Lettre d`information des kinésithérapeutes / physiothérapeutes

Lettre d’information
des kinésithérapeutes / physiothérapeutes
AVRIL 2012, lettre 4
http://fr.cochrane.org
Contact : [email protected]
Sélection des revues systématiques : Issue 4, 2012
6 revues ont été sélectionnées qui concernent les domaines d’application de la physiothérapie
suivants :
- Cardio Respiratoire (0)
- Ergonomie et santé du travail (0)
- Musculo squelettique (2)
- Neurologie (2)
- Oncologie (1)
- Orthopédie (1)
- Pédiatrie (0)
- Personnes âgées (0)
- Sports (0)
- Urologie et santé de la femme (0)
- Autres (0)
1. Exercise interventions for shoulder dysfunction in patients treated for head and neck cancer
Objectives
To evaluate the effectiveness and safety of exercise interventions for the treatment of shoulder
dysfunction caused by the treatment of head and neck cancer.).
Authors' conclusions
Limited evidence from two RCTs demonstrated that PRT is more effective than standard
physiotherapy treatment for shoulder dysfunction in patients treated for head and neck cancer,
improving pain, disability and range of motion of the shoulder joint, but it does not improve quality
of life. However, although statistically significant the measured benefits of the intervention may be
small. Other exercise regimes were not shown to be effective compared to routine postoperative
physiotherapy. Further studies which apply other exercise interventions in head and neck cancer
patients in the early postoperative and radiotherapy period are needed, with long-term follow-up
discipline: oncologie
1
Newsletter des physiothérapeutes
Centre Cochrane Français
Avril 2012
2. Interventions for the management of temporomandibular joint osteoarthritis
Objectives
To investigate the effects of different surgical and non-surgical therapeutic options for the
management of TMJ OA in adult patients.
Authors' conclusions
In view of the paucity of high level evidence for the effectiveness of interventions for the
management of TMJ OA, small parallel group RCTs which include participants with a clear diagnosis
of TMJ OA should be encouraged and especially studies evaluating some of the possible surgical
interventions.
discipline: musculo squelettique
3. Interventions for treating acute elbow dislocations in adults
Objectives
To assess the effects of various forms of treatment for acute simple elbow dislocations in adults.
Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine which method of
treatment is the most appropriate for simple dislocations of the elbow in adults. Although weak and
inconclusive, the available evidence from a trial comparing surgery versus conservative treatment
does not suggest that the surgical repair of elbow ligaments for simple elbow dislocation improves
long-term function. Future research should focus on questions relating to non-surgical treatment,
such as the duration of immobilisation.
discipline: orthopédie
4. Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign
paroxysmal positional vertigo (BPPV)
Objectives
To assess whether the various modifications of the Epley manoeuvre for posterior canal BPPV
enhance its efficacy in clinical practice.
Authors' conclusions
There is evidence supporting a statistically significant effect of post-Epley postural restrictions in
comparison to the Epley manoeuvre alone. However, it important to note that this statistically
significant effect only highlights a small improvement in treatment efficacy. An Epley manoeuvre
alone is effective in just under 80% of patients with typical BPPV. The additional intervention of
postural restrictions has a number needed to treat (NNT) of 10. The addition of postural restrictions
does not expose the majority of patients to risk of harm, does not pose a major inconvenience, and
can be routinely discussed and advised. Specific patients who experience discomfort due to wearing
a cervical collar and inconvenience in sleeping upright may be treated with the Epley manoeuvre
alone and still expect to be cured in most instances.
2
Newsletter des physiothérapeutes
Centre Cochrane Français
Avril 2012
There is insufficient evidence to support the routine application of mastoid oscillation during the
Epley manoeuvre, or additional steps in an 'augmented' Epley manoeuvre. Neither treatment is
associated with adverse outcomes. Further studies should employ a rigorous randomisation
technique, blinded outcome assessment, a post-treatment Dix-Hallpike test as an outcome measure
and longer-term follow-up of patients.
discipline: neurologie
5. Patellar taping for patellofemoral pain syndrome in adults
Objectives
The objective was to assess the effects, primarily on pain and function, of patellar taping for treating
patellofemoral pain syndrome in adults.
Authors' conclusions
The currently available evidence from trials reporting clinically relevant outcomes is low quality and
insufficient to draw conclusions on the effects of taping, whether used on its own or as part of a
treatment programme. Further research involving large, preferably multi-centre, good quality and
well reported randomised controlled trials that measure clinically important outcomes and long-term
results is warranted. Before this, consensus is required on the diagnosis of patellofemoral pain
syndrome, the standardisation of outcome measurement and an acceptable approach for patellar
taping.
discipline: musculo squelettique
6. Treatment for cramps in amyotrophic lateral sclerosis/motor neuron disease
Objectives
To systematically assess the effect of interventions on muscle cramps as a primary or secondary
endpoint or adverse event in people with ALS/MND.
Authors' conclusions
There is no evidence to support the use of any intervention for muscle cramps in ALS/MND. More
and larger randomised controlled trials evaluating treatments for muscle cramps in ALS/MND are
needed.
discipline: neurologie
Cette sélection a été réalisée par un groupe indépendant de kinésithérapeutes / physiothérapeutes.
Si vous êtes intéressés pour participer à la sélection titres des revues Cochrane pour les physiothérapeutes, vous pouvez
adresser un email à : [email protected]
3
Newsletter des physiothérapeutes
Centre Cochrane Français
Avril 2012