scholarly journals A Multivariable Prediction Model for the Chronification of Non-traumatic Shoulder Pain: A Systematic Review

2016 ◽  
Vol 19 (2;2) ◽  
pp. 1-10 ◽  
Author(s):  
Filip Struyf
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Shoulder Pain ◽  
Evidence Synthesis ◽  
Complete Recovery ◽  
International Classification Of Functioning ◽  
Large Variability ◽  
Poor General Health ◽  
Moderate Evidence ◽  
Best Evidence Synthesis

Background: Shoulder pain is the third most common musculoskeletal complaint and many patients have an unfavorable outcome with long-term disability. Only 50% of all new episodes of shoulder pain show complete recovery within 6 months. Little is known about factors that contribute to chronicity of shoulder pain, although such information is needed for the management of patients with acute and sub-acute shoulder pain. Objective: To systematically review the literature for prognostic factors which are potential predictors for either recovery or chronification in patients with acute and sub-acute nontraumatic shoulder pain. Study Design: Systematic review. Setting: This systematic review examined all studies involving the prognosis of shoulder pain patients. Methods: This systematic review was reported following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently scored the methodological quality of the selected studies. Due to heterogeneity of studies, a best-evidence synthesis of the available prognostic factors was provided. Results: Nine studies met our inclusion criteria and were included in this systematic review. There is strong evidence that high scores on the Shoulder Pain and Disability Index (SPADI), high scores on shoulder pain severity, and a long duration of complaints are factors that contribute to the chronification of shoulder pain. Moderate evidence was found supportive for other prognostic factors that enhance chronification, like being male, being over 55 years of age, having poor general health, having a gradual onset of complaints, a large amount of sick leave, the perception of high job demand, the perception of low social support, and the amount of visits to a health care professional. Also moderate evidence exists regarding factors that contributed to a reduced possibility of chronification: an active treatment policy and not taking medication on regular basis. Limitations: The large variability in definitions of shoulder pain, and patient selection bias. In addition, there is a paucity of strong longitudinal prospective studies. Conclusion: This systematic review found evidence that high scores on the SPADI questionnaire, more shoulder pain, and a longer duration of complaints are associated with chronification of shoulder pain. In order to reduce chronification, clinicians can use the International Classification of Functioning based model presented here that could aid their decision-making. Key words: Shoulder pain, prognostic factors, systematic review, prognosis, assessment

scholarly journals Prognostic factors for finger interphalangeal joint osteoarthritis: a systematic review

Rheumatology ◽  
2020 ◽  
Author(s):  
Karishma Shah ◽  
He Cai ◽  
Jennifer C E Lane ◽  
Gary S Collins ◽  
Nigel K Arden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Diagnostic Criteria ◽  
Evidence Synthesis ◽  
Risk Of Bias ◽  
Older Age ◽  
Cochrane Library ◽  
Limited Evidence ◽  
Moderate Evidence ◽  
Best Evidence Synthesis

Abstract Objective Radiographic hand OA affects one in five adults. Symptomatic hand OA can result in functional impairment, pain and reduced quality of life. A prevalent form of hand OA is IP joint OA, however prognostic factors for IP joint OA remain poorly understood. This systematic review aimed to identify prognostic factors for IP joint OA, and to summarize the diagnostic criteria for IP joint OA in prognostic studies. Methods EMBASE, MEDLINE, Scopus and The Cochrane Library were searched from inception until 19 February 2020 (PROSPERO CRD42019116782). Eligible studies described diagnostic criteria defining IP joint OA, and assessed potential prognostic factors for IP joint OA. Risk of bias was assessed using a modified Quality in Prognosis Studies (QUIPS) tool and a best evidence synthesis was used. Results Eighteen studies were included (risk of bias: eight high, three moderate, seven low). All defined OA radiographically, and three studies incorporated clinical symptoms into their definition of OA. Forty-nine potential prognostic factors were assessed. Eight were prognostic: older age in women, female gender (both moderate evidence); family history of Heberden’s nodes, Kashin–Beck disease, older age in men, dental occupation in men, finger fracture, parity (all limited evidence). Higher BMI in women (limited evidence) was prognostic for symptomatic radiographic OA. No prognostic factors for symptomatic OA were identified. Conclusion IP joint OA is most commonly defined radiographically, yet criteria were heterogeneous. Eight prognostic factors for radiographic IP joint OA and one for symptomatic radiographic IP joint OA were identified, all with limited or moderate evidence. Further studies on causality and on prognostic pathways are needed.

scholarly journals Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

2018 ◽  
Vol 53 (4) ◽  
pp. 251-262 ◽  
Author(s):  
Dimitris Challoumas ◽  
Paul D Kirwan ◽  
Dmytro Borysov ◽  
Christopher Clifford ◽  
Michael McLean ◽  
...  
Keyword(s):  
Systematic Review ◽  
Glyceryl Trinitrate ◽  
Strong Evidence ◽  
Evidence Synthesis ◽  
Clinical Effects ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Moderate Evidence ◽  
Best Evidence Synthesis ◽  
Topical Glyceryl Trinitrate

ObjectiveTo produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.DesignA systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.Data sourcesMEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.MethodsWe examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulderet al.ResultsA total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. For all tendinopathies, improvements in pain were significant when comparing GTN versus placebo in the short term (<8 weeks; poor evidence). Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following: patient satisfaction (strong evidence); chances of being asymptomatic with activities of daily living (strong evidence); range of movement (moderate evidence); strength (moderate evidence); pain (at night and with activity; poor evidence) and local tenderness (poor evidence). Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo (moderate evidence).Conclusions and relevanceTreatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions.

scholarly journals Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Francis Q. S. Dzakpasu ◽  
Alison Carver ◽  
Christian J. Brakenridge ◽  
Flavia Cicuttini ◽  
Donna M. Urquhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Pain ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Insufficient Evidence ◽  
Cross Sectional ◽  
Experimental Intervention ◽  
Best Evidence Synthesis ◽  
Cross Sectional Studies ◽  
Full Day

Abstract Background Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions. Methods Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies’ risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review. Results Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP – OR = 1.19(1.03 – 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 – 1.92)] and neck/shoulder pain [OR = 1.73(1.46 – 2.03)], but not with extremities pain [OR = 1.17(0.65 – 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting. Conclusions We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases. Protocol registration PROSPERO ID #CRD42020166412 (Amended to limit the scope)

scholarly journals An Overview of Strategies for Reducing Upper Extremity Physical Exposure Associated With Floor Mopping: A Systematic Review

2018 ◽  
Vol 61 (1) ◽  
pp. 43-63 ◽  
Author(s):  
Mari-Anne Wallius ◽  
Susanna Järvelin-Pasanen ◽  
Saara M. Rissanen ◽  
Pasi A. Karjalainen ◽  
Kimmo Räsänen
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Evidence Synthesis ◽  
Levels Of Evidence ◽  
Moderate Evidence ◽  
Positive Effects ◽  
Physical Exposure ◽  
Manual Search ◽  
Best Evidence Synthesis ◽  
The Impact

Objective: This systematic review synthesizes literature on upper extremity physical exposure associated with floor mopping, in order to (a) assess the impact of changes in mopping systems on physical exposure and (b) propose recommendations for strategies to reduce exposure. Background: Floor-cleaning tools and equipment have undergone major improvements. Existing studies have focused on mop design modifications and cleaning efficiency. However, less is known about strain responses caused by modern tools and methods. Method: Studies from 1987 to February 2017 were identified by electronic and manual search. All selected studies underwent a quality assessment. The evidence was organized into categories representing different strategies for reducing exposure. The levels of evidence were determined using a best evidence synthesis approach. Results: Eleven studies were included. Based on the review findings, currently there is moderate evidence suggesting that reduced physical exposure has been achieved through development of mopping systems. Levels of evidence for strategies associated with positive effects on physical exposure were: moderate evidence for mop design and handle type, insufficient evidence for mopping technique, and mixed evidence for mopping methods and environment modifications. Therefore, the present study suggests the use of adjustable mop handles as a strategy for reducing physical exposure. Conclusion: A more comprehensive approach to reducing physical exposure concerning floor mopping work is necessary. Application: Knowledge regarding physical exposure reduction can be applied as the basis for decision making in cleaning practice. Information can be incorporated into future research regarding development of floor-cleaning methods.

scholarly journals Prognostic Factors to Determine Survivorship of Meniscal Allograft Transplant: A Systematic Review

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110072
Author(s):  
Ding-yu Wang ◽  
Cassandra A. Lee ◽  
Yan-zhang Li ◽  
Bo Zhang ◽  
Nan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Acl Reconstruction ◽  
Strong Evidence ◽  
Evidence Synthesis ◽  
Cartilage Damage ◽  
Older Age ◽  
Cochrane Central Register ◽  
Meniscal Allograft ◽  
Best Evidence Synthesis

Background: There is much room for improvement and optimization of meniscal allograft survivorship. Purpose: To understand prognostic factors for survivorship using evidence-based selection criteria in order to identify patients who would best benefit from meniscal allograft transplant (MAT). Study Design: Systematic review; Level of evidence, 4. Methods: We conducted this systematic review to analyze prognostic factors for survivorship of MAT. The Cochrane Central Register, PubMed publisher, Embase.com , and Web of Science databases were searched through August 8, 2019. Included studies entailed patients of any age who received MAT with a reported association between prognostic factors and survivorship of the allograft. Two reviewers independently screened all titles and abstracts for eligibility, extracted the data, assessed the risk of bias using the Newcastle-Ottawa Scale, and performed a best-evidence synthesis. Results: The review included 18 studies with a total of 1920 patients. The mean follow-up time was 6.0 years (range, 2.1-11.2 years). A total of 20 prognostic factors were identified and shown to be associated with survivorship of MAT. Strong evidence was found that severe cartilage damage was associated with poor survivorship. Strong evidence was also found showing that sex, knee compartment, surgical side, concomitant anterior cruciate ligament (ACL) reconstruction, and concomitant osteotomy for malalignment had no effect on survivorship. Moderate evidence was found that body mass index (<36), tobacco use, and arthroscopic versus open procedure had no influence on survivorship. Conflicting evidence was found that older age and kissing cartilage lesions (lesions on both the femur and tibia vs on a single side) decreased survivorship. Conclusion: Severe cartilage damage decreases the survivorship of MAT. Concomitant ACL reconstruction and osteotomy showed no relationship to survivorship. Many determinants showed conflicting and limited evidence. Older age may be of interest and should be further studied.

scholarly journals Elbow tendinopathy and occupational biomechanical overload: A systematic review with best‐evidence synthesis

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Stefania Curti ◽  
Stefano Mattioli ◽  
Roberta Bonfiglioli ◽  
Andrea Farioli ◽  
Francesco S. Violante
Keyword(s):  
Systematic Review ◽  
Evidence Synthesis ◽  
Best Evidence Synthesis

scholarly journals Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

2018 ◽  
Vol 52 (20) ◽  
pp. 1312-1319 ◽  
Author(s):  
Martin Asker ◽  
Hannah L Brooke ◽  
Markus Waldén ◽  
Ulrika Tranaeus ◽  
Fredrik Johansson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Injury Prevention ◽  
Evidence Synthesis ◽  
Shoulder Injuries ◽  
Prevention Measures ◽  
Shoulder Injury ◽  
Limited Evidence ◽  
Best Evidence Synthesis ◽  
Overhead Sports

ObjectiveTo assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.DesignSystematic review with best-evidence synthesis.Data sourcesMedline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.Eligibility criteria for selecting studiesRandomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.ResultsOf 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.ConclusionsAll investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.PROSPERO trial registration numberCRD42015026850.

scholarly journals Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2664
Author(s):  
Ethan Lowry ◽  
Joanne Marley ◽  
Joseph G. McVeigh ◽  
Emeir McSorley ◽  
Philip Allsopp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Evidence Synthesis ◽  
Nutritional Intervention ◽  
Poor Quality ◽  
Chronic Widespread Pain ◽  
Small Sample ◽  
Vegan Diet ◽  
Poor Sleep ◽  
Best Evidence Synthesis

Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with Chlorella green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.

scholarly journals Do dissatisfied patients have unrealistic expectations? A systematic review and best-evidence synthesis in knee and hip arthroplasty patients

2020 ◽  
Vol 5 (4) ◽  
pp. 226-240 ◽  
Author(s):  
Frederique J. Hafkamp ◽  
Taco Gosens ◽  
Jolanda de Vries ◽  
Brenda L. den Oudsten
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Clinical Success ◽  
Evidence Synthesis ◽  
Outcome Expectations ◽  
Future Research ◽  
Success Rates ◽  
Best Evidence Synthesis ◽  
Almost All ◽  
The Relationship

End-stage osteoarthritis is commonly treated with joint replacement. Despite high clinical success rates, up to 28% of patients are dissatisfied with the outcome. This best-evidence synthesis aimed to review studies with different forms of study design and methodology that examined the relationship between (fulfilment of) outcome expectations of hip and knee patients and satisfaction with outcome. A literature search was performed in PubMed, Web of Science, PsycInfo, Cochrane, and Google Scholar to identify studies conducted up to November 2017. The methodological quality of studies was assessed using the Newcastle-Ottawa Scale. In this best-evidence synthesis systematic review, the following main results could be seen. In only half of all studies were preoperative expectations associated with level of satisfaction, while in almost all studies (93%), fulfilment of expectations was related to satisfaction. The effect of met expectations did not differ between hip and knee patients or study design. Fulfilment of expectations seems to be consistently associated with patient satisfaction with outcome. Emphasis in future research must be placed on the operationalization and measurement of expectations and satisfaction to determine the (strength of the) influence of these different forms of assessment on the (existence of the) relationship. Cite this article: EFORT Open Rev 2020;5:226-240. DOI: 10.1302/2058-5241.5.190015

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