A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain

BackgroundAn increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain. However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain. Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain.MethodsA search of the literature was conducted on seven databases (PubMed, Cochrane Center Register of Controlled Trials, Embase, Medline, CNKI, WanFang, and SinoMed) from the establishment of the databases to May 2022. This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies. The retrieved records were independently reviewed by two researchers. Further, the methodological quality was evaluated using the PEDro scale. All statistical analyses were performed using RevMan V.5.3 software. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results.ResultsSeventeen RCTs, including 1190 participants, were included in this meta-analysis. Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity (SMD = −0.83; 95% confidence interval [CI] = [-1.04 to −0.62]; p < 0.0001) and neck disability (MD = −3.65; 95% CI = [-5.67 to - 1.62]; p = 0.004). However, the studies had high heterogeneity, which could be explained by the type and control interventions. In addition, there were no significant differences in adverse events between the intervention and the control groups.ConclusionsManipulative therapy reduces the degree of chronic neck pain and neck disabilities.     

Yoga and Pilates compared to pelvic floor muscle training for urinary incontinence in elderly women: A randomised controlled pilot trial

Backgroundand purpose: There is limited evidence from randomised controlled trials (RCTs) regarding the use of yoga and Pilates for the management of urinary incontinence (UI) in women. This study aims to investigate the preliminary effects of using Pilates and yoga to manage UI.Materials and methodsAn assessor-blinded, prospective, three-arm parallel-group randomised controlled pilot trial was conducted in three elderly care centres in Hong Kong. Thirty women aged 60 years or above were included in the study. Study centres were randomly assigned to each of the three interventions (yoga, Pilates and pelvic floor muscle training [PFMT; standard care control]). Study interventions were provided once a week for four weeks, followed by unsupervised CD-guided home exercises for eight weeks. Outcomes included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), 1-h pad test, and feasibility measures such as adherence to the intervention programme, recruitment and retention rates and safety. Outcomes were assessed at baseline, 4 and 12 weeks. Statistical analysis was performed using two-way repeated measures analysis of covariance.ResultsAll three interventions demonstrated a statistically significant effect on ICIQ-SF scores from baseline to weeks 4 and 12. Significant effects in UI were reported for yoga compared with Pilates (mean: −2.93, 95% CI −5.35, −0.51; p = 0.02).ConclusionYoga poses intended to address the pelvic floor and core muscles were found to have superior benefits over Pilates exercises in terms of improved continence measured with the ICIQ-SF.     

The effect of yoga on pulmonary function in patients with asthma: A meta-analysis

BackgroundAsthma is one of the most common non-communicable diseases. Yoga with physical postures, breathing exercises, meditation, and relaxation may play an essential role in the complementary management of lower respiratory diseases. The study aimed to evaluate the impact of yoga (posture, breathing exercises, and meditation) on pulmonary function tests, asthma control tests, and health-related quality of adult asthmatic patients.MethodsMEDLINE, PubMed, Embase, Cochrane, Scopus, Google Scholar, ResearchGate, Clinical Key, and Academia electronic search engines were explored to search the relevant literature. The present study included adult asthmatic patients (age −18 and 60 years) with mild to moderate asthma, per GINA (Global Initiative for Asthma) guidelines. The effect of yoga was assessed on the following outcomes; pulmonary function tests, including FeV1 (Forced expiratory volume 1 s), FVC (Forced vital capacity), FeV1/FVC, peak expiratory flow rate (PEFR), health-related quality of life, and asthma control test. A fixed-effect model was applied to compute significance for statistical heterogeneity. P-value <0.05 was considered for statistical significance.ResultsFinally, fifteen articles were included for meta-analysis. The forest plot for overall effect of yoga intervention and usual care favors the yoga intervention for improvement in pulmonary function as FeV1 (SMD = 0.96, CI = 0.77–1.14, I² = 54%), FVC (SMD = 0.35, CI = 0.14–0.55, p = 0.11, I² = 50%), Fev1/FVC (SMD = 0.18, CI = −0.38-0.02, p = 0.02, I² = 50%), PEFR (SMD = 0.38, CI = 0.18–0.58, p = 0.0003, I² = 0%), asthma control test (SMD = 0.16, CI = 0.15–0.48, p = 0.31, I² = 86%) and health-related quality of life (SMD = 0.26, CI = 0.18–0.34, p = 0.02, I² = 51%) of asthmatic patients.ConclusionThis meta-analysis provides a moderate level of evidence regarding yoga as a complementary therapy in managing mild to moderate asthmatic patients. It also adds to the current knowledge of the same.     

Mat Pilates and belly dance: Effects on patient-reported outcomes among breast cancer survivors receiving hormone therapy and adherence to exercise

BackgroundBreast cancer treatment leads to several side effects. Exercise can help to reduce these side effects. However, it is unknown whether a mat Pilates or a belly dance intervention can improve the patient-reported outcomes of these women.ObjectiveExamine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on patient reported outcomes (PROs) among breast cancer survivors, at 16 weeks, six months, and 12 months; and investigate sociodemographic and clinical predictors of intervention adherence.MethodsSeventy-four breast cancer survivors who were receiving hormone therapy were randomly allocated into mat Pilates (n = 25), belly dance (n = 25) or control group (educational sessions) (n = 24). Mat Pilates and belly dance groups received a 16-week intervention, delivered three days a week and 60 min a session. The control group received three education sessions and continue usual care. The patient reported outcomes assessed were depressive symptoms (Beck Depression Inventory), stress (Perceived Stress Scale), optimism (Life Orientation Test), fatigue (FACT-F), sleep quality (Pittsburgh Sleep Quality Index) and pain (VAS), clinical and sociodemographic characteristics, and habitual physical activity (IPAQ short).ResultsAll three groups showed a significant improvement in fatigue, and this effect was maintained during follow-up. No significant effects were found for depressive symptoms, optimism, stress, or pain. A history of exercise prior to breast cancer and be inactive after diagnosis were significant predictors of adherence to interventions.ConclusionMat Pilates, belly dance and a few educational sessions can be effective in improving fatigue after 16 weeks of intervention.RegistrationClinicalTrials.gov (NCT03194997).     

Efficacy and Safety of Ayurveda interventions in the management of conjunctivitis: A systematic review and meta-analysis

BackgroundConjunctivitis is the inflammation of the conjunctiva. Although data on clinical efficacy and safety of various ayurvedic treatments in conjunctivitis is published, systematic review is not done. This systematic review and meta-analysis aims to evaluate the efficacy and safety of ayurvedic treatments in conjunctivitis.MethodsA literature search of the Cochrane Library (Cochrane central register of controlled trials: issue 6 of 12, June 2018), Pub Med, AYUSH research portal (Govt. of India), DHARA portal, Google scholar and online clinical trials registers was done. Randomized controlled trials (RCTs), quasi-randomized controlled trials (QRCTs), controlled clinical trials (CCTs) and multiple arms clinical trials were identified in which Ayurveda treatments with any dose, type, schedule, drug, dosage form, and advised Pathayapathya (lifestyle changes) were selected.ResultsWe identified 13 eligible RCTs, five CCTs and two multiple arms clinical trials which includes a total of 816 participants. Meta analysis of data from five trials showed that ayurvedic treatments benefitted more compared with non-ayurveda interventions in symptoms like itching (SMD = −0.98, 95% CI (−1.30,-0.65) p < 0.00001, I² = 38%), pain (SMD = −0.57, 95% CI (−0.87, −0.29, P = 0.0001, I² = 0%), ropy discharge (SMD = −1.02, 95% CI(−1.45, −0.59), P < 0.00001, I² = 0%), conjunctival congestion (SMD = −0.67, 95% CI (−0.91, −0.43), p < 0.00001, I² = 0%), foreign body sensation (SMD = −0.68, 95% CI(−1.06, −0.29), p = 0.0006, I² = 46%, Fig. 8) and lid heaviness (SMD = −0.66, 95% CI(- 0.98, −0.33), p < 0.0001, I² = 0%).ConclusionsAlthough some findings confirm the benefit of ayurveda as opposed to non ayurveda for the treatment of conjunctivitis, since the studies have high risk of bias and are of lower quality, the findings could not be generalized. There is a need for high quality studies in ayurveda in this regard.Prospero registrationCRD42019129436.     

Effects of progressive muscle relaxation on health-related outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials

Background and purposeProgressive muscle relaxation training (PMRT) has been widely applied to improve the physical and mental health of patients. The aim of this study was to evaluate the effects of PMRT on the symptoms and quality of life (QOL) of cancer patients.MethodsNine databases (Web of Science, CENTRAL, PubMed, Embase, CINAHL, OpenGrey, CNKI, Wanfang, and VIP database) were searched to identify randomized controlled trials (RCTs) that assessed the effects of PMRT on health-related outcomes for cancer patients. The risk of bias of the included studies and the evidence quality were appraised using the Cochrane Risk of Bias 2.0 tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, respectively. Meta-analysis was performed using RevMan 5.4.ResultsTwelve RCTs sampling 1147 patients were included. PMRT showed significant effects of alleviating anxiety [standardized mean difference (SMD) = −1.32, 95% CI (−1.88, −0.75), P < 0.001] and pain [SMD = −1.02, 95% CI (−1.93, −0.11), P = 0.030], and improving QOL [SMD = 1.65, 95% CI (0.53, 2.76), P = 0.004] in cancer patients. Regarding depression, self-esteem, nausea, and vomiting, PMRT showed better effects compared to the control group. However, no significant effect of reducing fatigue was detected [SMD = −1.00, 95% CI (−2.27, 0.27), P = 0.120]. The overall quality of evidence was moderate to very low.ConclusionPMRT is a promising complementary therapy that may improve the health-related outcomes of cancer patients. Future studies with rigorous research design are needed to obtain valid conclusions.     

Using ginseng for menopausal women's health care: A systematic review of randomized placebo-controlled trials

PurposeThis systematic review aimed to update the evidence of ginseng on menopausal women's health care.MethodsWe searched six databases (PubMed, AMED, EMBASE, the Cochrane Library, RISS, and KoreaMed) from their inception to April 2022 and included all placebo-controlled RCTs comparing any type of ginseng in menopausal women. The methodological quality of all studies was assessed using the Cochrane Risk of Bias Tool 2.0.ResultsWe included 15 RCTs with our inclusion criteria. The majority of studies considered bias a concern. Ginseng reduced menopausal symptoms in three studies (n = 515; standardized mean difference (SMD): −0.40, 95% confidence interval (CI): −0.73 to −0.07, P = 0.02) and lowed hot flashes (n = 515; SMD: −0.34, 95% CI: −0.66 to −0.01, P = 0.04). The meta-analysis of three other studies failed to show that ginseng was beneficial for sexual function (n = 491; SMD: 0.31, 95% CI: −0.30 to 0.92, P = 0.32). Three RCTs showed positive effects of ginseng on the quality of life score (n = 515, SMD: −0.31, 95% CI: −0.61 to −0.01, P = 0.05). In two studies, ginseng failed to produce significant effects on the vaginal maturation index and vaginal pH. Another three RCTs failed to demonstrate a beneficial effect of Korean red ginseng (KRG) on endometrial thickness.ConclusionThis study demonstrated that ginseng can significantly reduce hot flashes, menopausal symptoms, and quality of life in menopausal women. In contrast, neither KRG nor ginseng appeared to have any direct effect on sexual dysfunction, hormones or biomarkers, or endometrial thickness. More rigorous RCTs are needed to overcome the current limitations.     

Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer – A Systematic Review

BackgroundEmerging evidence suggests that exercise interventions may improve sexual dysfunction, one of the most common and distressing long-term adverse effects of cancer treatment.AimThe aim of this systematic review is to provide an overview of the effects of exercise on sexual dysfunction in prostate cancer patients.MethodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The systematic literature search was performed on 13th July 2021 using CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing sexual function in prostate cancer patients conducting an exercise intervention alone or in combination with other supportive interventions. The methodological quality was assessed using the Physiotherapy Education Database Score and Jadad scale. Outcomes were reported as between-group differences. Intragroup differences were also reported if significant.OutcomesPositive intervention effects on sexual function were primarily observed in patients following prostatectomy and undergoing anti-hormone treatment and for pelvic floor muscle exercises as well as aerobic and resistance exercise.Results22 RCTs (n = 1.752 patients) met the eligibility criteria, conducting either an exercise-only intervention (n = 10), a multimodal (exercise plus other supportive therapy) intervention (n = 4), or pelvic floor muscle exercises (n = 8). 6 RCTs assessed sexual dysfunction as a primary endpoint and 8 RCTs used dedicated assessment methods. 9 of the 22 RCTs found significant between-group differences in favor of the intervention group.Clinical ImplicationsThe multifaceted etiology of sexual dysfunction provides a strong rationale to further investigate the effects of exercise on sexual dysfunction in prostate cancer patients and also to consider a multidisciplinary approach.Strengths and LimitationsA strength is the comprehensive literature search to identify RCTs involving different exercise interventions and a wide range of sexual function assessments. Further, this is the first systematic review on this topic. The main limitations include the difficulty to compare studies due to the heterogeneity of exercise interventions and low questionnaire completion rates in some studies.ConclusionPreliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dyfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients.Nadine Reimer, Eva Maria Zopf, Rebecca Böwe, et al. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer – A Systematic Review. J Sex Med 2021;18:1899–1914.     

Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials

ObjectiveThis study aimed to evaluate the effects of motor imagery (MI) on walking function and balance in patients after stroke.MethodsRelated randomized controlled trials (RCTs) were searched in 12 electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Science Direct, Web of Science, Allied and Complementary Medicine, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, WanFang, and VIP) from inception to November 30, 2016, and Review Manager 5.3 was used for meta-analysis. References listed in included papers and other related systematic reviews on MI were also screened for further consideration.ResultsA total of 17 studies were included. When compared with “routine methods of treatment or training”, meta-analyses showed that MI was more effective in improving walking abilities (standardized mean difference [SMD] = 0.69, random effect model, 95% confidence interval [CI] = 0.38 to 1.00, P < 0.0001) and motor function in stroke patients (SMD = 0.84, random effect model, 95% CI = 0.45 to 1.22, P < 0.0001), but no statistical difference was noted in balance (SMD = 0.81, random effect model, 95% CI = −0.03 to 1.65, P = 0.06). Statistically significant improvement in walking abilities was noted at short-term (0 to < six weeks) (SMD = 0.83, fixed effect model, 95% CI = 0.24 to 1.42, P = 0.006) and long-term (≥six weeks) assessments (SMD = 0.45, fixed effect model, 95% CI = 0.25 to 0.64, P < 0.00001). Subgroup analyses suggested that MI had a positive effect on balance with short-term duration (0 to < six weeks) (SMD = 4.67, fixed effect model, 95% CI = 2.89 to 6.46, P < 0.00001), but failed to improve balance (SMD = 0.82, random effect model, 95% CI = −0.27 to 1.90, P = 0.14) with long-term (≥six weeks) duration.ConclusionMI appears to be a beneficial intervention for stroke rehabilitation. Nonetheless, existing evidence regarding the effects of MI in patients after stroke remains inconclusive because of significantly statistical heterogeneity and methodological flaws identified in the included studies. More large-scale and rigorously designed RCTs in future research with sufficient follow-up periods are needed to provide more reliable evidence on the effects of MI in post-stroke patients.     

Effects of neural mobilization in disorders associated with chronic secondary musculoskeletal pain: A systematic review and meta-analysis

PurposeTo evaluate the effect of neural mobilization (NM) in people with disorders associated with chronic secondary musculoskeletal pain due to persistent inflammation or diseases of the nervous system.MethodsA database search was conducted to select randomized controlled trials where NM, alone or within a multimodal protocol, was the main intervention for patients with neurological, autoimmune, or autoinflammatory disorders. The risk of bias and the certainty of evidence were assessed using the Cochrane Risk of Bias Tool for Randomized Trials and the GRADE approach. The primary outcome was pain intensity. Secondary measures were inflammatory biomarkers, range of motion and the level of spasticity.ResultsEleven studies were included (360 participants; 57% females). The most reported condition was arthritis, and the overall risk of bias was high in more than half of the studies. Pooled data showed a significant effect of NM, based on very low quality of evidence, on reducing pain intensity in people with systemic disorders (three studies: SMD = −0.58; 95% CI = −0.98, −0.18; p = 0.005), and the level of spasticity in individuals with brain or spinal cord injury (two studies: SMD = −0.85; 95% CI = −1.70, 0.00; p = 0.05).ConclusionsThere is scant and very low certainty of evidence to support that NM, compared to control interventions, may improve pain intensity and spasticity in patients with disorders associated with chronic secondary musculoskeletal pain. Further research with high methodological quality is needed to recommend for or against the use of NM in this population.     

Effects of baduanjin exercise on blood glucose,depression and anxiety among patients with type II diabetes and emotional disorders: A meta-analysis

BackgroundDiabetes mellitus (DM) is a group of metabolic disorders reflected by high blood glucose levels and lack of hormone insulin. Notably, T2DM patients are three times more likely to report depression than the general population. Conventional exercise training programs have been shown to be beneficial for T2DM, but less is known regarding the effects of Baduanjin exercise on hemoglobin A1c (HbA1c) and psychological measures among this unique group. Therefore, this systematic review and meta-analysis aimed to investigate the effects of Baduanjin exercise on HbA1c, depression, and anxiety among type 2 diabetes mellitus (T2DM) patients with emotional disorders.MethodsThe potential literature was searched from six electronic databases (PubMed, MEDLINE, CINAHL, Scopus, Wanfang, and CNKI) from their inception to July 2022. The randomized controlled studies that investigated the effects of Baduanjin on HbA1c, depression , and anxiety in T2DM with emotional disorders were included. The effect sizes were calculated using the random-effect models with a 95% confidence interval (CI). The Physiotherapy Evidence Database (PEDro) scale was employed to assess the study quality.ResultsEleven studies involving 755 T2DM participants with emotional disorders were analyzed in this study. The pooled results showed that Baduanjin had significant improvements in HbA1c (SMD = 0.75, 95% CI 0.46 to 1.04, p < 0.001), depression (SMD = 0.69, 95% CI 0.30 to 1.08, p < 0.01) and anxiety (SMD = 0.98, 95% CI 0.44 to 1.53, p < 0.01) compared to the control group.ConclusionFindings suggest that Baduanjin exercise may effectively alleviate HbA1c, depression, and anxiety among T2DM patients with emotional disorders. However, more well-designed studies are required to further substantiate the promising findings.     

Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients: A systematic review and meta-analysis

ObjectiveTo systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke.MethodsSystematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3).ResultsA total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95%CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = −1.77, 95%CI = −2.87 to −0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95%CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95%CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = −2.57, 95%CI = −3.14 to −2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients.ConclusionCurrent evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.     

Effects of a chair-yoga exercises on stress hormone levels,daily life activities,falls and physical fitness in institutionalized older adults

The aim of this study was to assess the changes mediated by exercise on activities of daily life and falls, physical fitness, salivary cortisol and alpha amylase in older adults living in social and health care givers centers.MethodsSample consisted in 35 women (83.81 ± 6.6 years old) were divided into two groups: chair-yoga exercises group (CY, n = 20) and control group (CG, n = 15). All subjects were evaluated before and after 14-weeks. CY was involved in exercise classes two times per week, while the GC did not participate in any exercise.ResultsFear of falling decreased in both groups, cortisol increased and alpha-amylase decreased in the CG. No significant changes occurred in physical fitness outcomes. Conclusion: CY practice was able to maintain the physical fitness scores and stress hormone levels, but was not able to improve the subject's perception on the ability to perform the instrumental activities of daily life.     

Effect of auricular acupressure on postpartum blues: A randomized sham controlled trial

AimTo investigate the effect of auricular acupressure on the severity of postpartum blues.MethodsA randomized sham controlled trial was conducted from February to November 2021, with 74 participants who were randomly allocated into two groups of either routine care + auricular acupressure (n = 37), or routine care + sham control (n = 37). Vacaria seeds with special non-latex adhesives were used to perform auricular acupressure on seven ear acupoints. There were two intervention sessions with an interval of five days. In the sham group, special non-latex adhesives without vacaria seeds were attached in the same acupoints as the intervention group. Severity of postpartum blues, fatigue, maternal-infant attachment, and postpartum depression were assessed.ResultsAuricular acupressure was associated with significant effect in reduction of postpartum blues on 10th and 15th days after childbirth (SMD = −2.77 and −2.15 respectively), postpartum depression on the 21st day after childbirth (SMD = −0.74), and maternal fatigue on 10th, 15th and 21st days after childbirth (SMD = −2.07, −1.30 and −1.32, respectively). Also, maternal-infant attachment was increased significantly on the 21st day after childbirth (SMD = 1.95).ConclusionAuricular acupressure was effective in reducing postpartum blues and depression, reducing maternal fatigue, and increasing maternal-infant attachment in the short-term after childbirth.Trial registrationRegistered prospectively in Iranian Registry of Clinical Trials (ID: IRCT20180218038789N2).     

The effects of a simulated laughter programme on mood,cortisol levels,and health-related quality of life among haemodialysis patients

ObjectiveThis study aimed to evaluate the effects of a simulated laughter programme on mood, cortisol levels, and health-related quality of life among haemodialysis patients.MethodsForty participants were randomly assigned to a laughter group (n = 20) or a control group (n = 20). Eleven participants completed the laughter programme after haemodialysis sessions and 18 control participants remained. The 4-week simulated laughter programme included weekly 60 min group sessions of simulated laughter, breathing, stretching exercises, and meditation, as well as daily 15 s individual laughter sessions administered via telephone. Mood, cortisol levels, and health-related quality of life were analysed using the rank analysis of covariance, and Wilcoxon's signed rank test.ResultsThe laughter group exhibited improvements in mood, symptoms, social interaction quality, and role limitations due to physical health.ConclusionThe simulated laughter programme may help improve mood and health-related quality of life among haemodialysis patients.     

Progressive resistance exercise as complementary therapy improves quality of life and body composition in anorexia nervosa: A randomized controlled trial

Backgroundand purpose: Exercise has not typically been used as an adjunct in treatment of anorexia nervosa (AN). This study aimed to examine the effects of progressive resistance exercise (PREx) on perceived quality of life (QoL) and body composition in adolescents with AN.Materials and methodsForty-four adolescents diagnosed with AN were randomly allocated to either PREx or control groups after hospitalization. The PREx group completed twenty-four PREx sessions over two months including three sets of 8–10 repetitions of eight whole-body exercises at a moderate intensity. QoL and body composition were evaluated at baseline and after two months using Health Questionnaire Short-Form 36 (SF-36) and anthropometric measurements.ResultsAt completion, forty-one participants (n = 19 PREx, and n = 22 controls) with mean age of 12.78 ± 0.88 years and mean body mass index of 18 ± 2.2 kg/m² were analyzed. Significant group x time effects were found on SF-36 role physical (RP) scores. Significant improvements with large effect sizes (d > 0.72) were found in RP, and arm circumferences in the PREx group. Spearman association analyses between percent change in anthropometric variables and change in QoL scores showed positive associations with moderate-to-large effect sizes in the PREx group among the following variables: mid-thigh-circumference, physical functioning (PF) and general health (GH); calf-circumference relaxed and body pain; biceps skinfold and GH scores; triceps-skinfold, and role physical (RP) and vitality (VT); supraspinale-skinfold and RP and VT; mid-thigh-skinfold and calf-skinfold and VT.ConclusionPREx after hospitalization enables modest positive changes in QoL associated to anthropometric changes in adolescents with AN without adverse effects on weight recovery.     

Efficacy and safety of Duhuo Jisheng decoction combined with Western medicine in the treatment of ankylosing spondylitis: A systematic review and meta-analysis

Backgroundand purpose: The effects of Duhuo Jisheng Decoction (DJD) on ankylosing spondylitis (AS) remain controversial. This study aimed to assess the efficacy and safety of DJD combined with Western medicine in treating AS.MethodsA total of nine databases were searched from the establishment of the databases to August 13th, 2021, for randomized controlled trials (RCTs) concerning the use of DJD combined with Western medicine to treat AS. Review Manager was used for the meta-analysis of the retrieved data. The risk of bias was evaluated using the revised Cochrane risk of bias tool for RCTs.ResultsThe results indicated that the combinational use of DJD and Western medicine resulted in significantly higher outcomes in terms of effective rate (RR = 1.40, 95% CI: 1.30, 1.51); thoracic mobility (MD = 0.32, 95% CI: 0.21, 0.43); morning stiffness time (SMD = −0.38, 95% CI: 0.61, −0.14); BASDAI (MD = −0.84, 95% CI: 1.57, −0.10); VAS for pain [spinal (MD = −2.76, 95% CI: 3.10, −2.42); peripheral joint (MD = −0.84, 95% CI: 1.16, −0.53)]; CRP (MD = −3.75, 95% CI: 6.36, −1.14); ESR: (MD = −4.80, 95% CI: 7.63, −1.97); and adverse reactions (RR = 0.50, 95% CI: 0.38, 0.66) in comparison to the Western medicine alone in treating AS.ConclusionCompared to the use of Western medicine, DJD combined with Western medicine improves the effective rate, functional scores, and symptoms of AS patients, with a reduced rate of adverse reactions.     

Vasopressin to Control Blood Loss during Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

ObjectiveMinimizing intraoperative blood loss during hysterectomy is crucial to lessen associated perioperative morbidity. The aim of this investigation is to conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that compared vasopressin versus normal saline in controlling intraoperative blood loss during hysterectomy.Data SourcesWe screened 5 major databases (PubMed, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials) from inception till July 18, 2021. We used the following query search in all databases: (vasopressin OR arginine vasopressin OR argipressin OR antidiuretic hormone) AND (hysterectomy) AND (saline OR placebo OR control OR no treatment) AND (randomized OR randomised OR randomly). There was no language restriction during database screening.Methods of Study SelectionWe considered all studies that met the following evidence-based criteria: (1) patients: individuals undergoing hysterectomy for any indication, (2) intervention: vasopressin, (3) comparator: normal saline, placebo, or no treatment, (4) outcomes: reliable extraction of any of our endpoints, and (5) study design: RCTs. We assessed risk of bias of included studies and pooled endpoints as mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI). We performed statistical analysis using the Review Manager software, version 5.4.0.Tabulation, Integration, and ResultsSeven RCTs with an overall low risk of bias met the inclusion criteria. This meta-analysis included a total of 455 patients; 232 and 223 patients were allocated to vasopressin and control group, respectively. The majority of RCTs were vaginal hysterectomy (n = 5), few abdominal hysterectomy, (n = 2) and no laparoscopic hysterectomy. The mean estimated intraoperative blood loss was significantly lower in favor of the vasopressin group compared with the control group (n = 6 RCTs, MD = ?119.85 mL, 95% CI [?177.55, ?62.14], p <.001). However, there was no significant difference between both groups regarding mean operating time, mean change in postoperative hemoglobin, mean hospital stay, rate of febrile morbidity, rate of pelvic infection, rate of perioperative blood transfusion, and rate of perioperative complications.ConclusionCompared with normal saline, vasopressin significantly reduced the estimated blood loss during hysterectomy but did not change any clinically significant outcomes. In addition, vasopressin was safe and did not correlate with an increase in the rates of febrile morbidity or pelvic infection.     

Are Endogenous Androgens Linked to Female Sexual Function? A Systemic Review and Meta-Analysis

BackgroundThe benefits of treatment with testosterone (T) in women with loss of desire suggest that low androgens may distinguish women with sexual dysfunction (SD) from others; however, evidence on this point is lacking.AimTo answer the question: is there an association between endogenous levels of androgens and sexual function in women?MethodsAn extensive search was performed in MEDLINE, Embase and PsycInfo. Four separate meta-analyses were conducted for total T, free T, Free Androgen Index (FAI), and Dehydroepiandrosterone sulphate (DHEAS). Cohort, cross-sectional, and prospective studies were included.OutcomesThe main outcome was the association between endogenous androgens and sexual desire. Global sexual function was considered as a secondary outcome. The effect measure was expressed as standardized mean difference (SMD).ResultsThe meta-analysis on total T included 34 studies involving 3,268 women, mean age 36.5 years. In 11 studies, a significant association was found between sexual desire, measured by validated psychometric instruments, and total T (SMD = 0.59 [0.29;0.88], P < 0.0001), with a moderate effect. The association with global sexual function (n = 12 studies) was also significant (SMD = 0.44 [0.21;0.67], P <0.0001). Overall, total T was associated with a better sexual function (SMD = 0.55 [0.28;0.82)], P < 0.0001), with similar results obtained when poor quality studies were removed. Age showed a negative relationship with the overall outcome. No differences were found when stratifying the studies according to menopausal status, type of menopause, age at menopause, use of hormonal replacement therapy, relationship status, method for T measurement, phase of the menstrual cycle or use of hormonal contraception. The meta-analysis of T derivatives (free T and FAI) also showed a significant, moderate association with sexual desire. In contrast, DHEAS seems not to exert any significant influence on desire, whilst showing a positive association with global sexual function.Clinical ImplicationsEndogenous androgens show a moderate association with a better sexual function in women; however, the role of psychological, relational and other hormonal factors should not be overlooked.Strengths & LimitationsThis represents the first attempt at meta-analyzing data available on the topic. A significant publication bias was found for total T.ConclusionThere appears to be a moderate association between total T and sexual desire/global sexual function, which is confirmed, although weak, in studies employing liquid chromatography-mass spectrometry (LC-MS). Similar results on desire were obtained for free T and FAI. DHEAS only showed a positive association with global sexual function. More research is needed.Maseroli E and Vignozzi L. Are Endogenous Androgens Linked to Female Sexual Function? A Systemic Review and Meta-Analysis. J Sex Med 2022;19:553–568.