scholarly journals Effectiveness of Mulligans Mobilisation with Movement on Shoulder Dysfunction: A Systematic Review

2020 ◽  
Author(s):  
V Meena ◽  
Jibu George Varghese
Keyword(s):  
English Language ◽  
Cochrane Review ◽  
Long Term Effects ◽  
Eligibility Criteria ◽  
Shoulder Dysfunction ◽  
Significant Difference ◽  
Wear And Tear ◽  
Randomised Control Trials ◽  
The Individual

Introduction: Shoulder dysfunction is common musculoskeletal disorder. This is due to repeated wear and tear of structures around the shoulder joint causing the malpositioning of shoulder. The Mulligan Mobilisation with Movement (MWM) has shown good results in treating the shoulder dysfunction. Aim: To systemically review the available literature of MWM is effective in improving pain, Range Of Motion (ROM) and functioning in patients with shoulder dysfunction. Materials and Methods: Five electronic databases like MEDLINE, PUBMED, Cochrane (CENTRAL), PEDro, and Google Scholar were searched up from March 2019 to September 2019 for randomised control trails of MWM in shoulder dysfunction subjects. The key words used were mobilisation with movement, mulligan’s mobilisation with movement, shoulder dysfunction. Eligibility criteria were Randomised Control Trials (RCT) with 6 out of 12 Cochrane review group for risk of bias assessment published in English language. Results: Nine out of ten studies showed significant changes in mulligan’s MWM group than the general treatment, active ROM exercises, sham’s technique, stretching’s strengthening and stabilisation exercises, end range and mid-range mobilisations, electrotherapeutic modalities and only one showed no significant difference between the two groups but improvements in the pain, ROM, strength and functioning of the subjects with shoulder dysfunction. Conclusion: On overall study of mulligan’s MWM treatment in shoulder dysfunction it has very good improvements on outcome measures such as ROM, pain, strength and functional ability. Further more studies are required for knowing the individual effects of mulligan’s MWM and its short term, long term effects.

scholarly journals Transitional Cell Carcinomas of the Urinary Tract in a Colony of Beagle Dogs

1989 ◽  
Vol 26 (6) ◽  
pp. 455-461 ◽  
Author(s):  
K. J. Nikula ◽  
S. A. Benjamin ◽  
G. M. Angleton ◽  
A. C. Lee
Keyword(s):  
Urinary Tract ◽  
Transitional Cell ◽  
Clinical Signs ◽  
Conclusive Evidence ◽  
Whole Body ◽  
Beagle Dogs ◽  
Long Term Effects ◽  
Significant Difference ◽  
Microscopic Features

Gross and light microscopic features of transitional cell carcinomas (TCC) of the urinary tract were examined in Beagle dogs used for the study of the long-term effects of low-dose, whole-body, 60Co gamma radiation. Thirty-eight cases of TCC occurred among 990 dogs that were from 0 to 14 years of age. There was no conclusive evidence of a radiation effect. The 38 TCC were equally divided between male and female dogs, but there was a significant difference in the sex distribution of urethra-origin TCC. Eleven males had a primary urethral TCC compared to only two females. There was no significant difference between the urethra-origin and bladder-origin TCCs in the number of tumors that caused clinical signs, metastasized, or that contributed to the death of the dog. All cases of urethral TCC in male dogs occurred in the prostatic urethra. The majority of these cases were not recognized to be neoplasms at gross necropsy, but microscopic examination revealed the TCC. Our findings differ from previous reports stating that TCC occurs more frequently in female than male dogs, and they especially differ from reports claiming that urethra-origin TCC is predominately a disease of female dogs.

scholarly journals The effective interventions to improve long-term physiotherapy exercise adherence among patients with lower limb osteoarthritis. A systematic review

2021 ◽  
Author(s):  
Pathmanathan Cinthuja ◽  
Nidhya Krishnamoorthy ◽  
Gamalendira Shivapatham
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
English Language ◽  
Data Extraction ◽  
Exercise Adherence ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Booster Sessions

Abstract Introduction: Osteoarthritis (OA) is a chronic condition that severely effects work life balance impacting psychosocial and socio-economic aspects. Physiotherapy exercise is one of the intervention methods for the management of OA. Adherence to the exercise by patients is essential for the effective management of OA. Objectives: To determine different methods used to enhance physiotherapy exercise adherence for more than 12 months among patients with osteoarthritis and to report the effective method to enhance exercise adherence among people with lower limb osteoarthritis. Design: Systematic review Methods: PubMed, Pedro, Web of Science, and EMBASE databases searched for randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in the English language from 2000 to 2020. The date of data extraction was 04 September 2020. Two independent researchers conducted literature search, assessed eligibility, extracted data, conducted methodology quality assessment using the PEDro scale, and conducted risk of bias assessment. A narrative synthesis of key outcomes is presented; preferred Reporting Items for Systematic review was used to report the review. The study protocol was registered in the Prospero (Prospero ID: CRD42020205653). Results: The primary search strategy identified 5839 potentially relevant articles, of which 5157 remained after discarding duplicates. After screening based on title and abstract, 40 papers were potentially eligible for inclusion. Five of these papers met all predefined eligibility criteria. Introducing methods to enhance exercise adherence has caused a significant increase in exercise adherence for the short term (less than six months or 12 months). There were no significant differences, long-term adherence with different methods, reported. The results indicate that booster sessions (89.69%) and telephone-linked communication (86%) had higher percentages for the exercise adherence. Secondary outcomes such as pain, stiffness, function, show positive outcomes with increasing exercise adherence. However, there were no significant differences reported. Conclusion: The booster sessions and telephone-linked communication appear to enhance exercise adherence for more than 12 months among patients with osteoarthritis. However, a number of high-quality studies are inadequate to confirm our findings. Therefore, more studies with higher methodological quality are needed to determine the best strategies to enhance long-term exercise adherence among people with osteoarthritis. Key terms: Osteoarthritis, Long term, Exercise adherence

scholarly journals Long-term and delayed functional recovery in patients with severe cerebrovascular and traumatic brain injury requiring tracheostomy

2019 ◽  
Vol 131 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Rafael Wabl ◽  
Craig A. Williamson ◽  
Aditya S. Pandey ◽  
Venkatakrishna Rajajee
Keyword(s):  
Brain Injury ◽  
Functional Recovery ◽  
Tube Feeding ◽  
Severe Brain Injury ◽  
Eligibility Criteria ◽  
Severe Stroke ◽  
Icu Discharge ◽  
Significant Difference

OBJECTIVEData on long-term functional recovery (LFR) following severe brain injury are essential for counseling of surrogates and for appropriate timing of outcome assessment in clinical trials. Delayed functional recovery (DFR) beyond 3–6 months is well documented following severe traumatic brain injury (sTBI), but there are limited data on DFR following severe cerebrovascular brain injury. The objective of this study was to assess LFR and DFR in patients with sTBI and severe stroke dependent on tracheostomy and tube feeding at the time of discharge from the intensive care unit (ICU).METHODSThe authors identified patients entered into their tracheostomy database 2008–2013 with sTBI and severe stroke, encompassing SAH, intracerebral hemorrhage (ICH), and acute ischemic stroke (AIS). Eligibility criteria included disease-specific indicators of severity, Glasgow Coma Scale score < 9 at time of tracheostomy, and need for tracheostomy and tube feeding at ICU discharge. Assessment was at 1–3 months, 6–12 months, 12–24 months, and 24–36 months after initial injury for presence of tracheostomy, ability to walk, and ability to perform basic activities of daily living (B-ADLs). Long-term functional recovery (LFR) was defined as recovery of the ability to walk or perform B-ADLs by the 24- to 36-month follow-up. Delayed functional recovery (DFR) was defined as progression in functional milestones between any 2 time points beyond the 1- to 3-month follow-up.RESULTSA total of 129 patients met the eligibility criteria. Functional outcomes were available for 129 (100%), 97 (75%), 83 (64%), and 80 (62%) patients, respectively, from assessments at 1–3, 6–12, 12–24 and 24–36 months; 33 (26%) died by 24–36 months. Fifty-nine (46%) regained the ability to walk and 48 (37%) performed B-ADLs at some point during their recovery. Among survivors who had not achieved the respective milestone at 1–3 months, 29/58 (50%) were able to walk and 28/74 (38%) performed B-ADLs at 6–12 months. Among survivors who had not achieved the respective milestone at 6–12 months, 5/16 (31%) were able to walk and 13/30 (43%) performed B-ADLs at 12–24 months. There was no significant difference in rates of LFR or DFR between patients with sTBI and those with severe stroke.CONCLUSIONSAmong patients with severe brain injury requiring tracheostomy and tube feeding at ICU discharge, 46% regained the ability to walk and 37% performed B-ADLs 2–3 years after injury. DFR beyond 1–3 and 6–12 months was seen in over 30% of survivors, with no significant difference between sTBI and severe stroke.

scholarly journals Short- and Long-Term Reduction of Door-to-Needle Time in Thrombolysis for Acute Stroke

2016 ◽  
Vol 44 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Bing Yu Chen ◽  
Aimen Moussaddy ◽  
Mark R. Keezer ◽  
Yan Deschaintre ◽  
Alexandre Y. Poppe
Keyword(s):  
Computed Tomography ◽  
Intracerebral Hemorrhage ◽  
Acute Stroke ◽  
Hospital Treatment ◽  
Long Term Effects ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Significant Difference ◽  
Clinical Benefits ◽  
Short And Long Term

AbstractBackground: More timely administration of tissue plasminogen activator (alteplase) for patients with acute ischemic stroke yields greater clinical benefits. We implemented door-to-needle (DTN) time reduction strategies at our center and evaluated their short- and long-term effects on in-hospital treatment delays and clinical outcomes. Methods: Strategies, including stroke team prenotification, direct computed tomography transfer, not routinely waiting for laboratory results and alteplase delivery on the computed tomography table, were implemented in June 2013. We included all thrombolysed patients admitted directly to our hospital between January 2012 and March 2015. In-hospital delays and symptomatic intracerebral hemorrhage rates were compared between patients pre- and postmodification, and the latter period was divided into early (first 6 months) and late (beyond 6 months) phases to assess the durability of our modifications. Results: Forty-eight individuals were treated premodification compared with 58 postmodification. The median DTN time was reduced from 75 to 46 minutes (p<0.0001). The median DTN time in the early and late postmodification phases was not significantly different (41 vs 46 minutes, p=0.4085). There was no significant difference in rates of symptomatic intracerebral hemorrhage (4.2 vs 1.7%, p=0.361) or stroke mimics (2.1 ves 5.2%, p=0.625) Conclusions: We were able to decrease our DTN time for acute stroke thrombolysis by implementing relatively simple modifications and these improvements persisted over time.

Imatinib Long Term Effects (ILTE) Study: An Independent, International Study in CML Patients.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1099-1099
Author(s):  
Carlo Gambacorti-Passerini ◽  
Dong-Wook Kim ◽  
François-Xavier Mahon ◽  
Giuseppe Saglio ◽  
Fabrizio Pane ◽  
...  
Keyword(s):  
Adverse Events ◽  
International Study ◽  
Imatinib Treatment ◽  
Long Term Effects ◽  
First Line ◽  
Eligibility Criteria ◽  
Serious Adverse Events ◽  
Second Cancers

Abstract Imatinib is an effective first line therapy for chronic myeloid leukemia (CML) and has substantially changed its biological and clinical behavior. Durable complete cytogenetic responses (CCyR) were reported in the majority of patients, with a rather benign side effect profile, despite the ‘off target’ inhibition of several other kinases, including Kit, PDGFR and Lck. Since available information is largely based on industry-sponsored trials and long-term field studies are lacking, the ILTE study was conceived as an industryindependent, academic, multicenter trial supported by the Italian Drug Safety Agency (AIFA). ILTE is an international study on a retrospective cohort and includes 31 centers in Europe, North/South America, Africa and Asia; therefore it is uniquely positioned to present a global picture of imatinib long-term effects. Consecutive patients with Ph+ CML who started imatinib between 01 September 1999 and 31 December 2004 were eligible if they were in Complete Cytogenetic Response (CCyR) after two years of imatinib treatment. Study endpoints were survival, serious adverse events (SAE, including second cancers), toxicities not qualifying as SAE (NSAE) but judged by the referring physician as substantially impacting quality of life, loss of CCyR, and development of PCR negativity. A total of 957 patients were enrolled, 92% of which met eligibility criteria. The median age of eligible patients was 50 (range 15–92) years; 59% of patients were males and the median follow-up was 3.1 years (excluding the first 2 years of treatment). As of Dec. 31 2007, 2564 person years were available for analysis. Eleven deaths were observed (only 3 of them caused by relapsed CML), with a standardized rate of 0.4/100 person years and an observed/expected ratio of 0.48 (95% CI = 0.24–0.85). One-hundred SAE were recorded (rate 3.9/100 person years, most frequent type “heart failure”), with 21% being considered related to imatinib. Second cancers were documented in 28 patients (rate 1.1/100 person years), with an observed/expected ratio of 1.27 (95% CI = 0.84–1.84). Among the 576 NSAE recorded (0.65/patient) the most frequent types were “edema, cramps, skin fragility, diarrhea”; 71% of them were related to imatinib. A total of 12 patients (1.4 %) discontinued imatinib because of toxicities during the period of observation. Thirty-four patients lost CCyR, corresponding to a rate of 1.4/100 person years (1.0 in patients with imatinib as first-line treatment, 1.5 in patients who were treated with imatinib &gt;6 months after diagnosis), with stable or increasing rates over time. Finally, 214 patients (24.5%) developed durable (&gt; 1 year) PCR negativity. In conclusion, the first report from ILTE shows that CML patients on imatinib die unfrequently of CML related causes, do not appear to have substantially higher second cancer rates than the general population, have mortality rates lower than expected in an age/sex matched population and do not show new types of imatinib-related adverse events. They also experience a low but steady rate of loss of CCyR and develop PCR negativity in approximately ¼ of cases. Follow-up and further analysis are ongoing. (Presented on behalf of the ILTE Investigators group)

Recommendation of dose banding of cytotoxics according to pharmacokinetic criteria.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2549-2549
Author(s):  
Etienne Chatelut ◽  
Melanie White-Koning ◽  
Ron H.J. Mathijssen ◽  
Sharyn D. Baker ◽  
Alex Sparreboom
Keyword(s):  
Capacity Planning ◽  
Simple Procedure ◽  
Drug Stability ◽  
Exposure Dose ◽  
Analytical Control ◽  
Individual Dose ◽  
Significant Difference ◽  
Patient Waiting Time ◽  
The Individual

2549 Background: Dose-banding has been recently suggested in order to optimize chemotherapy preparation. Ranges (or bands) of body surface area (BSA) are predefined. The individual dose of a particular patient is calculated according to a single BSA value per band, usually the mid-point of the BSA band in which the actual BSA of the patient lies. Thanks to this simple procedure, chemotherapy provision can be rationalized and chemotherapies can be prepared in advance for drugs with sufficient long-term drug stability. The primary purpose of dose-banding is to reduce patient waiting time and improve capacity planning of the pharmacy production, but additional benefits can also be found, such as reduced potential for medication errors, reduced drug wastage, and prospective quality control of preparations. The objective of this analysis was to compare dose-banding to individual BSA-dosing (current practice) according to pharmacokinetic (PK) criteria. Methods: Dose-banding was defined according to three bands of BSA: BSA<1.7m², 1.7m²≤BSA<1.9m², and BSA≥1.9m² for which the values of 1.55m², 1.80m², and 2.05m² were allocated, respectively. By using individual actual values of clearance of six drugs (cisplatin, docetaxel, paclitaxel, doxorubicin, topotecan, and irinotecan) from a total of 1,206 adult cancer patients, the AUCs corresponding to the two dosing methods were compared to a target value of AUC for each drug. Results: Over all 6 drugs, by using dose-banding the percent change of individual dose in comparison with BSA dosing ranged between -14% and +22%. In terms of capacity to attain the target AUC, there was no significant difference in precision when using dose-banding as compared to BSA-dosing for all drugs except paclitaxel (precision of 23.2% versus 21.8%, respectively). For all drugs including paclitaxel, distributions of AUC values were very similar with both dosing methods. Conclusions: For these 6 drugs and maybe others, dose-banding may be implemented without any risk of increasing interindividual plasma exposure. Dose-banding would make it possible to anticipate chemotherapy preparation and analytical control without any delay for the patients.

scholarly journals Gameplay as a Source of Intrinsic Motivation for Individuals in Need of Ankle Training or Rehabilitation

2012 ◽  
Vol 21 (1) ◽  
pp. 69-84 ◽  
Author(s):  
Niels Christian Nilsson ◽  
Stefania Serafin ◽  
Rolf Nordahl
Keyword(s):  
Intrinsic Motivation ◽  
Long Term Effects ◽  
Future Health ◽  
Rehabilitation Process ◽  
Design And Implementation ◽  
Quantitative Test ◽  
Ankle Rehabilitation ◽  
The Future ◽  
The Individual

Injuries to the ankle may be a source of great discomfort and the long-term effects can negatively influence the future health of the individual who has suffered the injury. Wobble boards represent a relatively inexpensive type of equipment that may be used to train one's ankles preventively or as part of the rehabilitation process once the damage has been done. However, individuals in need of such training frequently lack the motivation necessary in order to successfully complete the training or rehabilitation process. This paper details the design and implementation of a prototype intended to alleviate this problem by leveraging games' potential as a source of intrinsic motivation. More specifically, the prototype enables users to control a game by means of a wobble board, thus allowing them to perform the necessary exercises while playing. An expert on ankle rehabilitation assessed the efficacy of the training facilitated by the prototype, and 40 individuals partook in a quantitative test performed in order to determine whether the prototype could potentially provide the needed motivation. Based on the findings from the two tests, it is concluded that the prototype does ensure correct ankle training and the act of playing was experienced as intrinsically motivating by the majority of the test participants.

scholarly journals Oncological and quality of life outcomes following extralevator versus standard abdominoperineal excision for rectal cancer

2017 ◽  
Vol 99 (5) ◽  
pp. 402-409 ◽  
Author(s):  
D Kamali ◽  
A Sharpe ◽  
A Musbahi ◽  
A Reddy
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Abdominoperineal Excision ◽  
Long Term Effects ◽  
Recurrence Rates ◽  
Oncological Outcomes ◽  
Significant Difference

INTRODUCTION There is increasing and conflicting research debating the oncological benefits of extralevator abdominoperineal excision (ELAPE) compared with standard abdominoperineal excision (SAPE). However, there is very little in the literature on the long-term effects on patients’ wellbeing following the two procedures. The aim of this study was to determine the oncological outcomes and long-term quality of life (QoL) of patients at two hospitals having undergone ELAPE or SAPE. METHODS Consecutive patients with rectal cancer who underwent either ELAPE or SAPE between January 2009 and June 2015 at a single centre were analysed. Oncological outcomes were determined by histology and follow-up imaging. QoL data were obtained prospectively using the QLQ-C30 and QLQ-CR29 questionnaires. RESULTS A total of 48 patients (36 male, 12 female; 27 ELAPE, 21 SAPE) were reviewed. The mean age was 67.4 years and the median follow-up duration was 44 months (range: 6–79 months). Four patients (2 ELAPE, 2 SAPE) developed local recurrence. Rates of distant metastasis were similar (ELAPE: 11%, SAPE: 14%). There was no significant difference in mean global health status score (ELAPE: 77.3, SAPE: 65.3). Impotence was the most frequently reported problem (mean symptom scores of 89.7 and 78.8 for ELAPE and SAPE respectively). CONCLUSIONS This is the largest study with the longest follow-up period that compares QoL after ELAPE with that after SAPE. Although more radical in nature, ELAPE did not demonstrate any significant impact on QoL compared with SAPE. There was no significant difference in long-term oncological outcome between the groups. Impotence remains a significant problem for all patients and they should be well informed of this risk prior to surgery.

Acute and long-term effects of grape and pomegranate juice consumption on vascular reactivity in paediatric metabolic syndrome

2010 ◽  
Vol 20 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Mohammad Hashemi ◽  
Roya Kelishadi ◽  
Mahin Hashemipour ◽  
Afshin Zakerameli ◽  
Noushin Khavarian ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Endothelial Function ◽  
Grape Juice ◽  
Pomegranate Juice ◽  
Controlled Clinical Trial ◽  
Flow Mediated Dilation ◽  
Long Term Effects ◽  
Daily Consumption ◽  
Significant Difference

AbstractObjectivesThis study, which to the best of our knowledge is the first of its kind, aimed to determine the acute and long-term effects of the consumption of grape and pomegranate juices on endothelium function in adolescents with metabolic syndrome, and to compare the effects of these two kinds of juices.MethodsThis randomised controlled clinical trial was conducted in 2008 among 30 adolescents, aged 12–15 years, with metabolic syndrome. Participants were randomly assigned to two groups of equal number; one group was asked to drink 18 millilitre per kilogram per day of natural grape juice and the other group was asked to drink 240 millilitre per day of natural pomegranate juice once daily for 1 month. Juices were homemade without any added sweetener. Basal brachial artery dimension and flow-mediated dilation as an index of endothelial function and endothelial-dependent dilation after receiving nitoglycerin spray were evaluated by high-resolution B mode ultrasonography before juice consumption, 4 hours and 30 days after regular daily consumption.ResultsFlow-mediated dilation at 90 seconds and after nitoglycerin significantly improved at 4 hours and at 1 month after drinking both kinds of juices, without significant difference between the two groups. The change at 1 month versus 4 hours was significant only in the grape juice group.ConclusionDaily consumption of diets rich in antioxidants might improve endothelial function in adolescents with metabolic syndrome. These effects began as soon as 4 hours after juice consumption. Such beneficial effects should be considered in dietary recommendations for the paediatric age group, notably in obese individuals.

scholarly journals Effects of a physiotherapist-led approach based on a biopsychosocial model for spinal disorders: protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e055144
Author(s):  
Takahiro Miki ◽  
Yu Kondo ◽  
Hiroshi Kurakata ◽  
Tsuneo Takebayashi ◽  
Mina Samukawa
Keyword(s):  
English Language ◽  
Long Term Effects ◽  
Short Term ◽  
Spinal Disorders ◽  
Ethical Approval ◽  
Registration Number ◽  
Randomised Controlled ◽  
Cause Of Pain

IntroductionLow back pain and neck pain are among the most common musculoskeletal disorders, and their related medical costs are rising every year. Many interventions are based on the biopsychosocial (BPS) model since the cause of pain is more multifaceted. Physiotherapists have increased opportunities to perform multidisciplinary interventions alone in clinical practice due to a lack of understanding of the model and its cost. Therefore, physiotherapist-led interventions using the BPS model are important and require an updated report summarising their effectiveness. Thus, the purpose of this study will be to summarise and synthesise the effects of physiotherapist-led interventions using the BPS model for spinal disorders.Methods and analysisWe will search the Web of Science, CENTRAL, MEDLINE, PsycINFO, CINAHL and PEDro electronic databases, using a date range from inception to September 2021. We will include only randomised controlled trials for patients diagnosed with spinal disorders who received physiotherapist-led interventions based on the BPS model. The search will be limited to English-language publications. Pain intensity and disability are the primary outcomes. Secondary outcomes are any psychological factors. We will examine the short-term, medium-term and long-term effects, and a subgroup analysis will be conducted, if possible, to investigate the role of additional physiotherapist training.Ethics and disseminationThis study is exempt from ethical approval because it involves publicly available documents. The findings will be submitted for publication in a relevant peer-reviewed journal.PROSPERO registration numberCRD42021258071.

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