A Systematic Appraisal of Conflicts of Interest and Researcher Allegiance in Clinical Studies of Dry Needling for Musculoskeletal Pain Disorders.

OBJECTIVE: The purpose of this study was to determine the frequency and methods of conflicts of interest (COI) reporting in published dry needling (DN) studies and to determine the frequency of researcher allegiance (RA). METHODS: A pragmatic systematic search was undertaken to identify DN studies that were included in systematic reviews. Information regarding COI and RA were extracted from the full text of the published DN reports, and study authors were sent a survey inquiring about the presence of RA. A secondary analysis also was undertaken based on study quality/risk of bias scores that were extracted from the corresponding systematic reviews and study funding extracted from each DN study. RESULTS: Sixteen systematic reviews were identified, containing 60 studies of DN for musculoskeletal pain disorders, 58 of which were randomized controlled trials. Of the DN studies, 53% had a COI statement. None of these studies disclosed a COI. Nineteen (32%) authors of DN studies responded to the survey. According to the RA survey, 100% of DN studies included at least 1 RA criterion. According to the data extraction, 1 RA criterion was met in 45% of the DN studies. The magnitude of RA per study was 7 times higher according to the surveys than in the published reports. CONCLUSION: These results suggest that COI and RA might be underreported in studies of DN. In addition, authors of DN studies might be unaware of the potential influence of RA on study results and conclusions. IMPACT: Improved reporting of COI/RA might improve credibility of results and help identify the various factors involved in complex interventions provided by physical therapists. Doing so could help optimize treatments for musculoskeletal pain disorders provided by physical therapists.

From evidence to practice: early integration of palliative care in a comprehensive cancer center.

PURPOSE: The American Society of Clinical Oncology (ASCO) recommends that all patients with a diagnosis of advanced cancer be referred to a palliative care team within 8 weeks of diagnosis. The benefits of early integrated palliative care are well recognized; however, there is a lack of consensus to guide operational aspects of a palliative care service within a comprehensive cancer center. In this study, we explore current palliative care referral patterns at an academic cancer center and provide recommendations for operationalizing palliative care services as a program within comprehensive cancer centers in order to adequately meet the needs of patients with advanced cancer. METHODS: A retrospective chart review of patients with newly diagnosed metastatic cancer or advanced hematologic malignancy referred to the palliative care team at a comprehensive cancer center from January 1, 2021, to October 31, 2021, was conducted. Institutional Review Board (IRB) approval was obtained prior to the initiation of the chart review. RESULTS: A total of 243 patients with newly diagnosed metastatic cancer or advanced hematologic malignancy were included in this review. Patients with gastrointestinal (26%), gynecologic (19%), and thoracic (21%) malignancies constituted 66% of the total cohort. The most frequent reason for referral was pain (52%). In total, 39% of patients were referred within 8 weeks of an advanced cancer diagnosis. CONCLUSION: ASCO recommends that all patients with advanced cancer be referred to a palliative care specialist within 8 weeks of diagnosis. Of the newly referred patients with advanced cancer, only 39% were referred to the palliative care team within 8 weeks of their diagnosis. This considerable gap suggests the need for a consensus with regard to operationalizing the palliative care team.

Physical Therapist Management of Total Knee Arthroplasty.

A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.

The effects of joint mobilization on individuals with patellofemoral pain: a systematic review.

OBJECTIVE: To investigate and synthesize the effects of joint mobilization on individuals with patellofemoral pain syndrome. DATA SOURCES: Five electronic databases (CINAHL, the Cochrane Central Register of Controlled Trials, PubMed, Scopus, and SPORTDiscus) were used. REVIEW METHODS: Each database was searched from inception to 1 November 2017. Randomized controlled trials investigating a manual therapy intervention, with or without co-interventions, for persons with patellofemoral pain were included. Two reviewers independently screened the retrieved literature and appraised the quality of the selected studies using the PEDro rating scale. A third reviewer was used in cases of discrepancy to create a consensus. RESULTS: A total of 361 articles were identified in the search. Twelve randomized trials with a total of 499 participants were selected for full review. Within-group improvements in pain and function were noted for the manual therapy groups. Between-group improvements for short-term outcomes (three months or less) were greatest when joint mobilization was directed to the knee complex and used as part of a comprehensive approach. CONCLUSION: In the articles reviewed, joint mobilization appears to be most effective in improving pain and function when coupled with other interventions, although its discrete effect is unclear due to the reviewed studies' design and reporting.