Experiences and perceptions of adults pre- and/or post-lumbar spine surgery: a meta-ethnography.

STUDY DESIGN: Qualitative meta-ethnography. Pre-registered with OSF:10.17605/OSF.IO/UTZE6. PURPOSE: To understand the patient experience pre- and/or post-lumbar spine surgery. METHODS: Literature search: A literature search was conducted in MEDLINE, EMBASE, EmCare and CINAHL from inception to October 17, 2022. Study selection criteria: Peer-reviewed qualitative or mixed-method studies of English text investigating the beliefs, perceptions, or experiences of adults (≥18 years old) pre- and/or post-lumbar spine surgery for degenerative, non-traumatic or non-infectious concerns. Data synthesis: The eMERGE meta-ethnography reporting guidelines were followed to create themes and subthemes from the original themes of the included studies. A quality appraisal was performed using the McMaster Quality Appraisal tool. RESULTS: We included 18 studies and identified five themes that were separated into pre- and post-operative categories. The two pre-operative themes included [1]: the influence of physiotherapy interventions on patients' experiences, and [2] the importance of education/the power of communication, and the three post-operative themes included [1]: psychosocial coping [2], redefining oneself post-operatively, and [3] experience with the healthcare system. CONCLUSIONS: These findings emphasize the complexity of the peri-operative experience for individuals undergoing lumbar spine surgery. Future research should focus on addressing psychosocial factors that may optimize patient experiences and recovery following LSS.

The results of this study identified potential pre-operative and post-operative factors that may influence whether patients' have positive or negative perioperative experiences with lumbar spine surgery.Health care providers should be encouraged to focus on psychosocial factors that can be implemented in the health care system to improve the perioperative experience of patients undergoing lumbar spine surgery.

How do we define and measure sarcopenia? A meta-analysis of observational studies.

OBJECTIVE: this study aimed to investigate how sarcopenia has been defined and measured in the literature reporting its prevalence, and how different definitions and measurement tools can affect prevalence estimates. DESIGN: systematic review and meta-analysis. SETTING AND PARTICIPANTS: community-dwelling older people. METHODS: meta-analysis of data collected from observational studies. We performed an electronic search in five databases to identify studies reporting the prevalence of sarcopenia. We used descriptive statistics to present data pertaining sarcopenia definition and measurement tools, and the quality-effects model for meta-analysis of pooled prevalence. RESULTS: we found seven different operational definitions for sarcopenia and a variety of tools applied to assess the sarcopenic markers; muscle mass, muscle strength and physical performance. The prevalence of sarcopenia varied between the definitions with general estimates ranging from 5% based on the European Working Group on Sarcopenia in Older People (EWGSOP1) criterion to 17% with the International Working Group on Sarcopenia. According to the tool used to assess muscle mass, strength and physical performance, prevalence values also varied within definitions extending from 1 to 7%, 1 to 12% and 0 to 22%, respectively. CONCLUSION AND IMPLICATIONS: the criteria used to define sarcopenia, as well as the measurement tools applied to assess sarcopenic markers have influence in the prevalence of sarcopenia. The establishment of a unique definition for sarcopenia, the use of methods that guarantee an accurate evaluation of muscle mass and the standardisation of measurement tools are necessary to allow a proper diagnosis and comparison of sarcopenia prevalence among populations.

Exclusion of Older Adults from Ongoing Clinical Trials on Low Back Pain: A Review of the WHO Trial Registry Database.

BACKGROUND/OBJECTIVES: The burden of low back pain (LBP) is high, especially for older adults who experience a higher number of years living with a disability. However, this population is not being well represented in clinical trials (CTs). This study analyzed the International Clinical Trial Registry Platform (ICTRP) database from the World Health Organization to verify the future trend in the participation of older adults in registered CTs on LBP. DESIGN: We performed a cross-sectional review of the ICTRP searching for prospective protocols planning interventions for LBP with registration dates from January 2015 through November 2018. From the protocols of the eligible studies, we extracted those planning to include older adults. RESULTS: A total of 167 protocols for CTs for LBP were planning to recruit participants older than 65 years. However, only five registries (2.99%; pooled sample = 169 participants) were designed to target participants specifically older than 65 years. The exclusion of older participants was not justified and imposed through an arbitrary upper-age limit in 93.6% of the protocols. Most of the protocols are from single-center studies, and a greater number are planned to be carried out in developed regions. Higher interest was in pharmacologic interventions, devices/technology, and physical rehabilitation. CONCLUSION: Older adults with LBP will continue to be underinvestigated in CTs for LBP in the near future. In general, ongoing trials are small, planned in developed regions, and proposing pharmacologic interventions to deal with LBP. J Am Geriatr Soc 67:603-608, 2019.

How do we define and measure sarcopenia? Protocol for a systematic review.

BACKGROUND: The loss of muscle mass is a natural aging consequence. A reduction of muscle mass that surpasses the physiological rate is considered the key factor responsible for the development of a geriatric syndrome called sarcopenia. However, a new understanding of the importance of muscle quality over quantity is rising; as a result, different definitions for sarcopenia has been used. Due to the negative impact on elder's health and quality of life, the number of research investigating the causes, prevalence, and management of sarcopenia is increasing, although a consensus on sarcopenia definition is still missing. This systematic review will assess observational studies reporting the presence of sarcopenia aiming to verify how sarcopenia is defined, the diagnosis criteria, and the tools used for assessment. In addition, we will investigate the influence of the definition and diagnostic tools on the prevalence rate. METHODS: Keywords related to the condition, population, and type of study will be combined to build a search strategy for each of the following databases MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Google Scholar. Two independent reviewers will analyze the retrieved papers for eligibility and the methodological quality of eligible studies. The definition of sarcopenia and diagnostic tools used in each study and the prevalence estimates will be extracted. Descriptive statistics will be used to report the definitions of sarcopenia, diagnostic tools, and whether these influence or not, the prevalence rates. DISCUSSION: Sarcopenia is receiving greater attention in geriatrics research in recent years. Therefore, it is important to investigate how this condition is defined in the literature and whether these definitions can interfere with the reported estimates devoting more efforts on the topic. The results of this study can help to determine the most used definitions of sarcopenia reported in the literature, its strengths and limitations, and open a discussion about a need for a more valid, easy, and suitable one. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015020832.