RESUMEN
INTRODUCTION: Lymphoedema associated with breast cancer is caused by an interruption of the lymphatic system, together with factors such as total mastectomy, axillary dissection, positive lymph nodes, radiotherapy, use of taxanes and obesity. Physiotherapy treatment consists of complex decongestive therapy, manual lymphatic drainage and exercises, among other interventions. Currently, there are several systematic review and randomised controlled trials that evaluate the efficacy of these interventions. However, at present, there are no studies that compare the effectiveness of all these physical therapy interventions. The purpose of this study is to determine which physical therapy treatment is most effective in reducing breast cancer-related lymphoedema, improving quality of life and reducing pain. METHODS AND ANALYSIS: MEDLINE, PEDro, CINAHL, EMBASE, LILACS and Cochrane Central Register of Controlled Trials will be searched for reports of randomised controlled trials published from database inception to June 2022. We will only include studies that are written in English, Spanish and Portuguese. We will also search grey literature, preprint servers and clinical trial registries. The primary outcomes are reduction of secondary lymphoedema associated with breast cancer, improvements in quality of life and pain reduction. The risk of bias of individual studies will be evaluated using the Cochrane Risk of Bias 2.0 Tool. A network meta-analysis will be performed using a random-effects model. First, pairs will be directly meta-analysed and indirect comparisons will be made between the different physical therapy treatments. The GRADE system will be used to assess the overall quality of the body of evidence associated with the main results. ETHICS AND DISSEMINATION: This protocol does not require approval from an ethics committee. The results will be disseminated via peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CDR42022323541.
Asunto(s)
Neoplasias de la Mama , Linfedema , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/terapia , Enfermedad Crónica , Femenino , Humanos , Linfedema/cirugía , Linfedema/terapia , Mastectomía/efectos adversos , Metaanálisis como Asunto , Metaanálisis en Red , Dolor/complicaciones , Modalidades de Fisioterapia , Calidad de Vida , Revisiones Sistemáticas como Asunto , TaxoidesRESUMEN
Los trastornos de salud mental poseen un origen multifactorial; según cifras de la Organización Mundial de la Salud, estos afectan aproximadamente a unos 450 millones de personas y al 10% de la población mundial adulta. Entre otros factores, también puede afectar la economía y el producto nacional bruto entre un 3 y 4%. Esta revisión se planteó como objetivo determinar la eficacia de los efectos asociados a la actividad física y al deporte como factor protector de enfermedades de salud mental. En Chile, los trastornos de salud mental fueron los causantes del 8,9% de las muertes el año 2009. Estos trastornos principalmente se han asociado al abuso del consumo de alcohol y drogas; el consumo de marihuana en la población adolescente representa un 13,5% y en la población adulta, un 33%. Actualmente se considera que la práctica regular de actividad física y deporte es un factor protector, ante diversos trastornos de salud mental, como anorexia, depresión, distemia, estabilidad emocional, entre otros, debido a que, es bien sabido, que el deporte ayuda a mejor los estados de ánimo asociados, estrés, ansiedad y depresión. Chile ha incluido entre sus políticas 2011 2020 el aumento de la actividad física en la población, considerando el alto índice de sedentarismo, y además, como un método preventivo de diversas patologías de salud mental. Esta revisión concluye la existencia de evidencia positiva con relación al uso de la actividad física y el deporte como factor de protección de enfermedades de salud mental.
Mental health disorders have a multifactorial origin, according to figures from the World Health Organization these affect approximately 450 million people and 10% of the adult world population.Being able to affect the economy and the gross national product between 3 and 4%. The aim of this review was to determine the efficacy of the effects associated with physical activity and sports as a protective factor for mental health illnesses. In Chile, mental health disorders were the cause of 8.9% of deaths in 2009. These disorders have been mainly associated with the abuse of alcohol and drugs, showing marijuana use in the adolescent population 13.5 % and 33% in the adult population. Currently has been raised to the regular practice of physical activity and sport asa protective factor against various mental health disorders such as anorexia, depression, dystemia, emotional stability among others, because it is well known that sport helps improve the states of associated mood, stress, anxiety and depression. Chile has included among its policies 2011-2020 the increase of physical activity in the population considering the high rate of sedentary lifestyle, as well as preventive method of various pathologies of mental health. This review concludes the existence of positive evidence regarding the use of physical activity and sport as a protective factor for mental health illnesses.
Asunto(s)
Humanos , Deportes , Ejercicio Físico , Factores Protectores , Trastornos Mentales/prevención & control , Anorexia , Chile , DepresiónRESUMEN
Propósito: este Critically Appraised Topic (CAT) pretende responder a la pregunta ¿puede la estimulación eléctrica transcutánea de baja frecuencia disminuir el dolor en sujetos que presentan osteoartritis de rodilla? Método: se analizó el artículo Electroestimulación transcutánea para la osteoartritis de la rodilla, revisión sistemática Cochrane, de Rutjes et al (2009). Se comprobó la validez de los resultados, aplicabilidad y efectividad de este procedimiento en pacientes con osteoartritis de rodilla. Resultados: la electroestimulación transcutánea de baja frecuencia puede reducir el dolor en sujetos con osteoartrosis de rodilla (IC 95 por ciento -1,36 a -0,34), con una SMD de -0,85. Conclusión: se concluye que no se aprueba ni desaconseja su aplicación orientada en la reducción del dolor.
Purpose. The aim of this CAT (Critically Appraised Topic) was to check the validity of the results and effectiveness of Transcutaneous Electrical Stimulation in subjects with knee osteoarthritis and answer the question: In subjects with osteoarthritis of the knee, does low frequency transcutaneous electrical stimulation reduce pain? Method. We conducted an analysis of the article "Transcutaneous Electrical Stimulation for osteoarthritis of the knee, Cochrane Systematic Review" of Rutjes et al (2009). We analyzed validity of results, applicability and effectiveness of this intervention in patients with knee osteoarthritis. Results. Low frequency transcutaneous electrical stimulation may reduce pain in subjects with knee osteoarthritis. SMD -0.85 (95 percent CI -1.36 to -0.34). Conclusion. The intervention is neither endorsed nor discouraged in knee pain reduction.