A Systematic Review of the Effectiveness of Manipulative Therapy in Treating Lateral Epicondylalgia Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review Conducting and Reporting Case Series and Audits - Author Guidelines for Acupuncture in Medicine Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report Systematic Reviews of Animal Studies; Missing Link in Translational Research?
Abstract Lateral epicondylalgia is a commonly encountered musculoskeletal complaint . Currently , there is no agreement regarding the exact underlying pathoanatomical cause or the most effective management strategy . Various forms of joint manipulation have been recommended as treatment . The purpose of this study was to systematic ally review available literature regarding the effectiveness of manipulation in treating lateral epicondylalgia . A comprehensive search of Medline , CINAHL , Health Source , SPORTD iscus , and the Physiotherapy Evidence Data base ending in November 2007 was conducted . Thirteen studies , both r and omized and non-r and omized clinical trials , met inclusion criteria . Articles were assessed for quality by one review er using the 10-point PEDro scale . Quality scores ranged from 1 - 8 with a mean score of 5.15 ± 1.85 . This score represented fair quality overall ; however , trends indicated the presence of consistent method ological flaws . Specifically , no study achieved successful blinding of the patient or treating therapist , and less than 50 % used a blinded outcome assessor . Additionally , studies varied significantly in terms of outcome measures , follow-up , and comparison treatments , thus making comparing results across studies difficult . Results of this review support the use of Mulligan 's mobilization with movement in providing immediate , short- , and long-term benefits . In addition , positive results were demonstrated with manipulative therapy directed at the cervical spine , although data regarding long-term effects were limited . Currently , limited evidence exists to support a synthesis of any particular technique whether directed at the elbow or cervical spine . Overall , this review identified the need for further high- quality studies using larger sample sizes , valid functional outcome measures , and longer follow-up periods Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the  Michigan H and Outcomes Question naire ( MHQ ) , the  Patient Evaluation Measure ( PEM ) , and the  Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted This article aims to give guidance on the conduct and reporting of case series and audits of acupuncture , based on common problems that have arisen in the past . This type of project , and particularly the prospect i ve case series or pre- post-intervention study , may give valuable evidence of the overall effectiveness of acupuncture for example in different situations and in different conditions and provides one step in the research pathway before generating an hypothesis . The project should be design ed with the aim of reducing bias as much as possible . Careful and detailed planning is essential for the project to produce worthwhile results that readers can evaluate and replicate . Ethical issues should be considered and formal approval may be necessary . The patient group should be recruited systematic ally and baseline data obtained . The treatment given should be systematic and decisions to change or end treatment made explicit . The outcome should be measured in ways that are known to be reliable and valid . Musculoskeletal problems can be evaluated with scales for pain and confirmed by measuring one other symptom such as stiffness or one other aspect such as bothersomeness . Global change scores also provide supporting information , and the MYMOP ( Measure Yourself Medical Outcome Profile ) measure is popular when patients with different conditions are included . The design of question naires for beliefs and attitudes is a specialised area that should not be attempted without expert help . Adverse events should also be recorded . Analysis of the data and the best way of summarising and presenting the results are also discussed BACKGROUND Multiple sclerosis ( MS ) is a major cause of chronic , neurological disability , with a significant long-term disability burden , often requiring comprehensive rehabilitation . OBJECTIVES To systematic ally evaluate evidence from published Cochrane Review s of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS ( pwMS ) , to improve patient outcomes , and to highlight current gaps in knowledge . METHODS We search ed the Cochrane Data base of Systematic Review s up to December 2017 , to identify Cochrane Review s that assessed the effectiveness of organised rehabilitation interventions for pwMS . Two review ers independently assessed the quality of included review s , using the Revised Assessment of Multiple Systematic Review s ( R-AMSTAR ) tool , and the quality of the evidence for reported outcomes , using the GRADE framework . MAIN RESULTS Overall , we included 15 review s published in the Cochrane Library , comprising 164 r and omised controlled trials ( RCTs ) and four controlled clinical trials , with a total of 10,396 participants . The included review s evaluated a wide range of rehabilitation interventions , including : physical activity and exercise therapy , hyperbaric oxygen therapy ( HBOT ) , whole-body vibration , occupational therapy , cognitive and psychological interventions , nutritional and dietary supplements , vocational rehabilitation , information provision , telerehabilitation , and interventions for the management of spasticity . We assessed all review s to be of high to moderate method ological quality , based on R-AMSTAR criteria .Moderate- quality evidence suggested that physical therapeutic modalities ( exercise and physical activities ) improved functional outcomes ( mobility , muscular strength ) , reduced impairment ( fatigue ) , and improved participation ( quality of life ) . Moderate- quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation , and interventions that provided information improved patient knowledge . Low-qualitty evidence suggested that neuropsychological interventions , symptom-management programmes ( spasticity ) , whole body vibration , and telerehabilitation improved some patient outcomes . Evidence for other rehabilitation modalities was inconclusive , due to lack of robust studies . AUTHORS ' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit , although the certainty of evidence varies across the different types of interventions evaluated by the review s. Structured , multidisciplinary rehabilitation programmes and physical therapy ( exercise or physical activities ) can improve functional outcomes ( mobility , muscle strength , aerobic capacity ) , and quality of life . Overall , the evidence for many rehabilitation interventions should be interpreted cautiously , as the majority of included review s did not include data from current studies . More studies , with appropriate design , which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge Background This systematic review up date d and extended the " UK evidence report " by Bronfort et al. ( Chiropr Osteopath 18:3 , 2010 ) with respect to conditions/ interventions that received an ' inconclusive ’ or ' negative ’ evidence rating or were not covered in the report . Methods A literature search of more than 10 general medical and specialised data bases was conducted in August 2011 and up date d in March 2013 . Systematic review s , primary comparative studies and qualitative studies of patients with musculoskeletal or non-musculoskeletal conditions treated with manual therapy and reporting clinical outcomes were included . Study quality was assessed using st and ardised instruments , studies were summarised , and the results were compared against the evidence ratings of Bronfort . These were either confirmed , up date d , or new categories not assessed by Bronfort were added . Results 25,539 records were found ; 178 new and additional studies were identified , of which 72 were systematic review s , 96 were r and omised controlled trials , and 10 were non-r and omised primary studies . Most ' inconclusive ’ or ' moderate ’ evidence ratings of the UK evidence report were confirmed . Evidence ratings changed in a positive direction from inconclusive to moderate evidence ratings in only three cases ( manipulation/mobilisation [ with exercise ] for rotator cuff disorder ; spinal mobilisation for cervicogenic headache ; and mobilisation for miscellaneous headache ) . In addition , evidence was identified on a large number of non-musculoskeletal conditions not previously considered ; most of this evidence was rated as inconclusive . Conclusions Overall , there was limited high quality evidence for the effectiveness of manual therapy . Most review ed evidence was of low to moderate quality and inconsistent due to substantial method ological and clinical diversity . Areas requiring further research are highlighted Background The method ological quality of animal studies is an important factor hampering the translation of results from animal studies to a clinical setting . Systematic review s of animal studies may provide a suitable method to assess and thereby improve their method ological quality . Objectives The aims of this study were : 1 ) to evaluate the risk of bias assessment in animal-based systematic review s , and 2 ) to study the internal validity of the primary animal studies included in these systematic review s. Data Sources We systematic ally search ed Pubmed and Embase for SRs of pre clinical animal studies published between 2005 and 2012 . Results A total of 91 systematic review s met our inclusion criteria . The risk of bias was assessed in 48 ( 52.7 % ) of these 91 systematic review s. Thirty-three ( 36.3 % ) SRs provided sufficient information to evaluate the internal validity of the included studies . Of the evaluated primary studies , 24.6 % was r and omized , 14.6 % reported blinding of the investigator/caretaker , 23.9 % blinded the outcome assessment , and 23.1 % reported drop-outs . Conclusions To improve the translation of animal data to clinical practice , systematic review s of animal studies are worthwhile , but the internal validity of primary animal studies needs to be improved . Furthermore , risk of bias should be assessed by systematic review s of animal studies to provide insight into the reliability of the available evidence
The physiotherapy assessment s such as pain , swelling , range of motion , muscle strength , balance , gait and functional assessment demonstrated good concurrent validity .
Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability , except for lumbar spine posture , orthopaedic special tests , neurodynamic testa and scar assessment
Purpose The purpose of this review is to systematic ally explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders .