RESUMEN
PURPOSE: To evaluate the current evidence comparing low level to high level laser therapy to reveal any superiorities in the treatment of musculoskeletal disorders. METHODS: Five databases were searched till September 2022 to obtain relevant RCTs comparing high intensity and low-level laser therapies in the management of musculoskeletal disorders. Two authors assessed the methodological quality of the included studies using the Physiotherapy Evidence Database scale and meta-analysis was conducted for studies that showed homogeneity. RESULTS: Twelve articles were included in this systematic review with a total population of 704 participants across various musculoskeletal pathologies including tennis elbow, carpal tunnel syndrome, chronic non-specific low back pain, knee arthritis, plantar fasciitis, and subacromial impingement. There were no statistical differences between the two interventions in pain, electrophysiological parameters, level of disability, quality of life, postural sway or pressure algometer, however, Low level laser therapy showed superiority in increasing grip strength compared to high intensity laser therapy while results were significant in favour of high intensity laser therapy regarding long head of biceps diameter and cross sectional area, supraspinatus thickness and echogenicity and acromio-humeral distance. CONCLUSION: The current literature suggests no superiority of both types of laser therapy in musculoskeletal disorders, however, more RCTs with larger sample size are required to reach a definitive conclusion regarding the superiority of either form of laser therapy in musculoskeletal disorders.
Asunto(s)
Terapia por Luz de Baja Intensidad , Enfermedades Musculoesqueléticas , Humanos , Enfermedades Musculoesqueléticas/radioterapia , Terapia por Luz de Baja Intensidad/métodos , Terapia por Láser/métodos , Síndrome del Túnel Carpiano/radioterapia , Calidad de Vida , Codo de Tenista/radioterapia , Resultado del TratamientoRESUMEN
This systematic review aims to examine the evidence of adding postural insole to traditional physical therapy to improve weight distribution, gait, mobility, balance, and postural control in stroke survivors. Five databases were searched to retrieve all related randomized controlled trials examining the effect of insole on stroke patients. Two independent authors checked the potential articles against eligibility criteria according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A meta-analysis was conducted for available outcomes and the statistical heterogeneity was examined using the I2 test. Of 762 articles, only 15 with 448 patients were included after they met the inclusion criteria with most of them including participants exceeding 6 months of stroke incidence. When insole was used as compelled body weight shifting method, pooled statistical analysis revealed significant improvement in gait velocity [standardized mean difference (SMD)â =â 0.67; 95% confidence interval (CI): 0.31, 1.02; P â =â 0.0003], cadence (SMDâ =â 0.67; 95% CI: 0.16, 1.18; P â =â 0.01] and stride length (SMDâ =â 1.11; 95% CI: 0.57, 1.65; P â <â 0.0001), while no significant effect on step length (SMDâ =â 0.48; 95% CI: -0.37, 1.33; P â =â 0.27). Pooled statistical analysis of balance outcomes revealed significant improvement in weight-bearing symmetry balance (SMDâ =â 0.82; 95% CI: 0.25, 1.39; P â =â 0.005) and long-term improvement in Berg Balance Scale (SMDâ =â 1.19; 95% CI: 0.19, 2.20; P â =â 0.02), while no difference was observed in balance confidence (SMDâ =â 0.44; 95% CI: -0.15, 1.04; P â =â 0.14) and sensorimotor functions (SMDâ =â 0.36; 95% CI -0.39, 1.11; P â =â 0.35). Insoles significantly improved spatiotemporal gait parameters, gait symmetry, and static balance compared with traditional physical therapy alone.
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Equilibrio Postural , Rehabilitación de Accidente Cerebrovascular , Humanos , Equilibrio Postural/fisiología , Rehabilitación de Accidente Cerebrovascular/métodos , Marcha/fisiología , Ortesis del Pié , Trastornos Neurológicos de la Marcha/rehabilitación , Trastornos Neurológicos de la Marcha/fisiopatología , Accidente Cerebrovascular/fisiopatologíaRESUMEN
Burn injury is a complicated traumatic event with both systemic and local consequences. These complications include long periods of bed rest, pain, muscle weakness, vitamin D deficiency, and bone mineral density loss. Whole-body vibration demonstrated effectiveness in improving muscle power and bone mineral density in various musculoskeletal populations. This systematic review of randomized controlled trials aims to assess evidence for the effectiveness of using whole-body vibration on postburn survivors with at least 1% total body surface area on sensory and motor outcomes. A systematic search was conducted across six databases, which are, PubMed, Cochrane, PEDro, Scopus, Web of Science, and Google Scholar, from inception till March 2022. Retrieved studies were screened by title and abstract and full-text in two stages using Rayyan web-based. Included studies were assessed for risk of bias using the Cochrane risk of bias tool ROB 2.0. Six randomized controlled trials with 203 participants were included. Five of the included studies demonstrated an overall high risk of bias. Compared to conventional physiotherapy programs, whole-body vibration demonstrated improvement in functional mobility and balance using timed up and go and Biodex balance assessment, respectively. However, there were no differences between whole-body vibration and conventional physiotherapy program alone in bone mineral density and muscle power. Although the current evidence of whole-body vibration is limited, whole-body vibration combined with traditional physical therapy programs may improve functional mobility and balance in postburn survivors compared to physical therapy programs alone.
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Quemaduras , Vibración , Humanos , Vibración/uso terapéutico , Quemaduras/complicaciones , Quemaduras/terapia , Modalidades de Fisioterapia , Densidad Ósea/fisiología , Fuerza Muscular/fisiología , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: To evaluate the efficacy of different physical therapy interventions that could validate decisions taken by health care providers in the field of rehabilitation of patients with hemophilia according to the International Classification of Functioning, Disability and Health (ICF), including body functions and structures, activity, and participation. DATA SOURCES: Seven databases-PubMed, Cochrane Library, Scopus, Web of Science, Physiotherapy Evidence Database, Google Scholar, and Clinicaltrials.gov-were systematically searched for randomized controlled trials evaluating any physical therapy modality to manage hemophilia. STUDY SELECTION: After abstract and full-text filtration, a methodological quality assessment was performed using the Physiotherapy Evidence Database scale for the studies that met the eligibility criteria. DATA EXTRACTION: Relevant data were extracted from eligible studies and outcomes were categorized according to the ICF. DATA SYNTHESIS: Using Review Manager and Microsoft Excel, a quantitative analysis using standardized mean differences with the 95% confidence interval was completed. Statistical heterogeneity between studies was explored using the I2 test. A fixed effect model was applied to all data analyses. If heterogeneity was statistically significant, the Der Simonian and Laird random effects models were used instead. RESULTS: 35 randomized controlled trials with 1216 participants were included in this systematic review; 13 of them dealt with pediatric patients. Most of the studies were of good quality; 12 studies were of low quality. Meta-analysis showed a significant difference in favor of manual therapy, laser, and therapeutic exercises on selected outcomes of body function and structure, activity, and participation categories of the ICF model. CONCLUSION: This systematic review recommends using manual therapy and therapeutic exercise modalities to improve join health status in combination with educational sessions to improve the quality of life of patients with hemophilic arthropathy. For pediatric patients with hemophilic arthropathy, using laser therapy is promising for improving functional capacity.
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Hemofilia A , Artropatías , Enfermedades Vasculares , Humanos , Niño , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Modalidades de FisioterapiaRESUMEN
OBJECTIVE: To evaluate the evidence of using Action Observation Therapy in the rehabilitation of children with Cerebral Palsy. STUDY DESIGN: Systematic review with meta-analysis of Randomised Controlled Trials. METHODS: For the purpose of identifying relevant studies, six databases were searched from inception until July 2020. The methodological quality was assessed by Physiotherapy Evidence Database scale. The outcomes were classified within the framework of the International Classification of Functioning. A pooled meta-analysis was performed on studies that demonstrated homogeneity. RESULTS: Twelve randomised controlled trials with 307 participants were included with six of them were included in the meta-analysis. Non-significant difference between the groups was demonstrated by meta-analysis. Results of capacity assessed in post treatment and follow up evaluation were (0.06, -0.22 to 0.34, 95% (CI); P = 0.69 and (-0.35, -0.96 to 0.27, 95% (CI); P = 0.27); respectively. Actual performance in post-treatment and follow up were (0.10, -0.22 to 0.48, 95% (CI); P = 0.62) and (0.01, -0.40 to 0.41, 95% (CI); P = 0.97); respectively. Perceived performance evaluated using (ABILHAND-KIDS) were (0.30, -0.28 to 0.89, 95% (CI); P = 0.31) and (0.15, -0.43 to 0.73, 95% (CI); P = 0.61) for post treatment and follow up; respectively. Overall effect on activity domain was (0.08, -0.11 to 0.28, 95% (CI); P = 0.86) immediately and (0.04, -0.33 to 0.26, 95% (CI); P = 0.49) at follow-up; respectively. CONCLUSION: No evidence of benefit had been found to draw a firm conclusion regarding the effectiveness of action observation therapy in the rehabilitation of children with cerebral palsy due to limitations in methodological quality and variations between studies.