Methodological quality, guidance, and tools in scoping reviews: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and report on evidence (such as guidance) or tools regarding methodological quality or risk of bias of scoping reviews. INTRODUCTION: Scoping reviews have gained popularity in recent years but have been criticized for variations in their approaches. This scoping review will examine evidence on the methodological quality of scoping reviews. It will also identify and describe potential methods to inform the development of a tool for appraising the methodological quality of scoping reviews. INCLUSION CRITERIA: This review will consider all documents reporting on the development, evaluation, or use of tools addressing the critical appraisal or risk of bias of scoping reviews. The search will seek evidence published from 2005 onwards, corresponding with the publication of Arksey and O'Malley's framework for scoping reviews. METHODS: A three-step search strategy will be used to locate both published and unpublished documents. An initial search of MEDLINE identified keywords and MeSH terms. A second search of MEDLINE, Embase, and CINAHL will follow. Google and Google Scholar will be searched for difficult-to-locate and unpublished literature. The authors will use their professional networks, social media accounts, and professional newsletters to contact methodologists to obtain any additional materials. Documents will be independently screened, selected, and extracted by two researchers, and the data will be presented in tables.

Exercise therapy for the treatment of tendinopathies: a scoping review protocol.

OBJECTIVE: The aim of the review is to provide a map of exercise interventions and outcomes that have been reported for the treatment of any tendinopathy. INTRODUCTION: Tendinopathy is a common condition that affects athletic and non-athletic populations. Exercise is the mainstay of conservative management of tendinopathy, and a range of different exercise types are recommended. There is a significant body of literature on exercise for tendinopathy, but to date no scoping review has provided a clear map of interventions used and outcomes reported in the literature. INCLUSION CRITERIA: We will include people of any age or gender with a diagnosis of tendinopathy of any severity or duration at any anatomical location. We will exclude full-thickness/massive tears and plantar fasciitis. The exercise therapy may take place at any location, including hospital, community, or people's homes, and may be supervised or unsupervised. We will include systematic reviews, quantitative, qualitative, and mixed-methods studies conducted in any developed nation. METHODS: We will search MEDLINE, CINAHL, AMED, Embase, SPORTDiscus, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, Epistemonikos, four trial registries, and six gray literature databases. We will use Scopus to search for cited/citing articles from included studies and will perform hand searching where relevant. We will include literature from 1998 to 2020 in any language for which we can access translation. Studies will be screened by two independent reviewers at title/abstract and full-text screening stages; a third reviewer will resolve conflicts. Data will be extracted into a bespoke charting form and will be presented as figures/tables with accompanying narrative.

Low back pain: an assessment using positional MRI and MDT.

Current guidelines advise against the use of routine imaging for low back pain. Positional MRI can provide enhanced assessment of the lumbar spine in functionally loaded positions which are often relevant to the presenting clinical symptoms. The purpose of this case report is to highlight the use of positional MRI in the assessment and classification of a subject with low back pain. A low back pain subject underwent a Mechanical Diagnosis and Therapy (MDT) assessment and positional MRI scan of the lumbar spine. The MDT assessment classified the subject as "other" since the subjective history indicated a possible posterior derangement whilst the objective assessment indicated a possible anterior derangement. Positional MRI scanning in flexed, upright and extended sitting postures confirmed the MDT assessment findings to reveal a dynamic spinal stenosis which reduced in flexion and increased in extension.

The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.

STUDY DESIGN: Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. OBJECTIVE: To quantify sagittal migration of the lumbar nucleus pulposus in 6 functional positions. SUMMARY OF BACKGROUND DATA: Previous studies of the intervertebral disc response in the sagittal plane were limited to imaging of recumbent positions. Developments of upright magnetic resonance imaging permit investigation of functional weight-bearing positions. METHODS: T2-weighted sagittal scans of the L1-L2 to L5-S1 discs were taken of 11 volunteers in standing, sitting (upright, flexed, and in extension), supine, and prone extension. Sagittal migration of the nucleus pulposus was measured (mm) as distance from anterior disc boundary to peak pixel intensity. Lumbar lordosis (Cobb angle) was measured in each position. RESULTS: Fifteen comparisons between positions showed significant positional effects (14 at L4-L5, L5-S1, the most mobile segments). Prone extension and supine lying induced significantly less posterior migration than sitting. Flexed and upright sitting, significantly more than standing at L4-L5, as did flexed sitting compared with extended. CONCLUSION: These results support for the first time the validity of clinical assumptions about disc behavior in functional positions: sitting postures may increase risk of posterior derangement, and prone and supine may be therapeutic for symptoms caused by posterior disc displacement.