no differences found between the two groups when hypobaric lidocaine was administered (p = 1.00). This study confirmed that lidocaine for spinal anesthesia still causes TNS more frequently than most other local anesthetics, especially when hyperbaric or isobaric lidocaine was used.


Sign in / Sign up

Export Citation Format

Share Document