基于WHO-FICs架构智力残疾儿童青少年身体活动与运动康复的健康结局：系统综述的系统综述

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建智力残疾儿童青少年参与身体活动和运动康复的健康和功能结局的研究架构,系统分析智力残疾儿童青少年的主要健康与功能障碍表现、参与身体活动的方案以及健康和功能结局。 方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF),对智力残疾儿童青少年身体活动干预方案以及健康与功能结局进行系统分析,构建智力残疾儿童青少年健康与功能状况、身体活动干预方案以及健康与功能结局架构。检索Scopus、PubMed、Embase、Web of Science、中国知网、维普、万方数据,收集建库至2022年8月18日公开发表的智力残疾儿童青少年参与身体活动与运动康复的健康及功能结局的系统综述,进行系统综述。 结果 最终纳入系统综述8篇,来自5个国家,包括190项随机对照试验和7 011例参与者,研究领域主要涉及智力障碍、儿童神经病学、康复科学、残疾与健康、适应性体育、特殊教育等,发表时间集中在2018年至2022年。常见的健康状况主要有唐氏综合征、孤独症谱系障碍、脆性X综合征、Prade-Willi综合征、智力障碍、认知障碍;身体活动干预形式分为体适能类、技能类和活动类3类,活动频率每周1~5次,活动强度为中-高强度,持续时间1周~1.5年;健康结局体现在智力功能和适应性行为、身体活动、心理行为健康与社会适应、整体生活质量和福祉方面。 结论 基于WHO-FICs构建了智力残疾儿童青少年参与身体活动和运动康复的健康效果的理论架构。智力残疾儿童青少年主要功能障碍表现为智力功能和适应性行为、活动和心理健康、生活质量和福祉3个层面。其中智力功能和适应性行为层面涉及概念性技能、社交性技能和实践性技能,活动和参与层面表现为低体育活动参与度、久坐和肥胖,活动能力低,没有发展基本运动能力和身体素质。生活质量和福祉层面涉及情绪和情感、自尊、一般自我概念、幸福感、友谊、与他人的关系或社会成熟度、生活质量和福祉等。身体活动方式可以分为体适能类、技能类和运动项目类。主要健康和功能结局主要表现在三个领域：智力功能与适应性行为,活动和参与以及心理行为健康与社会适应、生活质量和福祉。在智力功能和适应性行为领域,主要健康结局涉及认知功能(执行功能、认知可塑性、工作记忆等)、心理功能(情绪自我控制、自我价值和自尊)。在活动和参与领域,主要健康结局涉及体适能(肌力和肌耐力、速度、灵敏性)和动作技能(基本动作技能、平衡、核心稳定性),提高体育活动参与度,促进其更好地适应与赋能(社交、亲社会行为等),达成健康目标(降低疾病风险、缓解焦虑和抑郁、肥胖管理)。在心理行为健康与社会适应、生活质量和福祉领域,参与身体活动与运动康复可以提升儿童青少年整体的生活质量和福祉。     

Effectiveness and Equity in Community-Based Rehabilitation on Pain,Physical Function,and Quality of Life After Unilateral Lower Limb Amputation: A Systematic Review

ObjectivesTo synthesize evidence for (1) the effectiveness of exercise-based rehabilitation interventions in the community and/or at home after transfemoral and transtibial amputation on pain, physical function, and quality of life and (2) the extent of inequities (unfair, avoidable differences in health) in access to identified interventions.Data SourcesEmbase, MEDLINE, PEDro, Cinahl, Global Health, PsycINFO, OpenGrey, and ClinicalTrials.gov were systematically searched from inception to August 12, 2021, for published, unpublished, and registered ongoing randomized controlled trials.Study SelectionThree review authors completed screening and quality appraisal in Covidence using the Cochrane Risk of Bias Tool. Included were randomized controlled trials of exercise-based rehabilitation interventions based in the community or at home for adults with transfemoral or transtibial amputation that assessed effectiveness on pain, physical function, or quality of life.Data ExtractionEffectiveness data were extracted to templates defined a priori and the PROGRESS-Plus framework was used for equity factors.Data SynthesisEight completed trials of low to moderate quality, 2 trial protocols, and 3 registered ongoing trials (351 participants across trials) were identified. Interventions included cognitive behavioral therapy, education, and video games, combined with exercise. There was heterogeneity in the mode of exercise as well as outcome measures employed. Intervention effects on pain, physical function, and quality of life were inconsistent. Intervention intensity, time of delivery, and degree of supervision influenced reported effectiveness. Overall, 423 potential participants were inequitably excluded from identified trials (65%), limiting the generalizability of interventions to the underlying population.ConclusionsInterventions that were tailored, supervised, of higher intensity, and not in the immediate postacute phase showed greater promise for improving specific physical function outcomes. Future trials should explore these effects further and employ more inclusive eligibility to optimize any future implementation.     

Gamification in Musculoskeletal Rehabilitation

Purpose of ReviewThis study is a narrative review aiming at evaluating the current literature of the last 5 years on gamification and musculoskeletal rehabilitation. The article search involved the following MeSH terms at PubMed: “gamification,” “exergaming,” and “rehabilitation.” Original studies in English language were included.Recent FindingsAfter careful analysis of the search results, 17 articles were included in this review. The use of games for rehabilitation was investigated in musculoskeletal rehabilitation conditions such as shoulder surgery, impingement syndrome, rheumatoid arthritis, osteoarthritis, low back pain, fibromyalgia, fracture, and ligament reconstruction. Results were similar or superior to conventional physical therapy or home-based exercises, with the additional benefit of improving motivation to the exercise program. Improvements in quality of life and perceived health status were also observed. The cost-effectiveness of this type of technology was also mentioned as an advantage of exergames in musculoskeletal rehabilitation.SummaryStudies involving gamification in musculoskeletal rehabilitation stress the potential of this resource in several aspects of physical fitness, health, and quality of life, also improving motivation and adherence to the exercise treatment.     

局部应用苯妥英治疗各类创口效果的系统评价

目的探讨局部应用苯妥英治疗各类创口的有效性和安全性.方法计算机检索MEDLINE(1966～2002.10)、EMBASE(1984～2002.10)、Cochrane 图书馆(2002年第4期)、Biologic Abstract(1993～1996)、Cancerlit(1997～2002.9)、Life Science Collection(1982～1995.3)、The International Pharmaceutical Abstract(1970～2002)和中国生物医学文献数据库(1978～2003.1),收集局部应用苯妥英治疗各类创口的对照试验.逐篇评价纳入研究的质量后,对研究结果进行描述性分析.结果共纳入9篇文献(1篇RCT、8篇同期非随机对照研究),共507例各类创口.文献质量评价结果显示,纳入文献的方法学质量均较低.多数研究的结果表明,局部应用苯妥英在健康肉芽组织的生长、痊愈率、痊愈时间以及降低创口细菌培养阳性率方面较对照药疗效好,但由于各种创口形成原因、对照干预措施以及结局评价指标上存在差异,未能进行Meta分析.仅一个研究报道有轻微的不良反应.结论评价者认为纳入论证强度低于随机对照试验的研究,其结论可能引起误导,因此要得出苯妥英治疗各类创口肯定有效的结论,尚需进行更多设计、执行和报告都良好的随机对照试验.     

心脏康复训练对冠心病患者生活质量的影响

目的探讨护士指导与支持下的病人自我管理型家庭心脏康复训练对改善冠心病患者生活质量的效果.方法将167名符合纳入与排除标准的冠心病患者随机分配到干预组与对照组.对照组84例接受常规治疗护理,干预组83例接受为期12周的患者自我管理型家庭心脏康复训练,包括药物管理、心绞痛管理、运动锻炼、饮食管理、戒烟等.生活质量用SF-36中文版测评.资料收集时间为干预前、干预后,以及干预结束后3个月随访时.结果接受心脏康复训练的干预组患者在一般健康状况、生理机能、生理职能、躯体疼痛、心理健康和精力方面的改善均显著优于对照组.三个月后随访时,其生理功能和生理职能的改善亦显著优于对照组.结论护士指导与支持下的患者自我管理型家庭心脏康复训练对改善冠心病患者的生活质量有积极作用.     

Effectiveness of nurse-led clinics in the early discharge period after percutaneous coronary intervention: A systematic review

BackgroundReadmission after percutaneous coronary intervention is common in the early postdischarge period, often linked to limited opportunity for education and preparation for self-care. Attending a nurse-led clinic within 30 d after discharge has the potential to enhance health outcomes.ObjectiveThe aim of the study was to synthesise the available literature on the effectiveness of nurse-led clinics, during early discharge (up to 30 d), for patients who have undergone percutaneous coronary intervention.Review method usedA systematic review of randomised and quasi-randomised controlled trials was undertaken.Data sourcesThe databases included PubMed, OVID, CINAHL, EMBASE, the Cochrane Library, SCOPUS, and ProQuest.Review methodsDatabases were searched up to November 2018. Two independent reviewers assessed studies using the Cochrane risk-of-bias tool.ResultsOf 2970 articles screened, only four studies, representing 244 participants, met the review inclusion criteria. Three of these studies had low to moderate risk of bias, with the other study unclear. Interventions comprised physical assessments and individualised education. Reported outcomes included quality of life, medication adherence, cardiac rehabilitation attendance, and psychological symptoms. Statistical pooling was not feasible owing to heterogeneity across interventions, outcome measures, and study reporting. Small improvements in quality of life and some self-management behaviours were reported, but these changes were not sustained over time.ConclusionsThis review has identified an important gap in the research examining the effectiveness of early postdischarge nurse-led support after percutaneous coronary intervention on outcomes for patients and health services. More robust research with sufficiently powered sample sizes and clearly defined interventions, comparison groups, and outcomes is recommended to determine effectiveness of nurse-led clinics in the early discharge period.     

Community Reintegration After Rehabilitation for Hip Fracture: A Systematic Review and Meta-analysis

ObjectiveTo investigate the effect of rehabilitation on the physical, social, and psychological dimensions of community reintegration after hip fracture.Data SourcesElectronic databases Embase, EMCare, MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health, and SPORTDiscus were searched from the earliest date available to second June 2021.Study SelectionSearching identified 1844 potentially relevant articles. Twenty randomized controlled trials evaluating physical retraining, cognitive retraining, and model of care interventions on physical, social and psychological aspects of community reintegration for 3075 adults after hip fracture were included.Data ExtractionData were extracted using predetermined templates for participant characteristics, intervention type and setting, and outcomes related to community reintegration. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and the Grading of Recommendations, Assessment, Development, and Evaluations approach was applied to each meta-analysis.Data SynthesisPost intervention data were pooled to calculate risk ratios (RRs), mean differences, standardized mean differences, and 95% confidence intervals (CIs) using inverse variance methods and a random-effects model. Compared with usual care or no rehabilitation, there was moderate-quality evidence to suggest that physical retraining interventions improved outdoor mobility (RR, 1.45; 95% CI, 1.09-1.91; I²=0%) and moderate-quality evidence to suggest that physical retraining improved Nottingham Extended Activities of Daily Living Scale scores (physical and social reintegration) by a mean 3.5 units (95% CI, 0.99-6.01; I²=0%). Meta-analyses showed no significant effect for cognitive retraining and model of care interventions on any dimension of community reintegration.ConclusionsPreliminary evidence suggests that physical rehabilitation after hip fracture improves physical and social aspects of community reintegration. The effect of psychological and home-based interventions on community reintegration is currently unclear. Further research is needed to determine the effect of rehabilitation on community reintegration, using interventions and measures that encompass all dimensions of community reintegration.     

Are Nonpharmacologic Interventions Delivered Through Synchronous Telehealth as Effective and Safe as In-Person Interventions for the Management of Patients With Nonacute Musculoskeletal Conditions? A Systematic Rapid Review

ObjectiveTo determine whether nonpharmacologic interventions delivered through synchronous telehealth are as effective and safe compared with in-person interventions for the management of patients with musculoskeletal conditions in improving pain, functioning, self-reported recovery, psychological outcomes, or health-related quality of life using rapid review methods.Data SourcesWe searched MEDLINE, CINAHL, Embase, and Cochrane Central Register of Controlled Trials from 2010 to August 2020 for randomized controlled trials (RCTs) published in English or French; we updated our search in January 2021.Study SelectionOne reviewer screened citations in 2 phases (phase 1: title/abstract; phase 2: full-text) selecting RCTs comparing synchronous telehealth with in-person care for the management of musculoskeletal conditions. A random 10% sample was screened by 2 independent reviewers with minimum 95% agreement prior to full screening. One reviewer critically appraised and one reviewer validated appraisal for eligible RCTs.Data ExtractionOne author extracted participant characteristics, setting, sample size, interventions, comparisons, follow-up period, and outcome data. A second author validated data extraction.Data SynthesisWe summarized the findings narratively. Low- to moderate-quality evidence suggests that synchronous telehealth (ie, videoconference or telephone calls) alone or in combination with in-person care leads to similar outcomes as in-person care alone for nonspecific low back pain, generalized osteoarthritis, hip or knee osteoarthritis, and nonacute headaches in adults.ConclusionsSynchronous telehealth may be an option for the management of nonacute musculoskeletal conditions in adults. However, our results may not be generalizable to rural or low socioeconomic populations. Future research should investigate the outcomes associated the use of new technologies, such as videoconference.     

老年人参与身体活动对改善健康、生活质量和福祉效果的系统综述

目的 以世界卫生组织的相关重要文件作为研究的理论基础,建立老年人身体活动和康复活动架构,对老年人参与身体活动的健康和康复效果进行系统综述。方法 采用主题检索方式,检索Web of Science、PubMed、EBSCO、Google Scholar、中国知网和万方数据库建库至2021年6月30日与身体活动领域老年人身体活动和健康、生活质量相关的文献,提取文献内容,对老年人参与身体活动改善健康、生活质量和福祉的效果进行综述。结果 研究涉及的老年人参与的身体活动类别有有氧活动、发展肌肉的活动、发展骨骼的活动、平衡性活动和综合活动。老年人参与身体活动改善健康和康复效果,主要体现在改善身体健康和心理健康、促进社会适应和活动行为与营养;健康和康复影响主要体现在提高健康寿命,改善生活质量和福祉。在改善身体健康方面,老年人参与身体活动可以改善体适能、慢性疾病和身体功能;在改善心理健康方面,可以改善认知功能、情绪、人格特质和睡眠等。影响老年人身体活动参与和健康、康复效果的因素主要有个人因素和环境因素。结论 老年人参与所有形式的身体活动都可以提供健康效益,可促进健康老龄化,改善身体健康和心理健康,促进社会适应和活动行为与营养,提高健康寿命,改善生活质量和福祉。身体活动是一项健康相关服务,应促进老年人科学合理的身体活动,将身体活动与康复服务结合,促进老年人的健康、功能、福祉和生活质量。     

A physical exercise programme for palliative care patients in a clinical setting: Observations and preliminary findings

Abstract

Introduction

Reduced physical function and increased dependency have a significant negative impact on the quality of life of people who are terminally ill. Previous research indicates that participation in physical exercise can reduce distressing symptoms and improve physical functioning and quality of life in palliative care patients with a diagnosis of cancer. We describe the preliminary evaluation of an outpatient rehabilitation and exercise programme implemented in a hospice setting specifically designed for patients with a palliative diagnosis, and aimed at improving and maintaining physical functioning.

Methods

Eligible patients completed a programme of 10 gym-based exercise sessions including exercises to strengthen arms, legs, and core muscles, and to improve balance and cardiovascular fitness. This was further supported by a home-based exercise programme. Assessments of physical performance, fatigue, and quality of life were completed at baseline and immediately post-completion of the exercise programme.

Results

Improvements were observed in physical performance, fatigue, and overall quality-of-life scores post-intervention. There were high levels of attrition and many patients were lost to follow-up.

Discussion

While acknowledging the limitations of our design and small sample size, our findings contribute to the literature around the benefits of exercise for patients receiving palliative care. We recommend that exercise programmes implemented in clinical practice for palliative care patients should be individually tailored and supported by educational initiatives promoting the benefits of exercise to patients, families, and healthcare providers, and promoting early referral. Future work should explore the mechanisms by which such programmes might support improvements in quality of life, and how outcomes may differ for patients with different demographic and disease characteristics.     

Effectiveness of Technology-Based Distance Physical Rehabilitation Interventions for Improving Physical Functioning in Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials

ObjectiveTo study the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning in stroke.Data SourcesA systematic literature search was conducted in 6 databases from January 2000 to May 2018.Study SelectionInclusion criteria applied the patient, intervention, comparison, outcome, study design framework as follows: (P) stroke; (I) technology-based distance physical rehabilitation interventions; (C) any comparison without the use of technology; (O) physical functioning; (S) randomized controlled trials (RCTs). The search identified in total 693 studies, and the screening of 162 full-text studies revealed 13 eligible studies.Data ExtractionThe studies were screened using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and assessed for methodological quality and quality of evidence. Meta-analysis was performed if applicable.Data SynthesisA total of 13 studies were included, and online video monitoring was the most used technology. Seven outcomes of physical functioning were identified—activities of daily living (ADL), upper extremity functioning, lower extremity functioning, balance, walking, physical activity, and participation. A meta-analysis of 6 RCTs indicated that technology-based distance physical rehabilitation had a similar effect on ADL (standard mean difference 0.06; 95% confidence interval: ?0.22 to 0.35, P=.67) compared to the combination of traditional treatments (usual care, similar and other treatment). Similar results were obtained for other outcomes, except inconsistent findings were noted for walking. Methodological quality of the studies and quality of evidence were considered low.ConclusionsThe findings suggest that the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning might be similar compared to traditional treatments in stroke. Further research should be performed to confirm the effectiveness of technology-based distance physical rehabilitation interventions for improving physical functioning of persons with stroke.     

Effect of psychosocial interventions on outcomes of patients with colorectal cancer: A review of the literature

PurposePatients with colorectal cancer experience physical, psychological and social challenges. Psychosocial interventions seem to be effective in improving the physical, psychological and social outcomes of cancer patients. There is a lack of research exploring the effectiveness of pre-operative and post-operative psychosocial interventions on the outcomes of colorectal patients. This literature review aimed to explore the effects of pre-operative and post-operative psychosocial interventions on the outcomes of patients with colorectal cancer, including physical, psychological and social functioning, as well as the quality of life.Methods and sampleA literature search for studies on psychosocial interventions for patients with colorectal cancer published between 2002 and 2012 was undertaken from electronic databases of Medline, CINAHL, Scopus, PsycINFO, Mednar, and Proquest. Hand-searching was conducted to find relevant papers from the reference lists of included articles.Key resultsEleven studies met the inclusion criteria and were included after methodological quality appraisal. A narrative summary was carried out. Various psychosocial interventions, including educational interventions, cognitive-behavioural therapy, relaxation training and supportive group therapy were found to reduce colorectal patients' length of hospital stay, days to stoma proficiency and hospital anxiety and depression, and to improve patients' quality of life. Home visits, telephone sessions, individual teaching sessions and group sessions were commonly conducted.ConclusionsVarious forms of psychosocial interventions were used to improve outcomes of patients with colorectal cancer. Further research is recommended to investigate the effects of psychosocial interventions carried out during both the pre- and post-operative period on colorectal patients' outcomes. Given the small number of studies identified, it is essential to take this into consideration when identifying strategies and conducting future psychosocial interventions for colorectal patients.     

Effects of Nonpharmaceutical Treatments on Symptom Management in Adults With Mild or Moderate Multiple Sclerosis: A Meta-analysis

ObjectiveThe aim of this study was to conduct a meta-analysis of clinical trials on the effect of nonpharmaceutical treatments on outcomes for multiple sclerosis (MS).MethodsThe CINAHL, Mantis, Medline, PEDro, PubMed, and Scopus databases were searched. Final papers meeting inclusion criteria were scored with the Physiotherapy Evidence Database for quality and included in a meta-analysis. Forty papers in the meta-analysis totaled 1673 participants. The interventions were grouped into 6 subcategories: physical activity, technology, rehabilitation, alternative, resistance training, and psychological.ResultsThe combined effect of interventions produced a large overall effect size for the outcome fatigue; medium effect sizes for functionality, balance, and quality of life; and no effect on pain or spasticity. Physical activity had the greatest effect, improving fatigue, function, and balance. Rehabilitation and resistance training had a large effect on functionality. Comparatively, psychological approaches had only a small effect on improving quality of life. Sample sizes of included papers tended to be small with large variability in design. Therefore, results should be interpreted cautiously.ConclusionOur results suggest there may be effective nonpharmaceutical treatment options available that can improve the symptoms of fatigue, poor functionality, balance, and quality of life. We found that physical activity, alternative approaches, rehabilitation, and resistance training were effective for improving the management of a number of MS symptoms.     

Promoting psychosocial well-being following a stroke: developing a theoretically and empirically sound complex intervention

BackgroundThe psychosocial consequences of stroke are complex and comprehensive and include substantial and longlasting impacts on mood, identity, social relationships, return to work and quality of life. Many studies have explored possible interventions to prevent or treat psychosocial problems, but the results have generally been disappointing. Very few studies have provided adequate theoretical accounts of the mechanisms assumed to contribute to positive outcomes.ObjectivesTo describe the development of a psychosocial nursing intervention aimed at promoting psychosocial health and well-being and to stimulate dialogue about how to develop and report theoretically and empirically sound complex interventions in nursing.DesignA systematic, stepwise approach was used, consistent with the framework recommended for developing and evaluating complex interventions by the UK Medical Research Council.Data sourcesSystematic reviews of empirical studies regarding the psychosocial consequences and needs of patients following stroke; qualitative, experiential studies of stroke and stroke recovery; theories of psychosocial well-being, coping, life skills, narrative approaches to rehabilitation and guided self-determination.Review methodsEach systematic review was examined to determine the major psychosocial challenges and needs experienced by stroke survivors, focusing on how these challenges and needs developed over the illness trajectory, how previous interventions had sought to address them and the effective mechanisms assumed to affect the level of success of interventions. Qualitative studies were examined to reveal the subjective experiences of stroke and stroke recovery, paying particular attention to the development of needs across time and context. A qualitative synthesis of the major characteristics of the trajectory of stroke rehabilitation and recovery during the first year was developed. Theories were examined to illuminate possible effective mechanisms and actions aimed at promoting psychosocial well-being during the stroke recovery process.ResultsA dialogue-based intervention comprising eight encounters between stroke survivors and trained health care workers was designed, based on narrative theories, empowerment philosophy and guided self determination. Worksheets and a guiding topical outline were developed to support the dialogue.ConclusionsThe UK Medical Research Council framework facilitated the systematic development of an empirically and theoretically informed complex nursing intervention aimed at promoting post-stroke psychosocial well-being.     

The Efficacy of Physical Therapy Modalities in Patients With Hemophilia: A Systematic Review of Randomized Controlled Trials With Meta-analysis

ObjectiveTo evaluate the efficacy of different physical therapy interventions that could validate decisions taken by health care providers in the field of rehabilitation of patients with hemophilia according to the International Classification of Functioning, Disability and Health (ICF), including body functions and structures, activity, and participation.Data SourcesSeven databases—PubMed, Cochrane Library, Scopus, Web of Science, Physiotherapy Evidence Database, Google Scholar, and Clinicaltrials.gov—were systematically searched for randomized controlled trials evaluating any physical therapy modality to manage hemophilia.Study SelectionAfter abstract and full-text filtration, a methodological quality assessment was performed using the Physiotherapy Evidence Database scale for the studies that met the eligibility criteria.Data ExtractionRelevant data were extracted from eligible studies and outcomes were categorized according to the ICF.Data SynthesisUsing Review Manager and Microsoft Excel, a quantitative analysis using standardized mean differences with the 95% confidence interval was completed. Statistical heterogeneity between studies was explored using the I² test. A fixed effect model was applied to all data analyses. If heterogeneity was statistically significant, the Der Simonian and Laird random effects models were used instead.Results35 randomized controlled trials with 1216 participants were included in this systematic review; 13 of them dealt with pediatric patients. Most of the studies were of good quality; 12 studies were of low quality. Meta-analysis showed a significant difference in favor of manual therapy, laser, and therapeutic exercises on selected outcomes of body function and structure, activity, and participation categories of the ICF model.ConclusionThis systematic review recommends using manual therapy and therapeutic exercise modalities to improve join health status in combination with educational sessions to improve the quality of life of patients with hemophilic arthropathy. For pediatric patients with hemophilic arthropathy, using laser therapy is promising for improving functional capacity.     

Effects of life review on mental health and well-being among cancer patients: A systematic review

BackgroundCancer patients often experience psychological distress. Life review has increasingly been used to enhance their mental health and well-being. However, no systematic review has synthesized the evidence, and its effects remain unclear.ObjectiveTo examine and synthesize the best available evidence on the effects of life review on mental health and well-being among cancer patients.DesignSystematic review of randomized controlled trials and clinical controlled trials.Data sourcesTwelve electronic databases were searched for published studies reported in English or Chinese, from inception to September 2016. Other supplementary sources, such as related websites, professional books, reference lists, and author contacts were also used for published or unpublished studies.Review methodsA comprehensive literature search was conducted to identify eligible randomized controlled trials or clinical controlled trials about the effects of life review on cancer patients. Study selection, quality assessment, and data extraction were independently performed by two reviewers. The results were synthesized without meta-analysis in this review.ResultsFifteen studies (899 participants) were identified; of that total, nine studies were rated as strong in quality, while six studies were of moderate quality. In addition to structured life review interviews, other elements such as memory prompts and a legacy product were integrated into life review programs. A majority of studies indicated that life review programs benefited cancer patients by reducing depression and anxiety, as well as improving their sense of hope, self-esteem and quality of life.ConclusionsLife review can improve mental health and well-being among cancer patients. This suggests that life review can be integrated into typical cancer treatment to enhance patients’ mental health and well-being. More research with rigorous design is necessary to further explore the effects of life review.     

Effects of yoga-based interventions on cognitive function in healthy older adults: A systematic review of randomized controlled trials

BackgroundThe world's elderly population is growing. Physical activity has positive effects on health and cognition, but is decreasing among the elderly. Interest in yoga-based exercises has increased in this population, especially as an intervention targeting balance, flexibility, strength, and well-being. Recent interest has arisen regarding yoga’s potential benefits for cognition.ObjectiveTo systematically review evidence from randomized controlled trials (RCTs) examining the effects of yoga-based interventions on cognitive functioning in healthy adults aged ≥60. A secondary aim was to describe intervention characteristics and, where possible, the extent to which these influenced study outcomes.MethodThe review was conducted in accordance with PRISMA guidelines. Searches were performed from inception to June 2020 using the following electronic databases: (1) PubMed (NLM); (2) Embase (Elsevier); (3) Cochrane Central (Wiley); (4) PsycINFO (EBSCOhost); and (5) Cinahl (EbscoHost). Inclusion criteria: RCTs of yoga-based interventions assessing cognition in healthy adults ≥60 years. Risk of bias was assessed using the revised Cochrane risk of bias tool.ResultsA total of 1466 records were initially identified; six studies (5 unique trials) were included in the review. Four of the six articles reported significant positive effects of yoga-based interventions on cognition, including gross memory functioning and executive functions. Intervention characteristics and assessment methods varied between studies, with a high overall risk of bias in all studies.ConclusionYoga-based interventions are associated with improvements in cognition in healthy older adults. Adequately powered RCTs with robust study designs and long-term follow-ups are required. Future studies should explicitly report the intervention characteristics associated with changes in cognitive function.