Slackline training and postural control in older adults: A systematic review and meta-analysis.

BACKGROUND: Exercise can reduce the negative effects of aging on postural control. The slackline training could potentially be an activity to improve postural control in older adults. However, the effects of slackline on postural control in older adults are not clear. This systematic review aimed to investigate the effects of slackline on postural control in older adults. METHODS: Randomized controlled trials were retrieved from ISI Web Knowledge, PubMed and Scopus using the descriptors "Slackline", "Slacklining", "Aged", "Aging", "Elderly", "Older adults", "Balance", "Postural Balance" and "Postural Control". Randomized controlled trials were selected. Postural control was evaluated through center of pressure (CoP), and slackline standing time during single leg stance. RESULTS: Four studies with 118 participants were included. The studies found that slackline improves slackline standing time in the tandem, and the single-legged postures, without differences in CoP displacement in single-leg position, results that were confirmed by the meta-analyses. CONCLUSION: Although slackline training improves task-specific performance, this improvement is not transferable to other tasks. This conclusion should be interpreted with caution considering the small number of studies, inconsistent designs, and general study limitations. Further studies are required before recommending slackline training to optimize the postural control of older adults.

Transcutaneous electrical stimulation in neck pain: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: The objective of this systematic review was to investigate the effectiveness of electrical stimulation (ES) for neck pain (NP). DATABASES AND DATA TREATMENT: The databases CINAHL, Embase, MEDLINE (via OVID), PEDro and Web of Science were searched, with no date restrictions. Two independent reviewers selected randomized controlled trials (RCTs) reporting pain, range of motion or psychosocial factors in people with NP, in which ES was applied. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. Thirty studies met eligibility criteria. RESULTS: Main results showed evidence of moderate quality that ES combined with other intervention significantly decreases the pain intensity compared to other intervention immediately post-treatment and at short-term follow-up; evidence of low quality showed significant effects of ES combined with other intervention in decreasing neck disability compared to other intervention immediately post-treatment; evidence of very-low quality that ES increased the pressure pain threshold compared to placebo immediately post-treatment and that ES + other intervention also increased the pressure pain threshold compared to other intervention at short-term follow-up. CONCLUSIONS: ES combined with other intervention seems to be useful to relieve pain and to improve disability in people with NP, however, more studies are needed. SIGNIFICANCE: Electrical stimulation seems to be effective for improving pain intensity, immediately post-treatment in people with neck pain, mainly as an adjunct therapeutic modality. Nevertheless, high-quality RCTs are still needed to investigate the efficacy of electrical stimulation in neck pain.

Can respiratory muscle training change the blood pressure levels in hypertension? A systematic review with meta-analysis.

The aim was to systematically review randomized controlled trials investigating the effects of respiratory training on blood pressure control in hypertensive individuals. Systematic review with meta-analysis was coducted following the guidelines from PRISMA statement. Searches for randomized controlled trials were performed in four electronic databases (PubMed, Cochrane Library, SCOPUS, and PEDro). Studies were included if they were randomized controlled trials that examined the impact of respiratory training on blood pressure of individuals with systemic arterial hypertension and the patients had no other associated disease. Eight studies were included for final analysis (total of 270 participants; 18-85 years) and presented an average score of 6.25 in the PEDro scale, being considered of high methodological quality. The meta-analysis showed a reduction in systolic and diastolic blood pressure for respiratory training when the load was applied [-15.72 (-18.63; -12.81) and -7.08 (-9.03; -5.13) mmHg, respectively]. There was also a reduction in systolic, but not in diastolic blood pressure when the training was performed without load [-5.08 (-7.49; -2.66) and -1.04 (-2.55; +0.46) mmHg, respectively]. The respiratory training has a positive effect in BP in hypertensive patients, however, only when performed with load seems to be able to promote some beneficial effect on diastolic blood pressure reduction.

The Effectiveness of Ischemic Compression Technique on Pain and Function in Individuals With Shoulder Pain: A Systematic Review.

OBJECTIVE: To systematically review current literature to determine the effectiveness of the ischemic compression (IC) technique on pain and function in individuals with shoulder pain. METHODS: This review was conducted according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Collaboration for Systematic Reviews; a search was performed in the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and Web of Science. Randomized clinical trials and quasi-randomized clinical trials were included, and the methodological quality was evaluated through the Physiotherapy Evidence Database scale. RESULTS: The search found 572 studies; of these, 71 were selected by title and, subsequently, 29 were selected through abstract analyses. After critical analyses, 5 studies were included. The methodological quality ranged from 4 (reasonable) to 9 (excellent) points. Pain was assessed by all studies using the visual analog scale, Global Perceived Effect scale, Numerical Rating Scale, pressure pain threshold, or Perceived Amelioration Numerical Scale. Function was evaluated by 3 studies through the Shoulder Pain and Disability Index; Neck Disability Index; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment; and Disabilities of the Arm, Shoulder, and Hand questionnaires. The studies showed that the IC technique produces immediate and short-term positive effects for pain, and positive short-term effects for shoulder function in individuals with shoulder pain. CONCLUSION: The IC technique seems to be beneficial for pain and shoulder function. However, caution is needed when considering this evidence owing to the limited quality of some studies, the few articles found, and the lack of standardization of the application parameters of the technique to facilitate its reproducibility.

Acute Effects of Hip Mobilization With Movement Technique on Pain and Biomechanics in Females With Patellofemoral Pain: A Randomized, Placebo-Controlled Trial.

CONTEXT: People with patellofemoral pain (PFP) present altered lower-limb movements during some activities. Perhaps, joint misalignment in the hip is one of the reasons for altered movement patterns in people with PFP. Some mobilization techniques have been designed to address joint misalignments. OBJECTIVE: To investigate the acute effects of hip mobilization with movement (MWM) technique on pain and biomechanics during squats and jumps in females with and without PFP. DESIGN: Randomized, placebo-controlled trial. SETTING: Movement analysis laboratory. PATIENTS: Fifty-six physically active females (28 with PFP and 28 asymptomatic) were divided into 4 groups: experimental group with PFP, sham group with PFP, experimental group without PFP, and sham group without PFP. INTERVENTION(S): The experimental groups received MWM for the hip, and the sham groups received sham mobilization. MAIN OUTCOME MEASURES: Pain, trunk, and lower-limb kinematics, and hip and knee kinetics during single-leg squats and landings. RESULTS: After the interventions, no difference between groups was found for pain. The PFP experimental group decreased hip internal rotation during squats compared with the PFP sham group (P = .03). There was no other significant difference between PFP groups for kinematic or kinetic outcomes during squats, as well as for any outcome during landings. There was no difference between asymptomatic groups for any of the outcomes in any of the tasks. CONCLUSIONS: Hip mobilization was ineffective to reduce pain in people with PFP. Hip MWM may contribute to dynamic lower-limb realignment in females with PFP by decreasing hip internal rotation during squats. Therefore, hip MWM could be potentially useful as a complementary intervention for patients with PFP.

Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: A Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients. METHODS: Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175). RESULTS: The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46). CONCLUSION: Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.

Current evidence demonstrates similar effects of kilohertz-frequency and low-frequency current on quadriceps evoked torque and discomfort in healthy individuals: a systematic review with meta-analysis.

BACKGROUND: Neuromuscular electrical stimulation (NMES) is widely utilized to enhance muscle performance. However, the optimal NMES waveform with respect to treatment effect has not been established. OBJECTIVE: To investigate the effects of kilohertz-frequency alternating current (KFAC) and low-frequency pulsed current (PC) on quadriceps evoked torque and self-reported discomfort. DATA SOURCES: PubMed, The Cochrane Library, EMBASE, MEDLINE, Physiotherapy Evidence Database (PEDro), SinoMed, ISI Web of Knowledge, and CINAHL were searched for randomized controlled trials (RCTs) and quasi-randomized controlled trials (QRCTs). STUDY SELECTION: Two reviewers independently selected potential studies according to the inclusion criteria, extracted data, and assessed methodological quality. DATA EXTRACTION AND SYNTHESIS: Studies were eligible if they compared KFAC versus PC interventions. Studies that included outcome measures for percentage of maximal isometric voluntary contraction (%MIVC) torque and self-reported discomfort level were eligible for evaluation. Seven studies involving 127 individuals were included. The methodological quality of eligible trials was moderate, with a mean of 5 on the 10-point PEDro scale. Overall, PC was no better than KFAC in terms of evoked torque and there was no difference in self-reported discomfort level. CONCLUSION: KFAC and PC have similar effects on quadriceps evoked torque and self-reported discomfort level in healthy individuals. The small number and overall methodological quality of currently available studies included in this meta-analysis indicate that new RCTs are needed to better determine optimal NMES treatment parameters.

Manual therapy for childhood respiratory disease: a systematic review.

OBJECTIVE: This study reviewed the scientific evidence available on the effects of manipulative techniques on children with respiratory diseases. METHOD: Three databases (SciELO, PEDro, and MEDLINE) were searched for clinical trials on the effects of manual therapy techniques on children and adolescents with respiratory diseases. The relevant studies were chosen by 2 independent researchers who assessed their abstracts and selected the studies that met the criteria for a complete and structured review. RESULTS: Of the 1147 relevant titles, 103 titles were selected for abstract assessment, and of these, 24 were selected for a full-text review. After critical analysis, 8 studies were included in the review and 16 were excluded for the following reasons: 1 covered only conventional therapy, 7 were not about the studied theme, and 8 included adults. Of the 8 studies included in the present review, 5 consisted of asthmatic children and the others of children with the following conditions: cystic fibrosis, bronchiolitis, recurrent respiratory infections, among others. Only 2 studies did not identify positive results with the use of manual therapy. The other 6 studies found some benefit, specifically in spirometric parameters, immunologic tests, anxiety questionnaire, or level of salivary cortisol. CONCLUSION: The use of manual techniques on children with respiratory diseases seems to be beneficial. Chiropractic, osteopathic medicine, and massage are the most common interventions. The lack of standardized procedures and limited variety of methods used evidenced the need for more studies on the subject.