European journal of physical and rehabilitation medicine最新文献

{"title":"Ultrasound-guided percutaneous lavage for the treatment of rotator cuff calcific tendinopathy: a systematic review with meta-analysis of randomized controlled trials.","authors":"Cristiano Sconza, Valentina Palloni, Domenico Lorusso, Federico Guido, Giacomo Farì, Lucrezia Tognolo, Ezio Lanza, Fabrizio Brindisino","doi":"10.23736/S1973-9087.24.08544-7","DOIUrl":"https://doi.org/10.23736/S1973-9087.24.08544-7","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided lavage (UGL) is a minimally invasive percutaneous treatment for rotator cuff calcific tendinopathy (RCCT). It involves the use of a syringe containing saline and/or anesthetic solution injected directly into the calcification allowing aspiration of the fragmented calcific material. The aim of this systematic review is to investigate if UGL is effective in improving pain, function, quality of life, range of motion (ROM), and in promoting complete resorption of calcifications in patients with RCCT.</p><p><strong>Evidence acquisition: </strong>Only randomized controlled trials considering people diagnosed with RCCT, at any stage and at any time of the onset of symptoms treated with UGL, were included. Embase, CENTRAL, CINHAL, PEDro and MEDLINE were explored up until May 2024. Two independent authors selected randomized controlled trials by title and abstract; afterwards, the full text was thoroughly evaluated. The risk of bias (ROB) was assessed using the Cochrane risk of bias 2 (ROB2) tool and the certainty of evidence was evaluated through the GRADE approach.</p><p><strong>Evidence synthesis: </strong>Seven studies (709 subjects) were included. Overall, three studies were judged as low risk of bias. Pooled results showed non-significant differences between UGL and extracorporeal shock-wave therapy (ESWT) at 12 weeks (SMD=-0.52, 95% CI -1.57, 0.54, P=0.34, I²=93%) and at 26 weeks (MD=-1.20, 95% CI -2.66, 0.27, P=0.11, I²=82%), while a significant difference favoring UGL (SMD=-0.52, 95% CI -0.85, -0.19, P=0.002, I²=38%) resulted at 52 weeks. In regard to function, pooled results showed non-significant difference between UGL and ESWT at 6 weeks (MD=3.34, 95% CI -11.45, 18.12, P=0.66, I²=79%) and at 52 weeks (SMD=0.10, 95% CI -0.40, 0.60, P=0.69, I²=30%). Considering the rate of resorption of calcifications between UGL combined with subacromial corticosteroid injection (SCI) versus injection alone, pooled results showed significant difference favoring UGL at <52 weeks (RR=1.63 95% CI 1.34, 1.98, P<0.00001, I²=0%). Certainty of evidence ranged from low to very low.</p><p><strong>Conclusions: </strong>UGL seems to be a reasonable and safe treatment for RCCT, however compared to other non/mini-invasive approaches, UGL showed doubtful results in controlling pain and increasing function and rate of calcifications resorption. These results should be interpreted with caution because certainty of evidence ranged from low to very low.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation of anterior pelvic tilt and trunk muscle endurance among patients with femoroacetabular impingement syndrome: a cross-sectional study.","authors":"Ángel González-DE-LA-Flor, Maríá García-Arrabé, Teresa Fernández-Pardo, Charles Cotteret","doi":"10.23736/S1973-9087.24.08378-3","DOIUrl":"https://doi.org/10.23736/S1973-9087.24.08378-3","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) significantly affects the physical function and quality of life of the young and middle-aged population. Pelvic tilt and trunk muscle endurance are physical features poorly studied in FAIS.</p><p><strong>Aim: </strong>This study aimed to compare the anterior pelvic tilt and anterior, lateral, and posterior trunk muscles endurance between people with FAIS and healthy individuals, within FAIS sub types and between the symptomatic and asymptomatic hip in people with FAIS.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Settings: </strong>Participants were recruited and screened for potential eligibility at the Rehabilitation, Sports Medicine, and Physiotherapy Unit between April 2021 and February 2022.</p><p><strong>Population: </strong>Sixty-nine patients with FAIS and 69 controls.</p><p><strong>Methods: </strong>A study adhering to STROBE guidelines recruited 138 participants (69 FAIS, 69 controls). The degree of pelvic tilt was measured by the palpation meter (PALM) tool. To assess trunk musculature endurance, isometric trunk tests described by McGill were performed (extension resistance test, flexion resistance test, and side plank test). Cases were classified based on FAIS subtypes. Differences between groups and subgroups were performed using t-tests and ANCOVA, respectively.</p><p><strong>Results: </strong>Significant differences in anterior pelvic tilt were observed between the control and FAIS groups (P<0.001, d=0.72). Participants with FAIS exhibited greater pelvic tilt (MD=1.57, 95% CI=0.83 to 2.3). Trunk muscle endurance showed statistically significant differences (P<0.001, d=0.72) for posterior muscles. In comparisons between symptomatic and asymptomatic hips, significant differences were found in pelvic tilt (P<0.001, d=0.26) and lateral trunk muscle endurance (P<0.001, d=0.43). FAIS subtypes demonstrated significant differences in lateral trunk muscle endurance (P=0.002, η<inf>p</inf>2=0.209).</p><p><strong>Conclusions: </strong>This study found that patients with FAIS present large anterior pelvic tilt and lower posterior trunk muscle endurance. Although anterior pelvic tilt was comparable for all FAIS subtypes, Pincer-type with or without labral tear exhibited lower lateral trunk muscle endurance compared with Cam-type with or without labral tear. In addition, the symptomatic hip of FAIS patients showed lower lateral trunk muscle endurance compared to the asymptomatic hip.</p><p><strong>Clinical rehabilitation impact: </strong>Incorporating rehabilitation strategies that address pelvic tilt and trunk muscle strengthening in individuals with FAIS might be considered as a potential means to improve these physical impairments, pending careful evaluation of their effectiveness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of single case experimental designs in evidence creation in rehabilitation.","authors":"Wendy Machalicek, Douglas P Gross, Susan Armijo-Olivo, Giorgio Ferriero, Carlotte Kiekens, Rachelle Martin, Margaret Walshe, Stefano Negrini","doi":"10.23736/S1973-9087.24.08713-6","DOIUrl":"https://doi.org/10.23736/S1973-9087.24.08713-6","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) are considered the gold standard of evidence guiding intervention selection in rehabilitation. However, conduct of sufficiently powered RCTs in rehabilitation can be expensive, pose ethical and attrition concerns when participants are assigned to ineffective treatment as usual conditions, and are infeasible with low-incidence populations. Single-case experimental designs (SCEDs), including N-of-1 RCTs are causal inference studies for small numbers of participants and not necessarily one participant as the name implies. These designs are increasingly used to evaluate the effectiveness of rehabilitation interventions in diverse clinical settings and employ design features including but not limited to randomization and each participant serving as their own control. These and other internal validity enhancements can increase the confidence in study results coming from these designs. This manuscript discusses the expanded application of SCEDs in rehabilitation contexts to answer everyday clinical rehabilitation research questions with emphasis on strategies to use: 1) to maximize internal validity of this family of designs; 2) improve utility, effectiveness, and acceptability of these designs for rehabilitation end-users (clinicians, policymakers, and participants); 3) build evidence bases in areas of rehabilitation where RCTs are uncommonly used. Primary considerations for situating SCEDs within the continuum of experimental designs include increasing internal validity within designs, improving transparency in conduct and reporting of these studies, and increasing access to advanced research methods training for rehabilitation professionals.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect and mechanism of motor imagery based on action observation treatment on dysphagia in Wallenberg Syndrome: a randomized controlled trial.","authors":"Le Wang, Yi Li, Ruyao Liu, Heping Li, Liugen Wang, Yongkang Yuan, Wenjian Li, Yunyun Song, Xi Zeng","doi":"10.23736/S1973-9087.24.08471-5","DOIUrl":"https://doi.org/10.23736/S1973-9087.24.08471-5","url":null,"abstract":"<p><strong>Background: </strong>The effect of motor imagery applied to dysphagia patients with Wallenberg syndrome has not yet been reported.</p><p><strong>Aim: </strong>This trial aimed to investigate the effect and mechanism of motor imagery based on action observation treatment in the rehabilitation of patients with dysphagia in Wallenberg syndrome.</p><p><strong>Design: </strong>A randomized controlled trial.</p><p><strong>Setting: </strong>The setting was in-patient.</p><p><strong>Population: </strong>Thirty patients with dysphagia of Wallenberg syndrome.</p><p><strong>Methods: </strong>The patients were divided into the experimental group and the control group. Both groups received conventional dysphagia treatment, and the experimental group underwent the addition of motor imagery based on action observation treatment to the control group once a day for 14 days. Overall swallowing function was assessed with specific scales before and after intervention. Meanwhile, the functional near infrared spectroscopy was used to detect changes in cerebral hemodynamics during the execution of volitional swallowing task and swallowing motor imagery.</p><p><strong>Results: </strong>The standardized swallowing assessment score (P=0.030), Murray secretion scale score (P=0.044) and swallowing quality of life score (P=0.011) of the experimental group improved better than those of the control group. In addition, multiple brain regions of the cortical presented extensive activation (P<0.05) during the execution of swallowing motor imagery. Moreover, there were significant differences (P<0.05) in brain regions pre-motor and supplementary motor cortex, right primary motor cortex, and right primary somatosensory cortex of the experimental group before and after treatment.</p><p><strong>Conclusions: </strong>The present study indicated that motor imagery based on action observation treatment could improve swallowing function for patients with dysphagia of Wallenberg syndrome as an add-on training. As a top-down rehabilitation training, the mechanism of this therapy may be related to the selective activation of mirror neuron system.</p><p><strong>Clinical rehabilitation impact: </strong>Motor imagery based on action observation treatment can be implemented as part of the therapeutic for dysphagia of Wallenberg syndrome.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed categories for reporting of service organization in rehabilitation in clinical trials: a discussion paper.","authors":"Cecilie Røe, Christoph Gutenbrunner, Andrea Bökel, Marit Kirkevold, Boya Nugraha, Nada Andelic, Juan Lu, Erik Bautz-Holter, Paul B Perrin, Audny Anke, Reidun Jahnsen, Grethe Månum, Emilie Howe, Line Kildal Bragstad, Helene L Soberg","doi":"10.23736/S1973-9087.24.08494-6","DOIUrl":"https://doi.org/10.23736/S1973-9087.24.08494-6","url":null,"abstract":"<p><strong>Background: </strong>The lack of standardized reporting for crucial organizational factors in rehabilitation poses a significant barrier to understanding their impact on patient outcomes in clinical trials and meta-analyses.</p><p><strong>Aim: </strong>Based on the categories in the International Classification of Service Organization in Rehabilitation (ICSO-R 2.0), we aimed to develop reporting standards specifically for organizational factors in clinical trials.</p><p><strong>Methods: </strong>A comprehensive two-step process was conducted. In Step 1, important categories were identified. The identification was based on previous results from a Delphi survey with international stakeholder participation, two systematic literature reviews and results from focus groups with users in Germany, Indonesia and Norway. Step 2 involved the necessary reduction of categories and the proposal of reporting specifications, achieved through two voting rounds among key researchers, stakeholders and users.</p><p><strong>Results: </strong>The suggested minimum reporting set comprises Context and Setting as well as Quality assurance and management. The Context and Setting is proposed to include whether the intervention is delivered by Hospital, Community or Other service providers. The Mode of delivery is proposed to be specified as Inpatient, Outpatient, In-home, or Tele-rehabilitation. Furthermore, the Level of specialization (Primary/Secondary) and the Phase of service delivery Acute, Subacute or Long-term rehabilitation services should be reported. The Quality assurance and management should be reported as Yes or No, with the option Yes requiring description of the quality assurance applied in the methods section.</p><p><strong>Conclusions: </strong>This study proposed a compulsory and standardized reporting of organizational factors in clinical trials to facilitate the generation of scientific evidence regarding effective service provision and delivery in rehabilitation medicine. Authors are encouraged to consider the proposed reporting set to testing, criticism, and modification to enhance its applicability and robustness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-inferiority of hybrid outpatient telerehabilitation: 3-month follow-up of a randomized controlled trial.","authors":"Richard Albers, Stella Lemke, David Fauser, Sebastian Knapp, Gert Krischak, Matthias Bethge","doi":"10.23736/S1973-9087.24.08458-2","DOIUrl":"10.23736/S1973-9087.24.08458-2","url":null,"abstract":"<p><strong>Background: </strong>International studies identified comparable or better effects for telerehabilitation compared with face-to-face rehabilitation or no rehabilitation in people with back pain. In German rehabilitation centers, a standardized back school for patients with back pain is provided usually face-to-face as part of a multimodal rehabilitation program.</p><p><strong>Aim: </strong>To examine the non-inferiority of a three-week, digitally assisted, multimodal rehabilitation that applies a digital version of a standardized back school (intervention group [IG]) against the same rehabilitation program applying the back school face-to-face (control group [CG]).</p><p><strong>Design: </strong>Our study was a non-blinded multicenter randomized controlled trial. Recruitment was conducted from 2022 to 2023. We analyzed outcomes at the end of rehabilitation and 3 months later.</p><p><strong>Setting: </strong>Implementation of the study and enrollment of participants was conducted in 8 German outpatient rehabilitation centers.</p><p><strong>Population: </strong>Rehabilitants aged 18-65 years with back pain were included.</p><p><strong>Methods: </strong>284 patients with back pain were randomized into the IG or CG using computer-generated block randomization. We excluded 14 patients as they withdrew their consent and requested removal of their data. We finally included 270 patients (IG: N.=127, CG: N.=143). The primary outcome was self-reported pain self-efficacy (10-60 points). Secondary outcomes were, amongst others, current health status and pain.</p><p><strong>Results: </strong>Our primary adjusted intention-to-treat analysis demonstrated that hybrid digitally assisted rehabilitation was non-inferior to face-to-face rehabilitation at the end of rehabilitation (b=-0.55; 95% CI=-2.75 to ∞) and at the 3-month follow-up (b=0.24; 95% CI=-2.86 to ∞). These results were in line with a non-adjusted intention-to-treat analysis, an adjusted complete case analysis, and an adjusted per-protocol analysis. Secondary outcomes were tested for superiority. Our primary adjusted intention-to-treat analysis found no significant group differences in the secondary outcomes.</p><p><strong>Conclusions: </strong>This study provides evidence that hybrid digitally assisted rehabilitation in patients with back pain is a sound alternative to face-to-face rehabilitation in an outpatient rehabilitation setting.</p><p><strong>Clinical rehabilitation impact: </strong>Hybrid digitally assisted rehabilitation can improve flexibility and access to rehabilitation. Further studies should examine which components and which time frame of rehabilitation can be digitized without any loss of effectiveness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisite treatment with percutaneous cryoneurolysis for the upper and lower limb in long-standing post-stroke spasticity.","authors":"Romain David, Mahdis Hashemi, Laura Schatz, Paul Winston","doi":"10.23736/S1973-9087.24.08346-1","DOIUrl":"10.23736/S1973-9087.24.08346-1","url":null,"abstract":"","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life expectancy and long-term survival after traumatic spinal cord injury: a systematic review.","authors":"Alessandro Zadra, Stefania Bruni, Antonio DE Tanti, Donatella Saviola, Mauro Ciavarella, Giovanni Cannavò, Jacopo Bonavita","doi":"10.23736/S1973-9087.24.08462-4","DOIUrl":"10.23736/S1973-9087.24.08462-4","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord injuries have a considerable impact on healthcare in terms of mortality and morbidity. To address the difficulties faced by people affected by this condition and to raise awareness among stakeholders and policymakers, it is crucial to understand factors impacting survival. The purpose of this study is to systematically review the literature on life expectancy in people with traumatic spinal cord injury (tSCI), identifying key factors influencing mortality and survival.</p><p><strong>Evidence acquisition: </strong>We conducted a systematic review, searching the literature for articles published up to July 2023 in PubMed, Web of Science, Cochrane Library, Google Scholar, and PEDro. Study outcomes had to be one of survival rate, life expectancy, standardized mortality ratio, or mortality rate. Only original research articles published in English were included. The quality of evidence was evaluated with the MINORS scale. The level of evidence was categorized according to the OCEBM model.</p><p><strong>Evidence synthesis: </strong>A comprehensive literature search yielded 102 articles, after the selection process 20 studies were included in our review. The main factors negatively influencing survival and life expectancy included higher neurological level of injury (NLI), completeness of the lesion, need for mechanical ventilation, increasing age, and male gender. The development of SCI-related comorbidities also negatively impacted survival as well as the lack of specialized care, especially in low-income countries. Additionally, pre-injury health status and personal income may affect survival.</p><p><strong>Conclusions: </strong>Current literature shows that people affected by tSCI have a shorter life expectancy compared to the general population, highlighting some factors as possible predictors. It is difficult to compare available evidence due to the methodological heterogeneity across studies, which makes it challenging to draw generalizable conclusions on life expectancy in people with tSCI. Further studies are required to address these issues and accurately estimate life expectancy accounting for gaps in the management of people affected by tSCI to improve their care.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of eccentric cycling in coronary rehabilitation program: a pragmatic randomized controlled trial versus conventional rehabilitation.","authors":"Delphine Besson, Amadou-Khalilou Sow, Isabelle Fournel, Anaïs Gouteron, Aurélie Gudjoncik, Jean M Casillas, Paul Ornetti, Davy Laroche","doi":"10.23736/S1973-9087.24.08364-3","DOIUrl":"10.23736/S1973-9087.24.08364-3","url":null,"abstract":"<p><strong>Background: </strong>This randomized controlled trial examined the feasibility of adding eccentric exercise to a conventional cardiac rehabilitation program (CCRP) for coronary heart disease patients.</p><p><strong>Methods: </strong>Ninety-three patients were randomly assigned to either the MIX group (eccentric ergometer + CCRP) or the CON group (concentric ergometer + CCRP) for 7 weeks. Training effectiveness was assessed based on \"good responders\" showing improved functional capacities, such as 6-minute walk test (6MWT) distance and maximal voluntary contraction of the plantar flexors (ankle MVC). Safety was monitored with a visual analog scale for muscle soreness, perceived exertion, and heart rate during training.</p><p><strong>Results: </strong>The proportion of good responders was similar between groups (26% in MIX, 29% in CON, P=0.744). Both groups improved in 6MWT (CON: 12.6%, MIX: 16.14%) and ankle MVC (CON: 15.5%, MIX: 11.30%), with no significant differences. Exercise tolerance did not differ significantly between the groups, but perceived effort was significantly lower in the MIX group (P<0.0001) compared to the CON group.</p><p><strong>Conclusions: </strong>Integrating eccentric exercise into cardiac rehabilitation is safe and well-tolerated. Nevertheless, this study did not find significant advantages over conventional programs for coronary heart disease patients. Further research should explore specific patient groups or conditions where eccentric exercise may be more beneficial, emphasizing personalized prescriptions and gradual workload progression for better cardiac rehabilitation outcomes.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis and meta-regression.","authors":"Lorenzo Lippi, Arianna Folli, Stefano Moalli, Alessio Turco, Antonio Ammendolia, Alessandro de Sire, Marco Invernizzi","doi":"10.23736/S1973-9087.24.08136-X","DOIUrl":"10.23736/S1973-9087.24.08136-X","url":null,"abstract":"<p><strong>Introduction: </strong>Plantar fasciopathy (PF) is a common musculoskeletal condition characterized by heel pain and functional impairment. Extracorporeal shock wave therapy (ESWT) has gained increasing interest in the treatment of PF, but the optimal ESWT program is still debated. Therefore, this systematic review with meta-analysis and meta-regression aimed at providing a comprehensive assessment of the efficacy and tolerability of ESWT in PF management.</p><p><strong>Evidence acquisition: </strong>Randomized controlled trials (RCTs) published until February 2023 were systematically searched on PubMed/MEDLINE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and PEDro. Studies assessing adult patients with PF treated with ESWT were considered. The primary outcome was the tolerability of ESWT, measured by treatment adherence, dropouts, and safety. Secondary outcomes were pain intensity and functional outcomes. Meta-analysis and meta-regression were performed to examine the relationship between ESWT program characteristics and treatment outcomes. The quality of included studies was assessed using the Jadad scale and the Cochrane risk-of-bias tool.</p><p><strong>Evidence synthesis: </strong>Eleven studies met the inclusion criteria and were included in the analysis. Our findings showed that ESWT is effective in reducing pain intensity assessed by Visual Analogue Scale [focal-ESWT: -2.818 (SE 0.803, -4.393, -1.244; P< 0.0001; radial-ESWT: -3.038 (SE 0.428, -3.878, -2.199; P<0.001)]. Meta-regression analysis indicated a positive relationship between specific ESWT parameters (frequency, number of pulses, energy flux density and frequency, and number of pulses, pressure) and pain intensity (all P<0.05) and dropout (all P<0.05).</p><p><strong>Conclusions: </strong>ESWT seems to be an effective and tolerable treatment for PF, albeit the peculiarity of parameters might affect both the efficacy in pain relief and the adherence to the treatment. Physicians should consider individual patient characteristics when selecting the ESWT parameters for PF treatment. Further high-quality studies are warranted to establish the optimal ESWT protocol to treat PF.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}