The Effectiveness of Combined Exercise and Self-Determination Theory Programmes on Chronic Low Back Pain: A Systematic Review and Metanalysis.

Low back pain is a pervasive issue worldwide, having considerable prevalence and a significant impact on disability. As low back pain is a complicated condition with many potential contributors, the use of therapeutic exercise, combined with other techniques such as self-determination theory programmes, has the potential to improve several outcomes. The aim of this systematic review was to explore the effectiveness of combined exercise and self-determination theory programmes on chronic low back pain. This study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A systematic search in three databases (PubMed/MEDLINE, Web of Science, and Scopus) was conducted from September to November 2023. After screening, a total of five random control trials with patients with chronic low back pain were included in this systematic review and meta-analysis. The results showed significant differences in disability (SMD = -0.98; 95% CI = -1.86, -0.09; p = 0.03) and in quality of life (SMD = 0.23; 95% CI = 0.02, 0.44; p = 0.03) in favour of the intervention group versus the control group.

Effect of Chest Physiotherapy on Quality of Life, Exercise Capacity and Pulmonary Function in Patients with Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is one of the most deleterious diseases of the pulmonary fibrosis spectrum. Its clinical presentation includes irreversible loss of lung function, and increasing cough, dyspnea and impaired quality of life. Chest physiotherapy can improve ventilation capacity, gas exchange, dyspnea, exercise capacity and quality of life. The aim of this study was to review the evidence about chest physiotherapy in IPF, specifically meta-analyzing quality of life, exercise capacity and pulmonary function. METHODS: A wide search was conducted in PubMed, Embase, Cochrane and Web of Science for articles included until October 2023. PROSPERO Identifier: CRD42022333496. The Downs and Black scale and the Cochrane tool were employed to evaluate quality assessments and to assess the risk of bias. Data were pooled, and a meta-analysis was conducted. RESULTS: We selected 10 studies in which a chest physiotherapy program was performed with a total of 340 patients; of these, three articles were meta-analyzed. Significant effects in favor of chest physiotherapy were found for quality of life (MD = -8.60, 95% CI = -11.30, -5.90; p < 0.00001; I2 = 24%), exercise capacity (MD = 37.62, 95% CI = 15.10, 60.13; p = 0.001; I2 = 65%) and pulmonary function (MD = 7.86, 95% CI = 2.54, 13.17; p = 0.004; I2 = 80%). CONCLUSIONS: The systematic review showed significant results for the application of chest physiotherapy regarding pulmonary capacity, diffusion of gases and quality of life in IPF patients. The meta-analysis showed a significant improvement associated with applying chest physiotherapy in pulmonary function, exercise capacity and quality of life.

Efficacy and Safety of Respiratory Telerehabilitation in Patients with Long COVID-19: A Systematic Review and Meta-Analysis.

The aim of this review was to identify, map, and synthesize the extent and nature of research activity on the use of telerehabilitation to support Long COVID-19 rehabilitation and examine the efficacy and safety of respiratory telerehabilitation in patients with Long COVID-19. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials that tested the effect of respiratory telerehabilitation interventions in patients with Long COVID-19 versus no intervention, usual care, placebo, or face-to-face intervention. The data were pooled, and a meta-analysis was completed for quality of life, dyspnea, lung function, anxiety and depression, respiratory muscle strength, functional capacity, and lower limb strength. Finally, 10 studies were included. The meta-analysis results show significant differences in favor of respiratory telerehabilitation in quality of life (p = 0.02), dyspnea (p < 0.00001), respiratory muscle strength (p < 0.001), functional capacity (p < 0.0001), and lower limb strength (p = 0.01) but not in lung function (p = 0.28) and anxiety and depression (p = 0.55). In addition, there were no statistically significant differences in adverse effects (p = 0.06) between the telerehabilitation and comparator groups. The results suggest that these interventions can improve quality of life, reduce dyspnea, and increase respiratory and lower extremity muscle strength as well as functional capacity in patients with Long COVID-19.

Effects of Physiotherapy on Pain and Mouth Opening in Temporomandibular Disorders: An Umbrella and Mapping Systematic Review with Meta-Meta-Analysis.

The aim of this meta-meta-analysis was to assess the current evidence regarding the effect of physical therapy (PT) interventions on pain and functional variables in temporomandibular disorders (TMD). We conducted an umbrella systematic review (SR) and four meta-meta-analyses (MMA) and created an evidence map to determine the effectiveness of PT on pain intensity and maximum mouth opening in patients with TMD. The quality of the included SR was assessed with the AMSTAR 2, and the risk of bias with ROBIS. Of the 31 SR included in the umbrella SR, only 10 were included in the MMA. The MMA showed moderate effects for manual therapy and therapeutic exercise, and large effects for low-level laser therapy on improving pain intensity and maximum mouth opening in patients with TMD, with a limited to moderate quality of evidence. The overlapping analyses showed only a slight overlap for all the MMA according to the corrected covered area (range from 0.07 to 0.2), 23.1% to 41.6%. This umbrella SR showed that manual therapy and exercise interventions, as well as low-level laser therapy interventions, are effective in the reduction in pain intensity and improvement of maximum mouth opening in TMD. This article presents a synthesis of the available evidence related to the various physical therapy interventions used in patients presenting with temporomandibular disorders. These results could help clinicians to select the optimal intervention for their patients and to reject those that are less useful.

The Spanish Version of the International Index of Erectile Function: Adaptation and Validation.

BACKGROUND: The International Index of Erectile Function (IIEF) is a widely employed questionnaire in urology to assess erectile dysfunction (ED) in both clinical research and practice. OBJECTIVE: To translate and culturally adapt the Spanish version of the International Index of Erectile Function (IIEF) and to analyze its psychometric properties in Spanish men with erectile dysfunction (ED). METHODS: Firstly, direct and reverse translations were performed. Secondly, a pilot study was carried out on 23 patients with the lowest possible education level without being illiterate. Finally, 170 participants completed the IIEF. Test-retest reliability, internal consistency and construct validity (exploratory factor analysis) were assessed. Concurrent and divergent validity were evaluated with the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short-Form Health Survey (SF-12), respectively. Discriminant validity (with and without anxiety or depression) was calculated using a receiver-operating characteristic curve analysis. RESULTS: High internal consistency (Cronbach's alpha = 0.968, total score) and moderate-to-excellent test-retest reliability were found. The factor analysis showed a two-factor structure (explained variance of 77.34%). Significant correlations of the IIEF total score (p < 0.01) and domains (p < 0.05) with HADS anxiety and depression scores were observed (concurrent validity), while non-significant correlations with SF-12 physical and mental summary scores were found (divergent validity). The IIEF total score could discriminate between participants with and without anxiety (p < 0.05) and depression (p < 0.01), with an optimal cut-off point of <39.50 for both anxiety (48.30% sensitivity and 78.75% specificity) and depression (50.00% sensitivity and 81.01% specificity). CLINICAL IMPLICATIONS: The psychometric properties of the IIEF have not been analyzed in Spanish people to date. Strengths and Limitations: The Spanish version of the IIEF was shown to be capable of discriminating between men with erectile dysfunction with and without depression or anxiety. There are some limitations to this study that should be noted. It was conducted on Spanish participants, and, thus, it should be employed with caution in other Spanish-speaking countries. This study was carried out on a selected population, and, therefore, the generalizability of its results to other populations might be limited. Moreover, a large majority of the participants (89.41%) had secondary or higher education. Future studies should be performed on a more general population with a varied geographical and educational background. CONCLUSIONS: The Spanish IIEF is a valid and reliable instrument for assessing erectile function among Spanish men with ED.

Systematic review of self-management programs for prostate cancer patients, a quality of life and self-efficacy meta-analysis.

OBJECTIVE: To investigate the efficacy of self-management interventions on quality of life and/or self-efficacy in patients diagnosed with prostate cancer through a systematic review with meta-analysis. METHODS: A search was conducted from database inception to March 2022 across three databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. RESULTS: A total of fifteen studies were included in the study. Self-management interventions were identified by the Practical Reviews in Self-Management Support. The meta-analysis showed that self-management interventions have a significant effect on self-efficacy CONCLUSION: Self-management programs could have positive effects on quality of life and improve self-efficacy in prostate cancer patients. PRACTICE IMPLICATIONS: Self-management components may be heterogeneous but show positive results in improving self-efficacy in prostate cancer survivors. Including self-management components in the rehabilitation of prostate survivors can improve their quality of life.