Quality of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The quality of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the quality of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the quality of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. Results: A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 3 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 40%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the quality of reporting

Completeness of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The completeness of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the completeness of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the completeness of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 4 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 30%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the completeness of reporting

Assessing the Feasibility and Acceptability of a Primary Care Socio-Ecological Approach to Improve Physical Activity Adherence among People with Type 2 Diabetes : The SENWI Project

Ajuts: This research was funded by Col·legi de Fisioterapeutes de Catalunya (CFC), grant number R05/21.Maintaining an active lifestyle is a key health behavior in people with type 2 diabetes (T2D). This study assessed the feasibility and acceptability of a socio-ecological Nordic walking intervention (SENWI) to enhance healthy behaviors in primary healthcare settings. Participants included individuals with T2D (n = 33; age 70 (95% CI 69-74)) and healthcare professionals (HCPs, n = 3). T2D participants were randomly assigned to a SENWI, active comparator, or control group for twelve weeks. Feasibility and acceptability were evaluated based on a mixed methodology. Quantitative data reported adherence information, differences between follow-up and dropout participants and pre- and post-intervention on physical activity, sedentary behavior, and health outcomes. Qualitative data acquisition was performed using focus groups and semi-structured interviews and analyzed using thematic analysis. Thirty-three T2D invited participants were recruited, and twenty-two (66.7%) provided post-intervention data. The SENWI was deemed acceptable and feasible, but participants highlighted the need to improve options, group schedules, gender inequities, and the intervention's expiration date. Healthcare professionals expressed a lack of institutional support and resources. Nevertheless, no significant difference between the SENWI follow-up and dropout participants or pre- and post- intervention was found (only between the active comparator and control group in the physical quality of life domain). Implementing the SENWI in primary healthcare settings is feasible and acceptable in real-world conditions. However, a larger sample is needed to assess the program's effectiveness in improving healthy behaviors and its impact on health-related outcomes in the long term

Effectiveness of home-based exercise delivered by digital health in older adults : a systematic review and meta-analysis

regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults. systematic review and meta-analysis. community-dwelling older adults over 65 years. exercises at home through DHI. physical function, HRQoL and falls. twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, −0.56 s, 95% confidence interval, CI −1.00 to −0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD −0.23; 95% CI −0.45 to −0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004). the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility

Avaluació i aplicació de noves intervencions en fisioteràpia per evitar caigudes en persones grans : una aproximació de la pràctica basada en l'evidència a la fisioteràpia geriàtrica

Antecedents: Els problemes relacionats amb l'equilibri i la força muscular en persones grans o afectades de malalties neurodegeneratives poden comportar conseqüències importants com ara les caigudes. L'entrenament mitjançant vibracions de cos sencer sembla ser una intervenció que podria comportar beneficis en els problemes relacionats amb les caigudes o mobilitat funcional, aspectes importants per l'autonomia de la persona. Malgrat això, la base d'evidència científica d'aquesta intervenció és incerta i poc estudiada. Mètodes: S'han realitzat dues revisions sistemàtiques per avaluar l'eficàcia i la seguretat de les intervencions amb vibracions de cos sencer, en un col·lectiu sobre el qual l'evidència és incerta (gent gran o persones afectades de malaltia neurodegenerativa). També s'ha portat a terme un assaig clínic aleatorizat per tal d'avaluar l'eficàcia de les intervencions de cos sencer per a la millora de l'equilibri i la força muscular en persones grans institucionalitzades de Catalunya. Addicionalment s'ha realitzat un seguiment de les caigudes per valorar-ne l'efecte. Resultats: L'entrenament amb vibracions de cos sencer sembla millorar la força muscular i l'equilibri en persones grans si es compara amb un grup control o placebo (el qual realitza el mateix exercici sense la vibració o bé no canvia les rutines diàries), però les diferències no semblen existir quan es compara amb la realització d'exercici físic o convencional (exercicis d'equilibri, entrenament de la resistència muscular, caminar o un programa de condicionament físic). En aquest cas, els efectes són similars excepte en la densitat mineral òssia. No hi ha cap estudi que avaluï l'eficàcia de l'entrenament amb vibracions de cos sencer per prevenir caigudes. Pel que fa a la seva eficàcia en les persones afectades de malalties neurodegeneratives, s'ha estudiat únicament en la malaltia de Parkinson i en l'esclerosi múltiple. No hi ha suficient evidència per refusar o no la intervenció, ja que no hi ha suficients estudis. Tot i això, una única sessió de vibracions mecàniques sembla millorar la deambulació en persones afectades de Parkinson. Discussió: Les revisions sistemàtiques permeten clarificar les incerteses davant una qüestió clínica, tot i englobant la millor evidència disponible. Les revisions sistemàtiques que avaluen intervencions de fisioteràpia estan condicionades, tant per les deficiències metodològiques dels corresponents assaigs clínics com també per una presentació dels resultats poc rigorosa. Així doncs, la qualitat de les evidències disponibles en les dues revisions s'ha vist afectada per les limitacions pròpies dels estudis originals i s'ha qualificat de moderada a baixa. No obstant això, aquestes debilitats juntament amb algunes incerteses encara existents, han estat el punt de partida per elaborar un protocol d'assaig clínic que pugui arribar a clarificar-les. Així doncs, s'ha pogut arribar a conclusions més clares sobre l'eficàcia de l'entrenament amb vibracions de cos sencer en persones grans, però, pel que fa a l'efecte en persones amb malalties neurodegeneratives, l'evidència roman incerta. Conclusions: L'entrenament amb vibracions de cos sencer pot millorar l'equilibri, la força i la potència muscular en comparació amb un grup control o placebo, encara que aquestes diferències no apareixen quan es compara amb la realització d'un programa d'exercici físic (exercici més convencional). Els resultats obtinguts en la densitat mineral òssia quan es comparen amb una intervenció basada en exercici físic no semblen ser clínicament rellevants. La intervenció sembla prou segura, tot i que es recomana que els futurs estudis prevegin un adequat mètode per controlar i seguir els possibles efectes adversos. Hi ha necessitat de més assaigs clínics controlats per poder avaluar millor els beneficis potencials de les vibracions de cos sencer en la prevenció de caigudes en gent gran, i en la millora de l'autonomia per a la realització de les activitats quotidianes en persones afectades de malalties neurodegeneratives.Background: Problems related with poor balance and muscle weakness in the elderly or in people with neurodegenerative diseases are factors that increase the risk of falls. The high prevalence of falls among the elderly (between 30% and 35%) and institutionalized aged people (40%), carries a high social and clinical impact. Whole body vibration training is an intervention that could promote a reduction in falls and an increase in mobility, which are key aspects for this population. However, the basis of scientific evidence for this intervention is unclear and poorly understood. Methods: We conducted two systematic reviews to evaluate the efficacy and safety of whole body vibration interventions in the elderly and in people with neurodegenerative disease. We also conducted a randomized clinical trial to assess the efficacy of whole body training in institutionalised elderly to improve balance and muscle strength. Additionally, we evaluated the incidence of falls to measure the effect of the intervention. Results: Whole body vibration training seems to improve muscle strength and balance in the elderly compared to a control or placebo group (who performed the same exercises as the intervention group but without the vibration, or who did not change their daily activities). However, there were no differences when compared to programs of physical or conventional exercise (balance exercises, resistance training, walking, or fitness). In this case, the effects were similar except regarding bone density. There are no studies in the currently available literature that evaluates the efficacy of whole body vibration training in the prevention of falls. Regarding its effect on people with neurodegenerative diseases, it has been studied only on those with Parkinson's disease and multiple sclerosis. Heterogeneity of interventions and outcomes measured make it difficult to determine the potential benefits among this population. For this reason, there is insufficient evidence regarding the effect of this intervention in the improvement of autonomy during the activities of daily living. However, a single session of whole body vibration training seems to improve parkinsonian gait. Discussion: Contemporary physiotherapists need fast, comprehensive, and reliable information to facilitate their decision-making process. Systematic reviews can clarify uncertainties using the best available evidence. However, systematic reviews that evaluate physiotherapy interventions are conditioned by methodological limitations of the trials included and by poor presentation of results. Thus, quality of the evidence available from the two systematic reviews conducted is moderate to low, mainly because of limitations in the studies, including deficiencies in design and methodology, heterogeneity of interventions, diversity in the methods of evaluation of outcomes, and a poor presentation of results. However, these weaknesses, together with uncertainties on this topic that still exist, were the starting point for developing a clinical trial protocol that could clarify these uncertainties. Thus, it was possible to arrive at clear conclusions about the efficacy of whole body vibration training in the elderly. Its effect on people suffering from neurodegenerative diseases remains unclear. Conclusions: Whole body vibration training can improve balance, strength, and muscle power compared to a control group or placebo, although these differences are not seen when compared against physical exercise programs (conventional exercise). The data results obtained on bone density do not seem to be clinically relevant. The intervention appears to be safe, although it is recommended that future studies anticipate an adequate method for controlling and monitoring possible adverse effects. There is a need for more controlled clinical trials to better evaluate the potential benefits of whole body vibration training in the prevention falls and in the improvement of the functional capacity in daily activities of people with neurodegenerative diseases

The Efficacy of the proprioceptive neuromuscular facilitation (PNF) approach in stroke rehabilitation to improve basic activities of daily living and quality of life : A systematic review and meta-analysis protocol

Proprioceptive neuromuscular facilitation (PNF) is a widely used rehabilitation concept, although its efficacy has not yet been demonstrated in stroke survivors. The aim of this systematic review is to identify, assess and synthesise the potential benefits of using PNF to improve the activities of daily living (ADL) and quality of life (QoL) of individuals with stroke. A systematic electronic search will be conducted in MEDLINE, Embase, CENTRAL and PEDro. We will include randomised or quasi-randomised controlled trials of PNF interventions conducted in stroke survivors up to April 2017. Two review authors will independently select relevant studies and will extract data using the Cochrane handbook for systematic reviews of interventions approach and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The methodological quality will be assessed by using the PEDro scale. Finally, with the permitted numeric data, we will carry out a meta-analysis. Ethical considerations will not be required. will be disseminated in a peer-review journal. This systematic review aims to examine the effects of PNF (neurophysiological approach) in order to clarify its efficacy in improving ADL and QoL in the rehabilitation process of stroke survivors

Whole body vibration for older persons: an open randomized, multicentre, parallel, clinical trial

Abstract Background Institutionalized older persons have a poor functional capacity. Including physical exercise in their routine activities decreases their frailty and improves their quality of life. Whole-body vibration (WBV) training is a type of exercise that seems beneficial in frail older persons to improve their functional mobility, but the evidence is inconclusive. This trial will compare the results of exercise with WBV and exercise without WBV in improving body balance, muscle performance and fall prevention in institutionalized older persons. Methods/Design An open, multicentre and parallel randomized clinical trial with blinded assessment. 160 nursing home residents aged over 65 years and of both sexes will be identified to participate in the study. Participants will be centrally randomised and allocated to interventions (vibration or exercise group) by telephone. The vibration group will perform static/dynamic exercises (balance and resistance training) on a vibratory platform (Frequency: 30-35 Hz; Amplitude: 2-4 mm) over a six-week training period (3 sessions/week). The exercise group will perform the same exercise protocol but without a vibration stimuli platform. The primary outcome measure is the static/dynamic body balance. Secondary outcomes are muscle strength and, number of new falls. Follow-up measurements will be collected at 6 weeks and at 6 months after randomization. Efficacy will be analysed on an intention-to-treat (ITT) basis and 'per protocol'. The effects of the intervention will be evaluated using the "t" test, Mann-Witney test, or Chi-square test, depending on the type of outcome. The final analysis will be performed 6 weeks and 6 months after randomization. Discussion This study will help to clarify whether WBV training improves body balance, gait mobility and muscle strength in frail older persons living in nursing homes. As far as we know, this will be the first study to evaluate the efficacy of WBV for the prevention of falls. Trial Registration ClinicalTrials.gov: NCT01375790</p

Pragmatic attitude in manual therapy randomized clinical trials. A descriptive study

To investigate the characteristics of the design and report of termed (so-called) pragmatic manual therapy randomized clinical trials

The Efficacy of the proprioceptive neuromuscular facilitation (PNF) approach in stroke rehabilitation to improve basic activities of daily living and quality of life: a systematic review and meta-analysis protocol

Introduction Proprioceptive neuromuscular facilitation (PNF) is a widely used rehabilitation concept, although its efficacy has not yet been demonstrated in stroke survivors. The aim of this systematic review is to identify, assess and synthesise the potential benefits of using PNF to improve the activities of daily living (ADL) and quality of life (QoL) of individuals with stroke. Methods and analysis A systematic electronic search will be conducted in MEDLINE, Embase, CENTRAL and PEDro. We will include randomised or quasi-randomised controlled trials of PNF interventions conducted in stroke survivors up to April 2017. Two review authors will independently select relevant studies and will extract data using the Cochrane handbook for sstematic reviews of interventions approach and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The methodological quality will be assessed by using the PEDro scale. Finally, with the permitted numeric data, we will carry out a meta-analysis. Ethics and dissemination Ethical considerations will not be required. Results will be disseminated in a peer-review journal. This systematic review aims to examine the effects of PNF (neurophysiological approach) in order to clarify its efficacy in improving ADL and QoL in the rehabilitation process of stroke survivor