scholarly journals YOGA IN CHRONIC NECK PAIN: AN EFFECTIVE COMPLEMENTARY THERAPEUTIC OPTION - A META - ANALYSIS

2018 ◽  
Vol 7 (2) ◽  
pp. 3-12
Author(s):  
Jaza Rizvi ◽  
Batool Hassan ◽  
Sadia Shafaq

BACKGROUND Neck pain is recognized as the fourth leading cause of disability worldwide. The severity of neck pain may lead to adverse outcomes related to individual’s health and well-being that augment the risk of disability and may severely interfere in activities of daily living (ADL’s) and participation in the society. AIM The aim of the quantitative analysis is to determine the effectiveness of yoga in relieving chronic neck pain and disability. METHODS Databases such as Google scholar, MEDLINE, PEDro, the Cochrane Library and Pub Med were explored from October-November for randomized controlled trials which assessed neck pain and related disability among chronic neck pain individuals. RESULTS Total six studies consisted of 298 participants with chronic neck pain. In risk of bias assessment, all six studies reported low risk of allocation and reporting bias, while one or two study disclosed high or unknown risk of bias in several domains. Moderate to large effect of -0.857 SMD at 95% CI suggest evidence in favor of the effectiveness of yoga; (Q 30.32, df 5, I2 83.51%) on a significant P-value of <0.0001. CONCLUSION The analysis of studies provided robust evidence with pool effect of -0.857 SMD at 95% CI (p<0.0001) concluded that yoga is an effectual and complementary method for the management of chronic or non-specific neck pain. KEYWORDS Yoga, Neck Pain, Cervical, Therapeutic, Prevention, Meditation

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.


2019 ◽  
Vol 2 (22.2) ◽  
pp. E55-E70 ◽  
Author(s):  
Ian D. Coulter

Background: Mobilization and manipulation therapies are widely used by patients with chronic nonspecific neck pain; however, questions remain around efficacy, dosing, and safety, as well as how these approaches compare to other therapies. Objectives: Based on published trials, to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic nonspecific neck pain. Study Design: A systematic literature review and meta-analysis. Methods: We identified studies published between January 2000 and September 2017, by searching multiple electronic databases, examining reference lists, and communicating with experts. We selected randomized controlled trials comparing manipulation and/or mobilization therapies to sham, no treatment, each other, and other active therapies, or when combined as multimodal therapeutic approaches. We assessed risk of bias by using the Scottish Intercollegiate Guidelines Network criteria. When possible, we pooled data using random-effects meta-analysis. Grading of Recommendations, Assessment, Development, and Evaluation was applied to determine the confidence in effect estimates. This project was funded by the National Center for Complementary and Integrative Health under award number U19AT007912 and ultimately used to inform an appropriateness panel. Results: A total of 47 randomized trials (47 unique trials in 53 publications) were included in the systematic review. These studies were rated as having low risk of bias and included a total of 4,460 patients with nonspecific chronic neck pain who were being treated by a practitioner using various types of manipulation and/or mobilization interventions. A total of 37 trials were categorized as unimodal approaches and involved thrust or nonthrust compared with sham, no treatment, or other active comparators. Of these, only 6 trials with similar intervention styles, comparators, and outcome measures/timepoints were pooled for meta-analysis at 1, 3, and 6 months, showing a small effect in favor of thrust plus exercise compared to an exercise regimen alone for a reduction in pain and disability. Multimodal approaches appeared to be effective at reducing pain and improving function from the 10 studies evaluated. Health-related quality of life was seldom reported. Some 22/47 studies did not report or mention adverse events. Of the 25 that did, either no or minor events occurred. Limitations: The current evidence is heterogeneous, and sample sizes are generally small. Conclusions: Studies published since January 2000 provide low-moderate quality evidence that various types of manipulation and/or mobilization will reduce pain and improve function for chronic nonspecific neck pain compared to other interventions. It appears that multimodal approaches, in which multiple treatment approaches are integrated, might have the greatest potential impact. The studies comparing to no treatment or sham were mostly testing the effect of a single dose, which may or may not be helpful to inform practice. According to the published trials reviewed, manipulation and mobilization appear safe. However, given the low rate of serious adverse events, other types of studies with much larger sample sizes would be required to fully describe the safety of manipulation and/or mobilization for nonspecific chronic neck pain. Key words: Chronic neck pain, nonspecific, chiropractic, manipulation, mobilization, systematic review, meta-analysis, appropriateness


2021 ◽  
Vol 12 ◽  
Author(s):  
Ying Wang ◽  
Iris Chi ◽  
Yuning Zhan ◽  
Wenjang Chen ◽  
Tongtong Li

Background: Neurocognitive disorders, such as mild cognitive impairment (MCI), dementia, and Alzheimer's disease, not only harm people's cognitive function but also lead to negative emotions, poor quality of life (QOL), and unsatisfactory level of well-being. Resilience can be defined as a dynamic and amendable process, which maintains or improves life satisfaction and quick recovery from own dilemma. However, no meta-analysis of randomized controlled trials (RCTs) has thus far examined the effectiveness of resilience interventions among persons with neurocognitive disorders, and the results of RCTs were inconsistent. This systematic review aimed to assess the effectiveness of resilience interventions on psychosocial outcomes among persons with neurocognitive disorders.Methods: Nine electronic Chinese and English databases (the Cochrane Library, PsycINFO, Web of Science, PubMed, Medline, Eric, JSTOR, CNKI, and WANGFANG) were searched through April 2021. Only RCTs were included, and the quality of the included studies was assessed by the Cochrane “Risk of Bias” tool. Meta-analysis was carried out on psychosocial outcomes, and heterogeneity was investigated by subgroup and sensitivity analysis. RevMan 5.4 was used for meta-analysis.Results: Fourteen RCT studies were identified, representing a total of 2,442 participants with neurocognitive disorders. The risk of bias was high or unclear for most included studies in the domains of allocation concealment, blinding participants, and interventionists. Meta-analysis showed that heterogeneity was low or moderate. There were significant differences in favor of resilience interventions compared with control on the outcome of QOL, using the Quality of Life-Alzheimer Disease scale (QOL-AD) [I2 = 36%, standardized mean difference (SMD) = 0.14, 95% CI (0.02, 0.26), p = 0.02], and no significant differences on depression, using the Cornell Scale for Depression in Dementia (CSDD) [I2 = 41%, SMD = −0.14, 95% CI (−0.34, 0.05), p = 0.16], and neuropsychiatric symptoms using the Neuropsychiatric Inventory Questionnaire (NPI-Q) [I2 = 62%, SMD = −0.10, 95% CI (−0.37, −0.16), p ≤ 0.46].Conclusions: Resilience interventions had a significant benefit on QOL but no significant benefit on depression and neuropsychiatric behavioral symptoms. More evidence is needed to answer questions about how to implement resilience interventions and how to evaluate their effectiveness.


2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A56-A56
Author(s):  
J PANG

Abstract Introduction Poor sleep quality is more prevalent in patients with neck pain than in the control without neck pain. The effectiveness of using different pillows in the management of neck pain, waking symptoms and sleep quality is inconclusive. Objectives To identify the randomized controlled trials assessing the effect of different types of pillows on sleep quality, spinal alignment, neck pain, waking symptoms and neck disability. Methods A systematic review was conducted by searching CINAHL Complete, Cochrane Library, EMBASE, Medline, Pubmed and Psychinfo databases from inception to September 2020. Two reviewers independently assessed the articles and evaluated the methodological quality using the Physiotherapy Evidence Database (PEDro) scale. Results Thirty-five articles fulfilled the inclusion criteria of the study. There were nine high-quality studies involving 555 participants. The meta-analysis revealed significant differences favouring the use of rubber pillows to reduce neck pain [standardized mean difference (SMD: -0.263; P &lt; 0.001). Moreover, favourable outcomes by using rubber and spring pillows were found in waking pain (SMD: -0.228; P &lt; 0.001), neck disability (SMD: -0.506; P = 0.020) and pillow satisfaction (SMD: 1.144; P &lt; 0.001). However, pillow designs did not influence sleep quality (SMD = 0.047; P = 0.703) or spinal alignment at side-lying position (SMD=0.049; P=0.280) in patients with chronic neck pain. Discussion The use of spring and rubber pillows shows positive effects on reducing neck pain and disability. Although pillow designs do not change the sleep quality, waking symptoms can be reduced with positive pillow satisfaction in patients with chronic neck pain.


2018 ◽  
Vol 129 (3) ◽  
pp. 417-427 ◽  
Author(s):  
Kristen K. MacKenzie ◽  
Angelitta M. Britt-Spells ◽  
Laura P. Sands ◽  
Jacqueline M. Leung

Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background Postoperative delirium complicates approximately 15 to 20% of major operations in patients at least 65 yr old and is associated with adverse outcomes and increased resource utilization. Furthermore, patients with postoperative delirium might also be at risk of developing long-term postoperative cognitive dysfunction. One potentially modifiable variable is use of intraoperative processed electroencephalogram to guide anesthesia. This systematic review and meta-analysis examines the relationship between processed electroencephalogram monitoring and postoperative delirium and cognitive dysfunction. Methods A systematic search for randomized controlled trials was conducted using Ovid MEDLINE, PubMed, EMBASE, Cochrane Library, and Google search using the keywords processed electroencephalogram, Bispectral Index, postoperative delirium, postoperative cognitive dysfunction. Screening and data extraction were conducted by two independent reviewers, and risk of bias was assessed. Postoperative delirium combined-effect estimates calculated with a fixed-effects model were expressed as odds ratios with 95% CIs. Results Thirteen of 369 search results met inclusion criteria. Postoperative cognitive dysfunction data were excluded in meta-analysis because of heterogeneity of outcome measurements; results were discussed descriptively. Five studies were included in the quantitative postoperative delirium analysis, with data pooled from 2,654 patients. The risk of bias was low in three studies and unclear for the other two. The use of processed electroencephalogram-guided anesthesia was associated with a 38% reduction in odds for developing postoperative delirium (odds ratio = 0.62; P &lt; 0.001; 95% CI, 0.51 to 0.76). Conclusions Processed electroencephalogram-guided anesthesia was associated with a decrease in postoperative delirium. The mechanism explaining this association, however, is yet to be determined. The data are insufficient to assess the relationship between processed electroencephalogram monitoring and postoperative cognitive dysfunction.


2021 ◽  
pp. 2002964
Author(s):  
Vanesa Bellou ◽  
Ioanna Tzoulaki ◽  
Maarten van Smeden ◽  
Karel G. M. Moons ◽  
Evangelos Evangelou ◽  
...  

IntroductionThe individual prognostic factors for COVID-19 are unclear. For this reason, we aimed to present a state-of-the-art systematic review and meta-analysis on the prognostic factors for adverse outcomes in COVID-19 patients.MethodsWe systematically reviewed PubMed from January 1, 2020 to July 26, 2020 to identify non-overlapping studies examining the association of any prognostic factor with any adverse outcome in patients with COVID-19. Random-effects meta-analysis was performed, and between-study heterogeneity was quantified using I2 metric. Presence of small-study effects was assessed by applying the Egger's regression test.ResultsWe identified 428 eligible articles, which were used in a total of 263 meta-analyses examining the association of 91 unique prognostic factors with 11 outcomes. Angiotensin-converting enzyme inhibitors, obstructive sleep apnea, pharyngalgia, history of venous thromboembolism, sex, coronary heart disease, cancer, chronic liver disease, chronic obstructive pulmonary disease, dementia, any immunosuppressive medication, peripheral arterial disease, rheumatological disease and smoking were associated with at least one outcome and had >1000 events, p-value <0.005, I2 <50%, 95% prediction interval excluding the null value, and absence of small-study effects in the respective meta-analysis. The risk of bias assessment using the Quality In Prognosis Studies tool indicated high risk of bias in 302 of 428 articles for study participation, 389 articles for adjustment for other prognostic factors, and 396 articles for statistical analysis and reporting.ConclusionsOur findings could be used for prognostic model building and guide patients’ selection for randomised clinical trials.


2021 ◽  
Vol 10 (19) ◽  
pp. 4473
Author(s):  
Aitor Garay-Sánchez ◽  
Carmen Suarez-Serrano ◽  
Mercedes Ferrando-Margelí ◽  
Jose Jesus Jimenez-Rejano ◽  
Yolanda Marcén-Román

(1) Background: The development of new technologies means that the use of virtual reality is increasingly being implemented in rehabilitative approaches for adult stroke patients. Objective: To analyze the existing scientific evidence regarding the application of immersive and non-immersive virtual reality in patients following cerebrovascular incidents and their efficacy in achieving dynamic and static balance. (2) Data sources: An electronic search of the databases Medline, Cochrane Library, PEDro, Scopus, and Scielo from January 2010 to December 2020 was carried out using the terms physiotherapy, physical therapy, virtual reality, immersive virtual reality, non-immersive virtual reality, stroke, balance, static balance, and dynamic balance. Selection of studies: Randomized controlled trials in patients older than 18 developed with an adult population (>18 years old) with balance disorders as a consequence of suffering a stroke in the previous six months before therapeutic intervention, including exercises harnessing virtual reality in their interventions and evaluations of balance and published in English or Spanish, were included. A total of two hundred twenty-seven articles were found, ten of which were included for review and of these, nine were included in the subsequent meta-analysis. (3) Data extraction: Two authors selected the studies and extracted their characteristics (participants, interventions, and validation instruments) and results. The methodological quality of the studies was evaluated using the PEDro scale, and the risk of bias was determined using the Cochrane risk-of-bias tool. Data synthesis: Of the selected studies, three did not show significant improvements and seven showed significant improvements in the intervention groups in relation to the variables. (4) Conclusions: Non-immersive virtual reality combined with conventional rehabilitation could be considered as a therapeutic option.


ISRN Pain ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-23 ◽  
Author(s):  
Pia Damgaard ◽  
Else Marie Bartels ◽  
Inge Ris ◽  
Robin Christensen ◽  
Birgit Juul-Kristensen

Chronic neck pain (CNP) is common and costly, and the effect of physiotherapeutic interventions on the condition is unclear. We reviewed the literature for evidence of effect of physiotherapy interventions on patients with CNP. Five bibliographic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and PEDro) were systematically searched. Randomised, placebo and active-treatment-controlled trials including physiotherapy interventions for adults with CNP were selected. Data were extracted primary outcome was pain. Risk of bias was appraised. Effect of an intervention was assessed, weighted to risk of bias. 42 trials reporting on randomised comparisons of various physiotherapy interventions and control conditions were eligible for inclusion involving 3919 patients with CNP. Out of these, 23 were unclear or at high risk of bias, and their results were considered moderate- or low-quality evidence. Nineteen were at low risk of bias, and here eight trials found effect on pain of a physiotherapy intervention. Only exercise therapy, focusing on strength and endurance training, and multimodal physiotherapy, cognitive-behavioural interventions, massage, manipulations, laser therapy, and to some extent also TNS appear to have an effect on CNP. However, sufficient evidence for application of a specific physiotherapy modality or aiming at a specific patient subgroup is not available.


2017 ◽  
Vol 31 (11) ◽  
pp. 1457-1465 ◽  
Author(s):  
Holger Cramer ◽  
Petra Klose ◽  
Benno Brinkhaus ◽  
Andreas Michalsen ◽  
Gustav Dobos

Objective: The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga in relieving chronic neck pain. Methods: PubMed/MEDLINE, the Cochrane Library, Scopus, and IndMED were screened through January 2017 for randomized controlled trials assessing neck pain intensity and/or neck pain-related disability in chronic neck pain patients. Secondary outcome measures included quality of life, mood, and safety. Risk of bias was assessed using the Cochrane tool. Results: Three studies on 188 patients with chronic non-specific neck pain comparing yoga to usual care were included. Two studies had overall low risk of bias; and one had high or unclear risk of bias for several domains. Evidence for short-term effects was found for neck pain intensity (standardized mean difference (SMD) = −1.28; 95% confidence interval (CI) = −1.18, −0.75; P < 0.001), neck pain-related disability (SMD = −0.97; 95% CI = −1.44, −0.50; P < 0.001), quality of life (SMD = 0.57; 95% CI = 0.17, 0.197; P = 0.005), and mood (SMD = −1.02; 95% CI = −1.38, −0.65; P < 0.001). Effects were robust against potential methodological bias and did not differ between different intervention subgroups. In the two studies that included safety data, no serious adverse events occurred. Conclusion: Yoga has short-term effects on chronic neck pain, its related disability, quality of life, and mood suggesting that yoga might be a good treatment option.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e058932
Author(s):  
Abubeker Alebachew Seid ◽  
Setognal Birara Aychiluhm ◽  
Ahmed Adem Mohammed

IntroductionRespiratory rehabilitation is the use of exercise, education, and behavioural interventions to alleviate symptoms and improve quality of life. Recent studies highlight that respiratory rehabilitation is effective and safe for patients with COVID-19. We aim to evaluate the effectiveness and feasibility of respiratory telerehabilitation on patients infected with COVID-19 by conducting a systematic review and meta-analysis.Methods and analysisPubMed, Web of Science, Science Direct, Physiotherapy Evidence Database, Google Scholar and Cochrane Library databases will be searched from inception to the end of November 2021. Randomised controlled trials investigating the effectiveness of telerehabilitation in the management of COVID-19 will be included. The primary outcomes will be functional capacity, cardiopulmonary exercise tests and quality of life. Secondary outcomes will include anxiety/depression level, sleep quality, mortality rate, completion rate, reason for withdrawal, adverse events, service satisfaction, cost-effectiveness and other potential factors. Two reviewers will independently screen and extract data and perform quality assessment of included studies. The Cochrane risk of bias tool will be used to assess risk of bias. Review Manager V.5.4 (Cochrane Collaboration) software will be used for statistical analysis. Heterogeneity will be analysed using I² statistics. Mean difference or standardised mean difference with 95% CI and p value will be used to calculate treatment effect for outcome variables.Ethics and disseminationEthical approval is not required because this systematic review and meta-analysis is based on previously published data. Final result will be published in peer-reviewed journal and presented at relevant conferences and events.PROSPERO registration numberCRD42021287975.


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