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1.
Crystian B. Oliveira Márcia R. Franco Chris G. Maher Paulo H. Ferreira Priscila K. Morelhão Tatiana M. Damato Cynthia Gobbi Rafael Z. Pinto 《Archives of physical medicine and rehabilitation》2018,99(9):1900-1912
Objective
To investigate the effectiveness of physical activity–based interventions using electronic feedback in reducing pain and disability compared to minimal or no interventions in patients with chronic musculoskeletal pain.Data Sources
The following electronic databases were searched: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Web of Science, Physiotherapy Evidence Database, and main clinical trial registers.Study Selection
Randomized controlled trials investigating the effect of physical activity interventions using electronic feedback (eg, physical activity monitors) on pain and disability compared to minimal or no interventions in adults with chronic musculoskeletal pain were considered eligible.Data Extraction
Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development and Evaluation system was used to assess the overall quality of the evidence.Data Synthesis
Four published randomized controlled trials and 4 registered unpublished randomized controlled trials were included. At short-term follow-up, pooled estimations showed no significant differences in pain (2 trials: n=116; SMD=?.50; 95% confidence interval, ?1.91 to 0.91) and disability (2 trials: n=116; SMD=?.81; 95% confidence interval, ?2.34 to 0.73) between physical activity–based interventions and minimal interventions. Similarly, nonsignificant results were found at intermediate-term follow-up. According to Grading of Recommendations Assessment, Development and Evaluation, the overall quality of the evidence was considered to be of low quality.Conclusions
Our findings suggest that physical activity–based interventions using electronic feedback may be ineffective in reducing pain and disability compared to minimal interventions in patients with chronic musculoskeletal pain. Clinicians should be cautious when implementing this intervention in patients with chronic musculoskeletal pain. 相似文献2.
Wendy H. Oldenmenger Pleun J. de Raaf Cora de Klerk Carin C.D. van der Rijt 《Journal of pain and symptom management》2013,45(6):1083-1093
ContextTo improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0–10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden.ObjectivesThe aim of this systematic review was to explore the evidence on cut points for the symptoms of the Edmonton Symptom Assessment Scale.MethodsRelevant literature was searched in PubMed, CINAHL®, Embase, and PsycINFO®. We defined a cut point as the lower bound of the scores representing moderate or severe burden.ResultsEighteen articles were eligible for this review. Cut points were determined using the interference with daily life, another symptom-related method, or a verbal scale. For pain, cut point 5 and, to a lesser extent, cut point 7 were found as the optimal cut points for moderate pain and severe pain, respectively. For moderate tiredness, the best cut point seemed to be cut point 4. For severe tiredness, both cut points 7 and 8 were suggested frequently. A lack of evidence exists for nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath. Few studies suggested a cut point below 4.ConclusionFor many symptoms, there is no clear evidence as to what the optimal cut points are. In daily clinical practice, a symptom score ≥4 is recommended as a trigger for a more comprehensive symptom assessment. Until there is more evidence on the optimal cut points, we should hold back using a certain cut point in quality indicators and be cautious about strongly recommending a certain cut point in guidelines. 相似文献