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Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: A systematic review and meta-analysis / Lu Luo in Annals of physical and rehabilitation medicine, Vol. 63, n°1 (Janvier 2020)
[article]
Titre : Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: A systematic review and meta-analysis Type de document : texte imprimé Auteurs : Lu Luo ; Haining Meng ; Ziwei Wang ; Shiqiang Zhu ; Song Yuan ; Yuyang Wang ; Qiang Wang Année de publication : 2020 Article en page(s) : p. 59-68 Note générale : doi.org/10.1016/j.rehab.2019.07.006 Langues : Anglais (eng) Mots-clés : Exercise therapy Intensity Stroke Cardiorespiratory fitness Safety Meta-analysis Résumé : Background
Knowledge of the optimal protocol and safety of particularly high-intensity exercise applied to individuals with stroke is lacking.
Objective
This systematic review and meta-analysis aimed to investigate the effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors.
Methods
We performed a systematic electronic search for articles in MedLine via PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and SPORTSDiscus up to April 1, 2019. Peak oxygen consumption (VO2peak), 6-min walk test (6MWT), fastest 10-m walk test (10MWT), and adverse events were assessed. The standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) were used to compute the effect size, and subgroup analysis was conducted to test the consistency of results as well as sensitivity analysis to assess the robustness of the results. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Results
We included 17 studies (PEDro score ≥ 4) in the meta-analysis. Post-intervention, high-intensity exercise had a significant effect on peak oxygen uptake (VO2peak; SMD = 0.56, P < 0.01, I2 = 8%; WMD = 2.53 mL/kg/min; high quality of evidence) and 6MWT (SMD = 0.26, P < 0.01, I2 = 40%; WMD = 17.08 m; moderate quality of evidence) but not fastest 10MWT (SMD = 0.33, P = 0.27, I2 = 77%; WMD = 0.05 m/s; low quality of evidence). Subgroup analysis showed better effects of higher-intensity treadmill training (≥ 70% heart rate reserve/VO2peak) for a longer duration (≥ 12 weeks) on VO2peak and 6MWT in sub-acute or chronic stroke survivors. The high-intensity exercise and control groups did not differ in adverse events including falls [odds ratio (OR) 1.40, P = 0.35, I2 = 11%; low quality of evidence], pain (OR 3.34, P = 0.09, I2 = 0%; moderate quality of evidence), or skin injuries (OR 1.08, P = 0.90, I2 = 0%; low quality of evidence).
Conclusions
Our meta-analysis suggests that high-intensity exercise is beneficial for cardiorespiratory fitness in stroke survivors and might be safe as a novel intervention in cardiopulmonary rehabilitation after stroke.Permalink : ./index.php?lvl=notice_display&id=90767
in Annals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 59-68[article] Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: A systematic review and meta-analysis [texte imprimé] / Lu Luo ; Haining Meng ; Ziwei Wang ; Shiqiang Zhu ; Song Yuan ; Yuyang Wang ; Qiang Wang . - 2020 . - p. 59-68.
doi.org/10.1016/j.rehab.2019.07.006
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 59-68
Mots-clés : Exercise therapy Intensity Stroke Cardiorespiratory fitness Safety Meta-analysis Résumé : Background
Knowledge of the optimal protocol and safety of particularly high-intensity exercise applied to individuals with stroke is lacking.
Objective
This systematic review and meta-analysis aimed to investigate the effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors.
Methods
We performed a systematic electronic search for articles in MedLine via PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and SPORTSDiscus up to April 1, 2019. Peak oxygen consumption (VO2peak), 6-min walk test (6MWT), fastest 10-m walk test (10MWT), and adverse events were assessed. The standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) were used to compute the effect size, and subgroup analysis was conducted to test the consistency of results as well as sensitivity analysis to assess the robustness of the results. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Results
We included 17 studies (PEDro score ≥ 4) in the meta-analysis. Post-intervention, high-intensity exercise had a significant effect on peak oxygen uptake (VO2peak; SMD = 0.56, P < 0.01, I2 = 8%; WMD = 2.53 mL/kg/min; high quality of evidence) and 6MWT (SMD = 0.26, P < 0.01, I2 = 40%; WMD = 17.08 m; moderate quality of evidence) but not fastest 10MWT (SMD = 0.33, P = 0.27, I2 = 77%; WMD = 0.05 m/s; low quality of evidence). Subgroup analysis showed better effects of higher-intensity treadmill training (≥ 70% heart rate reserve/VO2peak) for a longer duration (≥ 12 weeks) on VO2peak and 6MWT in sub-acute or chronic stroke survivors. The high-intensity exercise and control groups did not differ in adverse events including falls [odds ratio (OR) 1.40, P = 0.35, I2 = 11%; low quality of evidence], pain (OR 3.34, P = 0.09, I2 = 0%; moderate quality of evidence), or skin injuries (OR 1.08, P = 0.90, I2 = 0%; low quality of evidence).
Conclusions
Our meta-analysis suggests that high-intensity exercise is beneficial for cardiorespiratory fitness in stroke survivors and might be safe as a novel intervention in cardiopulmonary rehabilitation after stroke.Permalink : ./index.php?lvl=notice_display&id=90767 Exemplaires (1)
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Exclu du prêtEfficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis / Siew-Li Goh in Annals of physical and rehabilitation medicine, Vol. 62, n°5 (Septembre 2019)
[article]
Titre : Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis Type de document : texte imprimé Auteurs : Siew-Li Goh ; Monica S.M. Persson ; Joanne Stocks ; Yunfei Hou ; Jianhao Lin ; Michelle C. Hall ; Michael Doherty ; Weiya Zhang Année de publication : 2019 Article en page(s) : p. 356-365 Note générale : doi.org/10.1016/j.rehab.2019.04.006 Langues : Anglais (eng) Mots-clés : Knee osteoarthritis Exercise Meta-analysis Determinants Physical therapy Pain Function Quality of Life Résumé : Background
Exercise is an effective treatment for osteoarthritis. However, the effect may vary from one patient (or study) to another.
Objective
To evaluate the efficacy of exercise and its potential determinants for pain, function, performance, and quality of life (QoL) in knee and hip osteoarthritis (OA).
Methods
We searched 9 electronic databases (AMED, CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, PEDro, PubMed, SPORTDiscus and Google Scholar) for reports of randomised controlled trials (RCTs) comparing exercise-only interventions with usual care. The search was performed from inception up to December 2017 with no language restriction. The effect size (ES), with its 95% confidence interval (CI), was calculated on the basis of between-group standardised mean differences. The primary endpoint was at or nearest to 8 weeks. Other outcome time points were grouped into intervals, from < 1 month to ≥ 18 months, for time-dependent effects analysis. Potential determinants were explored by subgroup analyses. Level of significance was set at P ≤ 0.10.
Results
Data from 77 RCTs (6472 participants) confirmed statistically significant exercise benefits for pain (ES 0.56, 95% CI 0.44–0.68), function (0.50, 0.38–0.63), performance (0.46, 0.35–0.57), and QoL (0.21, 0.11–0.31) at or nearest to 8 weeks. Across all outcomes, the effects appeared to peak around 2 months and then gradually decreased and became no better than usual care after 9 months. Better pain relief was reported by trials investigating participants who were younger (mean age < 60 years), had knee OA, and were not awaiting joint replacement surgery.
Conclusions
Exercise significantly reduces pain and improves function, performance and QoL in people with knee and hip OA as compared with usual care at 8 weeks. The effects are maximal around 2 months and thereafter slowly diminish, being no better than usual care at 9 to 18 months. Participants with younger age, knee OA and not awaiting joint replacement may benefit more from exercise therapy. These potential determinants, identified by study-level analyses, may have implied ecological bias and need to be confirmed with individual patient data.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300624 Permalink : ./index.php?lvl=notice_display&id=84153
in Annals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 356-365[article] Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis [texte imprimé] / Siew-Li Goh ; Monica S.M. Persson ; Joanne Stocks ; Yunfei Hou ; Jianhao Lin ; Michelle C. Hall ; Michael Doherty ; Weiya Zhang . - 2019 . - p. 356-365.
doi.org/10.1016/j.rehab.2019.04.006
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 356-365
Mots-clés : Knee osteoarthritis Exercise Meta-analysis Determinants Physical therapy Pain Function Quality of Life Résumé : Background
Exercise is an effective treatment for osteoarthritis. However, the effect may vary from one patient (or study) to another.
Objective
To evaluate the efficacy of exercise and its potential determinants for pain, function, performance, and quality of life (QoL) in knee and hip osteoarthritis (OA).
Methods
We searched 9 electronic databases (AMED, CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, PEDro, PubMed, SPORTDiscus and Google Scholar) for reports of randomised controlled trials (RCTs) comparing exercise-only interventions with usual care. The search was performed from inception up to December 2017 with no language restriction. The effect size (ES), with its 95% confidence interval (CI), was calculated on the basis of between-group standardised mean differences. The primary endpoint was at or nearest to 8 weeks. Other outcome time points were grouped into intervals, from < 1 month to ≥ 18 months, for time-dependent effects analysis. Potential determinants were explored by subgroup analyses. Level of significance was set at P ≤ 0.10.
Results
Data from 77 RCTs (6472 participants) confirmed statistically significant exercise benefits for pain (ES 0.56, 95% CI 0.44–0.68), function (0.50, 0.38–0.63), performance (0.46, 0.35–0.57), and QoL (0.21, 0.11–0.31) at or nearest to 8 weeks. Across all outcomes, the effects appeared to peak around 2 months and then gradually decreased and became no better than usual care after 9 months. Better pain relief was reported by trials investigating participants who were younger (mean age < 60 years), had knee OA, and were not awaiting joint replacement surgery.
Conclusions
Exercise significantly reduces pain and improves function, performance and QoL in people with knee and hip OA as compared with usual care at 8 weeks. The effects are maximal around 2 months and thereafter slowly diminish, being no better than usual care at 9 to 18 months. Participants with younger age, knee OA and not awaiting joint replacement may benefit more from exercise therapy. These potential determinants, identified by study-level analyses, may have implied ecological bias and need to be confirmed with individual patient data.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300624 Permalink : ./index.php?lvl=notice_display&id=84153 Exemplaires (1)
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Exclu du prêtMedial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees / Hany Elbardesy in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees Type de document : texte imprimé Auteurs : Hany Elbardesy ; Hazem M. Salamah ; André McLeod Année de publication : 2021 Article en page(s) : p. 665-680 Note générale : https://doi.org/10.52628/87.7.12 Langues : Anglais (eng) Mots-clés : Medial pivot posterior stabilised total knee arthroplasty meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted this study following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680[article] Medial pivot versus (cam post) posterior stabilised total knee arthroplasty, systematic review and meta-analysis of 3837 knees [texte imprimé] / Hany Elbardesy ; Hazem M. Salamah ; André McLeod . - 2021 . - p. 665-680.
https://doi.org/10.52628/87.7.12
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 665-680
Mots-clés : Medial pivot posterior stabilised total knee arthroplasty meta-analysis Résumé : In the current literature, there is no consensus as to whether the medial pivot (MP) or posterior-stabilised (PS) knee provides the best result for the patient in the context of post-operative range of motion (ROM) and patient reported outcome measures (PROMs). The aim of this systematic review is to provide this equipoise with some clarity. We conducted this study following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Studies comparing the MP and PS knees from all regions and written in any language were included. Twenty- one studies were included in this meta-analysis. They were prepared and analysed using Review Manager V5.0 [Computer Program] (RevMan5). We calculated the risk ratio to measure the treatment effect, taking the heterogeneity of the studies into consideration. Random-effect models were also utilised. MP knees were found to have a significant advantage over PS knees in terms of WOMAC score at the midterm follow up, and insignificant advantages over PS knees in terms of ROM and FJS at one and two years follow- up. Additionally, the PS knees demonstrated an in significantly higher Knee Society Score (KSS) at short and midterm follow up. In terms of ROM, KSS, OKS and FJS this meta-analysis suggests a non-significant advantages for the MP knee compared with the PS prothesis in the short term. The MP implant also showed a significantly superior WOMAC score at short-term follow-up. An extended follow-up period is required to evaluate whether the MP knee is superior than the PS in the long-term. Permalink : ./index.php?lvl=notice_display&id=102017 Réservation
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DisponibleSubcuticular sutures versus staples for skin closure after primary hip arthroplasty / Hany Elbardesy in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)
[article]
Titre : Subcuticular sutures versus staples for skin closure after primary hip arthroplasty Type de document : texte imprimé Auteurs : Hany Elbardesy ; Rehan Gul ; Shane Guerin Année de publication : 2021 Article en page(s) : p. 55-64 Note générale : https://doi.org/10.52628/87.1.08 Langues : Anglais (eng) Mots-clés : total hip arthroplasty total joint arthroplasty skin closure meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic.
We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction.
We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction.
Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures.
However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined.Permalink : ./index.php?lvl=notice_display&id=96577
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64[article] Subcuticular sutures versus staples for skin closure after primary hip arthroplasty [texte imprimé] / Hany Elbardesy ; Rehan Gul ; Shane Guerin . - 2021 . - p. 55-64.
https://doi.org/10.52628/87.1.08
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 55-64
Mots-clés : total hip arthroplasty total joint arthroplasty skin closure meta-analysis Résumé : High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic.
We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction.
We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction.
Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures.
However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined.Permalink : ./index.php?lvl=notice_display&id=96577 Exemplaires (1)
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Exclu du prêtEvaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre / Tagbo ILOZUE in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)
[article]
Titre : Evaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre Type de document : texte imprimé Auteurs : Tagbo ILOZUE, Auteur Année de publication : 2014 Article en page(s) : p.322-330 Langues : Anglais (eng) Mots-clés : ultrasonography magnetic resonance imaging rotator cuff tear meta-analysis accuracy Résumé : To review the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of rotator-cuff tears, we performed a retrospective audit of patients who underwent shoulder arthroscopy at Hinchingbrooke hospital. The diagnostic accuracies of US for full and partial-thickness tears were 82% and 28% respectively. Those of MRI were 82% and 81% respectively. These were lower than expected from the literature. This discrepancy is likely to be the consequence of over-diagnosis in imaging and under-diagnosis at arthroscopy. Permalink : ./index.php?lvl=notice_display&id=34646
in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.322-330[article] Evaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre [texte imprimé] / Tagbo ILOZUE, Auteur . - 2014 . - p.322-330.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.322-330
Mots-clés : ultrasonography magnetic resonance imaging rotator cuff tear meta-analysis accuracy Résumé : To review the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of rotator-cuff tears, we performed a retrospective audit of patients who underwent shoulder arthroscopy at Hinchingbrooke hospital. The diagnostic accuracies of US for full and partial-thickness tears were 82% and 28% respectively. Those of MRI were 82% and 81% respectively. These were lower than expected from the literature. This discrepancy is likely to be the consequence of over-diagnosis in imaging and under-diagnosis at arthroscopy. Permalink : ./index.php?lvl=notice_display&id=34646 Exemplaires (1)
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Exclu du prêt