Juillet - Août 2013

Transcription

Juillet - Août 2013

CENTRE COCHRANE FRANÇAIS
Contact : [email protected]
Lettre d’information des kinésithérapeutes / physiothérapeutes
N°19 – Juillet - Août 2013
Sélection des revues systématiques : Juillet - Août 2013
14 revues ont été sélectionnées qui concernent les domaines d’application de la physiothérapie suivants :
- Cardio Respiratoire (2)
- Ergonomie et santé du travail (0)
- Musculo squelettique (7)
- Neurologie (3)
- Oncologie (0)
- Orthopédie (0)
- Pédiatrie (1)
- Personnes âgées (0)
- Sports (0)
- Urologie et santé de la femme (1)
- Autres (0)
_________________________________
Cognitive rehabilitation for spatial neglect following stroke
Objectives
To assess whether cognitive rehabilitation improves functional independence, neglect (as measured using standardised
assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect
measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are
effective and whether cognitive rehabilitation is more effective than standard care or an attention control.
Authors' conclusions
The effectiveness of cognitive rehabilitation interventions for reducing the disabling effects of neglect and increasing
independence remains unproven. As a consequence, no rehabilitation approach can be supported or refuted based on current
evidence from RCTs. However, there is some very limited evidence that cognitive rehabilitation may have an immediate
beneficial effect on tests of neglect. This emerging evidence justifies further clinical trials of cognitive rehabilitation for neglect.
However, future studies need to have appropriate high quality methodological design and reporting, to examine persisting
effects of treatment and to include an attention control comparator
discipline: Neurologie
Lire le résumé en français
Lettre d’information des physiothérapeutes
Centre Cochrane Français
Juillet – Août 2013
1
Electromechanical-assisted training for walking after stroke
Objectives
To investigate the effects of automated electromechanical and robotic-assisted gait training devices for improving walking after
stroke.
People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to
achieve independent walking than people who receive gait training without these devices. Specifically, people in the first three
months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type
of device is still not clear. Further research should consist of a large definitive, pragmatic, phase III trial undertaken to address
specific questions such as the following: What frequency or duration of electromechanical-assisted gait training might be most
effective? How long does the benefit last?
Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer
Objectives
The primary aim of this study was to determine the effects of exercise training on exercise capacity in people following lung
resection (with or without chemotherapy) for NSCLC. The secondary aims were to determine the effects on other outcomes such
as HRQoL, lung function (forced expiratory volume in one second (FEV1)), peripheral muscle force, dyspnoea and fatigue as well
as feelings of anxiety and depression.
The evidence summarised in our review suggests that exercise training may potentially increase the exercise capacity of people
following lung resection for NSCLC. The findings of our systematic review should be interpreted with caution due to disparities
between the studies, methodological limitations, some significant risks of bias and small sample sizes. This systematic review
emphasises the need for larger RCTs
discipline: Cardio respiratoire
Nebulised hypertonic saline solution for acute bronchiolitis in infants
Objectives
To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants with acute viral bronchiolitis.
Current evidence suggests nebulised 3% saline may significantly reduce the length of hospital stay among infants hospitalised
with non-severe acute viral bronchiolitis and improve the clinical severity score in both outpatient and inpatient populations
2
Oxygen therapy for cystic fibrosis
Objectives
To assess whether oxygen therapy improves the longevity or quality of life of individuals with CF.
There are no published data to guide the prescription of chronic oxygen supplementation to people with advanced lung disease
due to CF. Short-term oxygen therapy during sleep and exercise improves oxygenation but is associated with modest and
probably clinically inconsequential hypercapnia. There are improvements in exercise duration, time to fall asleep and regular
attendance at school or work. There is a need for larger, well-designed clinical trials to assess the benefits of long-term oxygen
therapy in people with CF administered continuously or during exercise or sleep or both. However, we do not expect any new
research to be undertaken in this area any time soon and do not plan to update this review again until any new evidence does
become available.
Respiratory muscle training for cervical spinal cord injury
Objectives
To evaluate the efficacy of RMT versus standard care or sham treatments in people with cervical SCI
In spite of the relatively small number of studies included in this review, meta-analysis of the pooled data indicates that RMT is
effective for increasing respiratory muscle strength and perhaps also lung volumes for people with cervical SCI. Further research
is needed on functional outcomes following RMT, such as dyspnoea, cough efficacy, respiratory complications, hospital
admissions, and quality of life. In addition, longer-term studies are needed to ascertain optimal dosage and determine any
carryover effects of RMT on respiratory function, quality of life, respiratory morbidity, and mortality
Strength training and aerobic exercise training for muscle disease
Objectives
To examine the safety and efficacy of strength training and aerobic exercise training in people with a muscle disease.
Moderate-intensity strength training in myotonic dystrophy and FSHD and aerobic exercise training in dermatomyositis and
polymyositis and myotonic dystrophy type I appear to do no harm, but there is insufficient evidence to conclude that they offer
benefit. In mitochondrial myopathy, aerobic exercise combined with strength training appears to be safe and may be effective in
increasing submaximal endurance capacity. Limitations in the design of studies in other muscle diseases prevent more general
conclusions in these disorders.
discipline: Musculo-squelettique
3
Electrotherapy for neck pain
Objectives
This systematic review assessed the short, intermediate and long-term effects of electrotherapy on pain, function, disability,
patient satisfaction, global perceived effect, and quality of life in adults with neck pain with and without radiculopathy or
cervicogenic headache
We cannot make any definite statements on the efficacy and clinical usefulness of electrotherapy modalities for neck pain. Since
the evidence is of low or very low quality, we are uncertain about the estimate of the effect. Further research is very likely to
change both the estimate of effect and our confidence in the results. Current evidence for PEMF, rMS, and TENS shows that
these modalities might be more effective than placebo. When compared to other interventions the quality of evidence was very
low thus preventing further recommendations.
Funding bias should be considered, especially in PEMF studies. Galvanic current, iontophoresis, EMS, and a static magnetic field
did not reduce pain or disability. Future trials on these interventions should have larger patient samples, include more precise
standardization, and detail treatment characteristics.
Interventions for preventing and treating pelvic and back pain in pregnancy
Objectives
To assess the effects of interventions for preventing and treating pelvic and back pain in pregnancy.
Moderate-quality evidence suggested that acupuncture or exercise, tailored to the stage of pregnancy, significantly reduced
evening pelvic pain or lumbo-pelvic pain more than usual care alone, acupuncture was significantly more effective than exercise
for reducing evening pelvic pain, and a 16- to 20-week training program was no more successful than usual prenatal care at
preventing pelvic or LBP. Low-quality evidence suggested that exercise significantly reduced pain and disability from LBP.
There was low-quality evidence from single trials for other outcomes because of high risk of bias and sparse data; clinical
heterogeneity precluded pooling. Publication bias and selective reporting cannot be ruled out.
Physiotherapy, OMT, acupuncture, a multi-modal intervention, or the addition of a rigid pelvic belt to exercise seemed to relieve
pelvic or back pain more than usual care alone. Acupuncture was more effective than physiotherapy at relieving evening lumbopelvic pain and disability and improving pain and function when it was started at 26- rather than 20-weeks' gestation, although
the effects were small.
There was no significant difference in LBP and function for different support belts, exercise, neuro emotional technique or spinal
manipulation (SMT), or in evening pelvic pain between deep and superficial acupuncture.
Very low-quality evidence suggested a specially-designed pillow may reduce night-time LBP.
Further research is very likely to have an important impact on our confidence in the estimates of effect and is likely to change
the estimates. Future research would benefit from the introduction of an agreed classification system that can be used to
categorise women according to presenting symptoms.
discipline: Urologie et santé de la femme
4
Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication
Objectives
To systematically review the evidence for the effectiveness of nonoperative treatment of lumbar spinal stenosis with neurogenic
claudication
Moderate and high-quality evidence for nonoperative treatment is lacking and thus prohibits recommendations for guiding
clinical practice. Given the expected exponential rise in the prevalence of lumbar spinal stenosis with neurogenic claudication,
large high-quality trials are urgently needed.
Non-pharmacological interventions for fatigue in rheumatoidarthritis
Objectives
To evaluate the benefit and harm of non-pharmacological interventions for the management of fatigue in people with
rheumatoid arthritis. This included any intervention that was not classified as pharmacological in accordance with European
Union (EU) Directive 2001/83/EEC.
This review provides some evidence that physical activity and psychosocial interventions provide benefit in relation to selfreported fatigue in adults with rheumatoid arthritis. There is currently insufficient evidence of the effectiveness of other nonpharmacological interventions.
Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with
back pain
Objectives
To assess the effectiveness of physical conditioning as part of a return to work strategy in reducing time lost from work and
improving work status for workers with back pain. Further, to assess which aspects of physical conditioning are related to a
faster return to work for workers with back pain.
The effectiveness of physical conditioning as part of a return to work strategy in reducing sick leave for workers with back pain,
compared to usual care or exercise therapy, remains uncertain. For workers with acute back pain, physical conditioning may
have no effect on sickness absence duration. There is conflicting evidence regarding the reduction of sickness absence duration
with intense physical conditioning versus usual care for workers with subacute back pain. It may be that including workplace
visits or execution of the intervention at the workplace is the component that renders a physical conditioning programme
effective. For workers with chronic back pain physical conditioning has a small effect on reducing sick leave compared to care as
usual after 12 months follow-up. To what extent physical conditioning as part of integrated care management may alter the
effect on sick leave for workers with chronic back pain needs further research
5
Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication
Objectives
The main objective of this review was to provide an accurate overview of studies evaluating the effects of supervised versus
non-supervised exercise therapy on maximal walking time or distance on a treadmill for people with intermittent claudication
SET has statistically significant benefit on treadmill walking distance (maximal and pain-free) compared with non-supervised
regimens. However, the clinical relevance of this has not been demonstrated definitively; additional studies are required that
focus on quality of life or other disease-specific functional outcomes, such as walking behavior, patient satisfaction, costs, and
long-term follow-up. Professionals in the vascular field should make SET available for all patients with intermittent claudication
Traction for low-back pain with or without sciatica
Objectives
To assess the effects of traction compared to placebo, sham traction, reference treatments and no treatment in people with
LBP.
These findings indicate that traction, either alone or in combination with other treatments, has little or no impact on pain
intensity, functional status, global improvement and return to work among people with LBP. There is only limited-quality
evidence from studies with small sample sizes and moderate to high risk of bias. The effects shown by these studies are small
and are not clinically relevant.
Implications for practice
To date, the use of traction as treatment for non-specific LBP cannot be motivated by the best available evidence. These
conclusions are applicable to both manual and mechanical traction.
Implications for research
Only new, large, high-quality studies may change the point estimate and its accuracy, but it should be noted that such change
may not necessarily favour traction. Therefore, little priority should be given to new studies on the effect of traction treatment
alone or as part of a package.
Désinscription : Si vous souhaitez ne plus recevoir ce document, veuillez-vous désabonner sur le site du Centre Cochrane Français
Cette sélection a été réalisée par un groupe indépendant de kinésithérapeutes / physiothérapeutes.
Le centre Cochrane français est le centre national de la collaboration Cochrane, organisation internationale, indépendante (ne recevant en
particulier aucun financement de l’industrie pharmaceutique), à but non lucratif, dont l’objectif est de synthétiser les connaissances dans le
domaine de la santé. Une de ces activités principales est la production de revues systématiques évaluant l’efficacité des interventions
diagnostiques, thérapeutiques, préventives et organisationnelles dans le domaine de la santé. Ces revues sont accessibles dans la banque de
données Cochrane.
Le centre Cochrane français est organisé sous la forme d’un Groupement d’intérêt scientifique (GIS) qui associe la Haute Autorité en Santé,
l’INSERM, l’Ecole des Hautes Etudes en Santé Publique et l’Assistance Publique – Hôpitaux de Paris. Il est financé par le Ministère des Affaires
sociales et de la Santé. Le centre Cochrane a mis en place un programme destiné à la traduction de l’ensemble des résumés des revues
Cochrane. Ces traductions ont été rendues possibles grâce, outre à la contribution financière du ministère français des affaires sociales et de
la santé, et à celle des organismes canadiens suivants (Instituts de recherche en santé du Canada, ministère de la Santé et des Services
Sociaux du Québec, Fonds de recherche du Québec-Santé et Institut national d'excellence en santé et en services sociaux).
6

Juillet - Août 2013

Transcription

Documents pareils

4228 Holland Dr Des Moines, IA 50310 | Home for Sale | Real

Imagine you are working for the Scottish Tourist Board and you are

U2.1: Projet: Mon école Unité 2.1: Au lycée

Hi I`m Julia Fornage. After years of working as a pastry chef, I

Grade 7 course descriptions

Sciences de la nature - maternelle

Le Cercle Français, Pi Delta Phi

here - South Asian Women`s Community Centre

COCHRANE FRANCE

Jacksonville State University College of Arts and Sciences Updated

Concept de beaute

Review of Spatial Organization: The Geographer`s View of the World

The use of scientific evidence and knowledge by managers

Inflation in the number of monospecific genera in