Efficacy of pharmacological and non-pharmacological therapy on pain intensity and disability of older people with chronic nonspecific low back pain: a protocol for a network meta-analysis.

BACKGROUND: The purpose of this network meta-analysis (NMA) is to investigate the efficacy of pharmacological and non-pharmacological therapy on pain intensity and disability of older people with chronic nonspecific low back pain, providing comprehensive evidence for an informed decision-making. METHODS: We will perform a systematic search to identify randomized controlled trials of pharmacological and non-pharmacological interventions for older people with chronic nonspecific low back pain. MEDLINE, Cochrane Library, Embase, AMED, PsycINFO, and PEDro will be searched without language or date restrictions. Our primary outcomes are pain intensity and disability. Risk of bias will be assessed for all studies using the revised Cochrane risk-of-bias (RoB) tool 2.0. For each pairwise comparison between the different interventions, estimated mean differences and their 95% confidence intervals will be presented. Standard pairwise meta-analyses will be performed using random effects models in STATA version 16. The competing interventions will be ranked using the surface under the cumulative ranking curve (SUCRA) for the outcomes of interest at short and long terms. The confidence in the results from NMA will be assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. DISCUSSION: This NMA compares efficacy of interventions for nonspecific chronic low back pain in older people. It will provide reliable evidence for patients, clinicians, stakeholders, and researchers in this field where competing therapies, many of extraordinarily little value, are commonly used in clinical practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022312565.

Hip passive stiffness is associated with hip kinematics during single-leg squat.

INTRODUCTION: Single-leg squat (SLS) is a test commonly used to assess lower limb function in rehabilitation. Increased hip adduction and internal rotation (IR) is associated with dynamic knee valgus, which is related to hip and knee overload. Proximal and distal factors, such as hip passive stiffness, poor hip muscle strength and excessive foot misalignment may influence hip movement. However, previous studies focus on how proximal and distal factors affected knee joint movement and did not reported the influence on hip joint. OBJECTIVE: This study investigated the association of hip external rotators (ER) strength, hip passive stiffness and shank-forefoot alignment (SFA) with hip adduction and IR during SLS. DESIGN: Cross-sectional study. METHOD: Forty-six health participants of both sexes (23.47 ± 4.29 years, 60.40 ± 11.28 kg, 1.67 ± 8.9 m) had SFA, hip ER torque, hip passive stiffness and hip kinematics assessed. Multiple linear regressions were performed to identify the factors which associated with mean and peak hip adduction and IR movement during SLS. RESULTS: Only hip passive stiffness was associated with mean (R2 = 0.164; Confidence Interval (CI) 95% = [-0.250, -0.048]; p = 0.005) and peak (R2 = 0.116; CI 95% = [-0.223, -0.210]; p = 0.019) hip IR movement. CONCLUSION: Hip passive stiffness was associated with mean and peak hip IR movement during the SLS. These results suggest that individuals with reduced hip passive stiffness may demonstrate increased hip IR movement during SLS.

Correlation between goniometric and photogrammetric assessment of shank-forefoot alignment in athletes.

BACKGROUND: The shank-forefoot alignment (SFA) measurement has been previously developed to enhance the applicability of foot alignment measurement in sports preseason assessment because it is reliable and less time consuming. The use of SFA measurements in the clinical context, usually done with photogrammetry, may be simplified by using the universal goniometer and no longer requiring the image processing step that takes additional time and equipment. OBJECTIVE: Investigate the correlation between the goniometric and photogrammetric assessment of shank-forefoot alignment in athletes. PARTICIPANTS: Thirty volleyball athletes were recruited during a preseason assessment. METHODS: SFA measurements were assessed with a universal goniometer and photogrammetry. For both assessments the participants were positioned in prone with the rearfoot facing up and the ankle actively maintained in 90° of dorsiflexion. The examiner did not have access to the SFA outcome values from both measurements. A second examiner did the bi-dimensional analysis with SIMI MOTION (photogrammetric measure) and read the goniometer measures during the other SFA assessment. Data normality was tested using Shapiro-Wilk test and Pearson was used to determine the correlation between both measurements. RESULTS: A reliability study determined the Intraclass Correlation Coefficient (ICC3,3) for intra-rater reliability of 0.93 for photogrammetry and of 0.81 for goniometry assessment. The correlation (p < 0.001) between these two measurements was 0.71, which indicates a moderate relationship. CONCLUSIONS: This study describes a reliable and practical measurement procedure for shank-forefoot alignment using the universal goniometer that can be easily applied in clinical context.

Effect of interactive media on the development of children and adolescents: systematic review with meta-analysis

Abstract Aim: to investigate through a systematic review of randomized controlled trials (RCTs) the effects of interactive media on the cognitive, language, and motor development of children and adolescents. Methods: Searches were performed with the Medline, AMED, Embase, PEDro, Cochrane, Psychinfo, and ERIC databases in May 2017 with updated in July 2020. For the search strategy, we used descriptors related to "randomized controlled trial", "interactive media" and "children and adolescents up to 18 years old". RCTs that investigated the effectiveness of interactive media in cognitive, motor, and language development of children and adolescents up to 18 years of age with typical development were included. When appropriate, meta-analyses were conducted using a random-effects model. Pooled data were presented using standardized mean difference and 95% confidence interval. We assessed the quality of evidence using the GRADE methodology and the methodological quality using the PEDro scale. Results: of the trials found, 14 references were eligible for this study. The GRADE methodology was used in 13 RCTs. Estimates showed a low level of evidence of a small effect of media use on cognitive development compared to that in the control group and another intervention. No effect on motor and language development. Conclusion: The results of this systematic review do not support claims about the advantages or disadvantages of interactive media in child development. High-quality evidence was found that interactive media is not superior to other interventions for cognitive and language development outcomes and quality of moderate evidence for motor and language development.