Australian Journal of Physiotherapy最新文献

{"title":"The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study","authors":"Natalie A. de Morton","doi":"10.1016/S0004-9514(09)70043-1","DOIUrl":"10.1016/S0004-9514(09)70043-1","url":null,"abstract":"<div><h3>Questions</h3><p>Does the PEDro scale measure only one construct ie, the methodological quality of clinical trials? What is the hierarchy of items of the PEDro scale from least to most adhered to? Is there any effect of year of publication of trials on item adherence? Are PEDro scale ordinal scores equivalent to interval data?</p></div><div><h3>Design</h3><p>Rasch analysis of two independent samples of 100 clinical trials from the PEDro database scored using the PEDro scale.</p></div><div><h3>Results</h3><p>Both samples of PEDro data showed fit to the Rasch model with no item misfit. The PEDro scale item hierarchy was the same in both samples, ranging from the most adhered to item <em>random allocation,</em> to the least adhered to item <em>therapist blinding</em>. There was no differential item functioning by year of publication. Original PEDro ordinal scores were highly correlated with transformed PEDro interval scores (r = 0.99).</p></div><div><h3>Conclusion</h3><p>The PEDro scale is a valid measure of the methodological quality of clinical trials. It is valid to sum PEDro scale item scores to obtain a total score that can be treated as interval level measurement and subjected to parametric statistical analysis.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 129-133"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70043-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review","authors":"Aline Scianni ,&nbsp;Jane M. Butler ,&nbsp;Louise Ada ,&nbsp;Luci F. Teixeira-Salmela","doi":"10.1016/S0004-9514(09)70037-6","DOIUrl":"10.1016/S0004-9514(09)70037-6","url":null,"abstract":"<div><h3>Question</h3><p>Do strengthening interventions increase strength without increasing spasticity and improve activity, and is there any carryover after cessation in children and adolescents with cerebral palsy?</p></div><div><h3>Design</h3><p>Systematic review with meta-analysis of randomised trials.</p></div><div><h3>Participants</h3><p>Children with spastic cerebral palsy between school age and 20 years.</p></div><div><h3>Intervention</h3><p>Strengthening interventions that involved repetitive, strong, or effortful muscle contractions and progressed as ability changed, such as biofeedback, electrical stimulation, and progressive resistance exercise.</p></div><div><h3>Outcome measures</h3><p>Strength was measured as continuous measures of maximum voluntary force or torque production. Spasticity was measured as velocity-dependent resistance to passive stretch. Activity was measured as continuous measures, eg, 10-m Walk Test, or using scales eg, the Gross Motor Function Measure.</p></div><div><h3>Results</h3><p>Six studies were identified and five had data that could be included in a metaanalysis. Strengthening interventions had no effect on strength (SMD 0.20, 95% CI −0.17 to 0.56), no effect on walking speed (MD 0.02 m/s, 95% CI −0.13 to 0.16), and had a small statistically-significant but not clinically-worthwhile effect on Gross Motor Function Measure (MD 2%, 95% CI 0 to 4). Only one study measured spasticity but did not report the between-group analysis.</p></div><div><h3>Conclusion</h3><p>In children and adolescents with cerebral palsy who are walking, the current evidence suggests that strengthening interventions are neither effective nor worthwhile.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 81-87"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70037-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suctioning adult patients","authors":"","doi":"10.1016/S0004-9514(09)70017-0","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70017-0","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 290"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70017-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136922430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary incontinence is associated with an increase in falls: a systematic review","authors":"Pauline E. Chiarelli ,&nbsp;Lynette A. Mackenzie ,&nbsp;Peter G. Osmotherly","doi":"10.1016/S0004-9514(09)70038-8","DOIUrl":"10.1016/S0004-9514(09)70038-8","url":null,"abstract":"<div><h3>Question</h3><p>Is urinary incontinence associated with falls in community-dwelling older people?</p></div><div><h3>Design</h3><p>A systematic review and meta-analysis of observational studies investigating falls and urinary incontinence.</p></div><div><h3>Participants</h3><p>Community-dwelling older people.</p></div><div><h3>Outcome measures</h3><p>Falls rather than fracture or injury, and any type of urinary incontinence.</p></div><div><h3>Results</h3><p>Odds ratios of nine studies were included in the meta-analysis. The odds of falling were 1.45 (95% CI 1.36 to 1.54) in the presence of any type of urinary incontinence. The odds of falling were 1.54 (95% CI 1.41 to 1.69) in the presence of urge incontinence. The odds of falling were 1.11 (95% CI 1.00 to 1.23) in the presence of stress incontinence. The odds of falling were 1.92 (95% CI 1.69 to 2.18) in the presence of mixed incontinence.</p></div><div><h3>Conclusion</h3><p>Urge urinary incontinence, but not stress urinary incontinence, is associated with a modest increase in falls. Falls prevention programs need to include an assessment of incontinence and referral for interventions to ameliorate the symptoms of urge incontinence.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 89-95"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70038-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People with non-specific chronic low back pain who have participated in exercise programs have preferences about exercise: a qualitative study","authors":"Susan C. Slade,&nbsp;Elizabeth Molloy,&nbsp;Jennifer L. Keating","doi":"10.1016/S0004-9514(09)70041-8","DOIUrl":"10.1016/S0004-9514(09)70041-8","url":null,"abstract":"<div><h3>Question</h3><p>What factors do participants in exercise programs for chronic low back pain perceive to be important for engagement and participation?</p></div><div><h3>Design</h3><p>Qualitative study of three focus groups.</p></div><div><h3>Participants</h3><p>18 adults with chronic low back pain who had participated in exercise programs for chronic low back pain.</p></div><div><h3>Results</h3><p>All focus group results concurred and two significant themes emerged from the focus group data. The first was that the experience of exercise informed participant preferences with respect to exercise environment and type of exercise. Participants described a range of positive and negative experiences, a desire to master exercise techniques, and a preference for exercise that matched their abilities and prior skills. The second significant theme was the helpful and empowering skills of the care-provider, and care-seeker ability to identify and articulate their own needs. Participants regarded carer expertise favourably when positive results were achieved early in the interaction, but were frustrated when they were not listened to and symptoms were aggravated. The relationship was enhanced by effective communication. Participants also recognised they needed to be aware of their own skills and abilities and, and that financial or family support incentives encouraged their adherence to a program.</p></div><div><h3>Conclusion</h3><p>People are likely to prefer and participate in exercise programs that are designed with consideration of their preferences, circumstances, and past exercise experiences. We propose that information about patient exercise preferences should be collected systematically.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 115-121"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70041-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People with low back pain typically need to feel ‘much better’ to consider intervention worthwhile: an observational study","authors":"Manuela Loureiro Ferreira ,&nbsp;Paulo Henrique Ferreira ,&nbsp;Robert Dale Herbert ,&nbsp;Jane Latimer","doi":"10.1016/S0004-9514(09)70042-X","DOIUrl":"10.1016/S0004-9514(09)70042-X","url":null,"abstract":"<div><h3>Question</h3><p>How much of an effect do five common physiotherapy interventions need to have for patients with low back pain to perceive they are worth their cost, discomfort, risk, and incovenience? Are there any differences between the interventions? Do specific characteristics of people with low back pain predict the smallest important difference?</p></div><div><h3>Design</h3><p>Cross-sectional, observational study.</p></div><div><h3>Participants</h3><p>77 patients with non-specific low back pain who had not yet commenced physiotherapy intervention.</p></div><div><h3>Outcome measures</h3><p>The smallest worthwhile effect was measured in terms of global perceived change (0 to 4) and percentage perceived change.</p></div><div><h3>Results</h3><p>Participants perceived that intervention would have to make them ‘much better’, which corresponded to 1.7 (SD 0.7) on the 4-point scale, or improve their symptoms by 42% (SD 23), to make it worthwhile. There was little distinction made between interventions, regardless of whether smallest worthwhile effects were quantified as global perceived change (<em>p</em> = 0.09) or percentage perceived change (<em>p</em> = 1.00). Severity of symptoms independently (<em>p</em> = 0.01) predicted percentage perceived change explaining 9% of the variance, so that for each increase in severity of symptoms of 1 point out of 10 there was an increase of 4% in the percentage perceived change that participants considered would make intervention worthwhile.</p></div><div><h3>Conclusions</h3><p>Typically people with low back pain feel that physiotherapy intervention must reduce their symptoms by 42%, or make them feel ‘much better’ for intervention to be worthwhile.</p><p><em><strong>eAddenda</strong></em>: <span>Appendix 1</span><svg><path></path></svg>, <span>Table 3</span><svg><path></path></svg> available at AJP. physiotherapy.asn.au</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 123-127"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70042-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals with chronic low back pain have a lower level, and an altered pattern, of physical activity compared with matched controls: an observational study","authors":"Cormac G. Ryan,&nbsp;P. Margaret Grant,&nbsp;Philippa M. Dall,&nbsp;Heather Gray,&nbsp;Mary Newton,&nbsp;Malcolm H. Granat","doi":"10.1016/S0004-9514(09)70061-3","DOIUrl":"10.1016/S0004-9514(09)70061-3","url":null,"abstract":"<div><h3>Question</h3><p>Is there a difference in the level and pattern of free-living physical activity between individuals with chronic low back pain and matched controls?</p></div><div><h3>Design</h3><p>Observational, cross-sectional study.</p></div><div><h3>Participants</h3><p>Fifteen individuals with chronic low back pain and fifteen healthy controls matched for age, gender, and occupation.</p></div><div><h3>Outcome measures</h3><p>Participants wore an activity monitor for seven days. Level of physical activity was measured as time standing and walking, and number of steps averaged over a 24-hour day (midnight to midnight), day time (9.00 am – 4.00 pm), and evening time (6.00 pm – 10.00 pm), and work days versus non-work days. Pattern of physical activity was measured as number of steps and cadence during short (&lt; 20 continuous steps), moderate (20–100 continuous steps), long (&gt; 100–499 continuous steps), and extra long walks (≥ 500 continuous steps).</p></div><div><h3>Results</h3><p>Over an average 24-hour day, the chronic low back pain group spent 0.7 fewer hours (95% CI 0.3 to 1.1) walking, and took 3480 fewer steps (95% CI 1754 to 5207) than the healthy controls. They took 793 fewer steps/day (95% CI –4 to 1591) during moderate walks, and 1214 fewer steps/day (95% CI 425 to 2003) during long walks, and 11 fewer steps/min (95% CI 4 to 17) during extra long walks than the healthy controls.</p></div><div><h3>Conclusion</h3><p>Individuals with chronic low back pain have a lower level, and an altered pattern, of physical activity compared with matched controls.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Pages 53-58"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70061-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restriction of the range of arm elevation exercises for one week after surgery for breast cancer can reduce the incidence of lymphoedema","authors":"Robyn Box","doi":"10.1016/S0004-9514(09)70065-0","DOIUrl":"10.1016/S0004-9514(09)70065-0","url":null,"abstract":"<div><h3>Question</h3><p>: Does restriction of full shoulder mobilisation for one week reduce the incidence and severity of lymphoedema in women after axillary lymph node dissection (ALND) for breast cancer?</p></div><div><h3>Design</h3><p><em><strong>:</strong></em> Randomised, controlled trial with concealed allocation and blinded assessment of some outcomes.</p></div><div><h3>Setting</h3><p>: Two hospitals in the United Kingdom.</p></div><div><h3>Participants</h3><p>: Adult women with early breast cancer admitted for surgery that included axillary lymph node dissection. Previous breast cancer, axillary surgery and local radiotherapy were exclusion criteria. Randomisation of 116 participants allotted 58 to a standard exercise regimen and 58 to the same regimen with restricted arm and shoulder movement for the first week.</p></div><div><h3>Interventions</h3><p>: All participants were prescribed four 10-minute exercise sessions per day, in which individual exercises were repeated slowly and rhythmically 3 to 4 times. The exercises included unresisted shoulder and elbow range-of-motion exercises while upright. The early mobilisation group commenced full shoulder mobilisation within two days after surgery. The exercises were modified for the delayed mobilisation group so that the arm was not elevated above horizontal for the first 7 days after surgery. Exercises encouraging full range of shoulder movement were introduced in the second week. The exercises were supervised during the hospital admission and were prescribed to continue for one year at home.</p></div><div><h3>Outcome measures</h3><p>: The primary outcome was the incidence of lymphoedema, defined as a 200 ml or greater difference in arm volume compared to the unoperated arm. Secondary outcome measures were the severity of lymphoedema again determined by volume, wound drainage volumes, range of shoulder motion, grip strength, and quality of life scores related to shoulder disability and breast cancer therapy.</p></div><div><h3>Results</h3><p>: 109 participants completed the study. After one year, 16 women in the early mobilisation group but only 6 women in the delayed mobilisation group had developed lymphoedema. Thus one case of lymphoedema was prevented for every 6 women managed with the exercise regimen that delayed shoulder mobilisation (95% CI 3 to 35). Lymphoedema severity and wound drainage were both significantly greater in the early mobilisation group. The groups did not differ significantly on the remaining secondary outcomes.</p></div><div><h3>Conclusion</h3><p>: The incidence of lymphoedema can be reduced by restricting exercises so that the arm is not elevated above horizontal for one week after ALND.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 64"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70065-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Instillation of normal saline before suctioning reduces the incidence of pneumonia in intubated and ventilated adults","authors":"Julie C. Reeve","doi":"10.1016/S0004-9514(09)70044-3","DOIUrl":"10.1016/S0004-9514(09)70044-3","url":null,"abstract":"<div><h3>Question</h3><p>Does the instillation of normal saline before suctioning reduce the incidence of ventilator-associated pneumonia in intubated and ventilated adults?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with blinded outcome assessment.</p></div><div><h3>Setting</h3><p>The medical/surgical intensive care unit of a tertiary oncology hospital in Brazil.</p></div><div><h3>Participants</h3><p>Adults expected to require at least 72 hours of mechanical ventilation via an endotracheal or tracheostomy tube. Previous ventilation within the past month and contraindications to bronchoscopy were exclusion criteria. Randomisation of 262 participants allotted 130 to the intervention group and 132 to a control group.</p></div><div><h3>Interventions</h3><p>Closed tracheal suction systems with heat and moisture exchangers were used with both groups and were changed regularly. All patients were nursed with backrest elevation to 45 degrees. Medical or nursing staff, who were blinded to group allocations, requested suctioning when any of the following occurred: visible or audible secretions, ventilator-patient asynchrony, and increased peak inspiratory pressures or decreased tidal volumes attributed to secretions. Respiratory therapists performed the suctioning according to a standardised procedure that included preoxygenation. The therapists instilled 8 mL of normal saline prior to suctioning in the intervention group only.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the incidence of ventilator-associated pneumonia (VAP). If VAP was suspected because of radiographic evidence plus either fever, leukocytosis, or purulent secretions, a bronchoscopy with standardised lavage was performed. VAP was considered confirmed if the bacterial density of the lavage fluid exceeded 1000 colony-forming units/mL. Secondary outcome measures included time to VAP, duration of mechanical ventilation, length of stay and mortality in the intensive care unit, unscheduled ventilation circuitry changes due to secretions, and number of suctions per day.</p></div><div><h3>Results</h3><p>All participants completed the study. Significantly fewer participants in the saline group developed VAP (14/130) than in the control group (31/132), relative risk reduction 0.54 (95% CI 0.18 to 0.74). This indicates that one patient will avoid developing VAP for every 8 patients in which saline instillation is used. Significant benefits of saline instillation were also seen in the incidence of VAP (9 vs 21 per 1000 days of mechanical ventilation, <em>p</em> = 0.01) and in the time to first VAP (<em>p</em> = 0.02). The groups did not differ significantly on the remaining secondary outcomes.</p></div><div><h3>Conclusion</h3><p>Instillation of normal saline before tracheal suctioning decreases the incidence of VAP in mechanically ventilated adults.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 136"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70044-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28250259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive weaning from ventilation reduces mortality, ventilator-associated pneumonia, and length of stay in intubated adults","authors":"Grant Willson","doi":"10.1016/S0004-9514(09)70083-2","DOIUrl":"10.1016/S0004-9514(09)70083-2","url":null,"abstract":"<div><h3>Objective</h3><p>To review the evidence as to whether early extubation with immediate application of non-invasive ventilation reduces mortality and ventilator-associated pneumonia and improves other outcomes in criticallyill adults receiving invasive ventilation.</p></div><div><h3>Data sources</h3><p>Medline, Embase, CENTRAL, searched up to April, 2008. This search was supplemented by hand-searching of conference proceeding and citation tracking.</p></div><div><h3>Study selection</h3><p>Randomised and quasi-randomised controlled trials involving adults with respiratory failure who required invasive ventilation for at least 24 hours in which extubation with immediate application of noninvasive ventilation was compared to continued invasive weaning. Outcome measures were mortality, ventilatorassociated pneumonia, weaning failure, length of stay in intensive care or hospital, total duration of ventilation (invasive and non-invasive), duration of ventilation related to weaning (after randomisation), duration of invasive-only ventilation, adverse events (arrhythmia, reintubation, tracheostomy), and quality of life.</p></div><div><h3>Data extraction</h3><p>Two reviewers extracted data and discrepancies were resolved by consensus and arbitration. Methodological quality was assessed.</p></div><div><h3>Data synthesis</h3><p>Of 1368 studies identified by the initial search, 12 studies with a total of 530 patients met the selection criteria and were included in the review. All included studies were of moderate to high quality according to the reviewers’ criteria. Based on the quantitative pooling of the available data from these trials, there was a statistically significant difference in mortality in favour of non-invasive weaning, relative risk 0.55 (95% CI 0.38 to 0.79). Non-invasive weaning also significantly reduced ventilator-associated pneumonia (relative risk 0.29, 95% CI 0.19 to 0.45), length of stay in the intensive care unit (by 6 days, 95% CI 4 to 9) and in the hospital (by 7 days, 95% CI 4 to 11), total duration of ventilation (by 6 days, 95% CI 2 to 9), duration of invasive ventilation (by 8 days, 95% CI 4 to 11), and tracheostomy (relative risk 0.16, 95% CI 0.04 to 0.75). The remaining secondary outcomes did not differ significantly. None of the included studies measured quality of life.</p></div><div><h3>Conclusion</h3><p>Non-invasive ventilation facilitates weaning and has substantial clinical benefits in adults with respiratory failure who require invasive ventilation.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 207"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70083-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28389168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}