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{ "count": 24730, "next": "http://api.gregory-ms.com/articles/?format=api&page=2447", "previous": "http://api.gregory-ms.com/articles/?format=api&page=2445", "results": [ { "article_id": 280, "title": "Whole-body vibration training for patients with neurodegenerative disease (Cochrane review) [with consumer summary]Select", "summary": "Whole-body vibration training for patients with neurodegenerative disease (Cochrane review) [with consumer summary] Sitja Rabert M, Rigau Comas D, Fort Vanmeerhaeghe A, Santoyo Medina C, Roque IFM, Romero-Rodriguez D, Bonfill Cosp X Cochrane Database of Systematic Reviews 2012;Issue 2 systematic review BACKGROUND: Whole-body vibration (WBV) may be a complementary training to standard physical rehabilitation programmes and appears to have potential benefits in the sensorimotor system performance of patients with neurodegenerative diseases. OBJECTIVES: The aim of this review was to examine the efficacy of WBV to improve functional performance according to basic activities of daily living (ADL) in neurodegenerative diseases. Additionally, we wanted to assess the possible effect on signs and symptoms of the disease, body balance, gait, muscle performance, quality of life and adverse events. SEARCH METHODS: We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2011 issue 4), Medline (1964 to 6 May 2011; via PubMed), Embase (1980 to 6 May 2011; via Ovid), PeDro (1929 to May 2011; via website), CINAHL (to September 2011; via Ovid) and PsycINFO (1806 to 6 May 2011; via Ovid). SELECTION CRITERIA: We included randomised controlled trials comparing single or multiple sessions of WBV to a passive intervention, any other active physical therapy or WBV with different vibration parameters. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. Disagreement was resolved by discussion or, if necessary, referred to a third review author. MAIN RESULTS: We included 10 trials, of which six focused on Parkinson's disease and four on multiple sclerosis. None of the studies reported data on the primary outcome (functional performance). In Parkinson's disease, after pooling two studies, a single session of WBV caused a significant improvement of gait measured using the Timed Up and Go test (TUG) in comparison to standing exercises (mean difference -3.09, 95% confidence interval -5.60 to -0.59; p = 0.02; I2 = 0%). Nevertheless, longer duration of WBV did not show significant results in comparison with physical therapy in body balance or signs and symptoms measured with the Unified Parkinson's Disease Rating Scale (UPDRS). In multiple sclerosis there was no evidence of a short-term or long-term effect of WBV on body balance, gait, muscle performance or quality of life. Adverse events were reported in few trials. In those trials that reported them, the intervention appeared to be safe. AUTHORS' CONCLUSIONS: There is insufficient evidence of the effect of WBV training on functional performance of neurodegenerative disease patients. Also, there is insufficient evidence regarding its beneficial effects on signs and symptoms of the disease, body balance, gait, muscle strength and quality of life compared to other active physical therapy or passive interventions in Parkinson's disease or multiple sclerosis. More studies assessing other functional tests and accurately assessing safety are needed before a definitive recommendation is established. Full text (sometimes free) may be available at these link(s): helpDOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/30992", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 294879, "given_name": "Mercè", "family_name": "Sitjà Rabert", "ORCID": null, "country": null }, { "author_id": 294880, "given_name": "David", "family_name": "Rigau Comas", "ORCID": null, "country": null }, { "author_id": 294881, "given_name": "Azahara", "family_name": "Fort Vanmeerhaeghe", "ORCID": null, "country": null }, { "author_id": 294882, "given_name": "Carme", "family_name": "Santoyo Medina", "ORCID": null, "country": null }, { "author_id": 294883, "given_name": "Marta", "family_name": "Roqué i Figuls", "ORCID": null, "country": null }, { "author_id": 294884, "given_name": "Daniel", "family_name": "Romero-Rodríguez", "ORCID": null, "country": null }, { "author_id": 294885, "given_name": "Xavier", "family_name": "Bonfill Cosp", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Whole-body vibration training", "patients", "neurodegenerative disease", "consumer" ], "doi": "10.1002/14651858.CD009097.pub2", "access": "restricted", "takeaways": " Whole-body vibration (WBV) appears to have potential benefits in the sensorimotor system performance of patients with neurodegenerative diseases . In Parkinson's disease, a single session of WBV caused a significant improvement of gait measured using the Timed Up and Go test (TUG) in comparison to standing exercises . In multiple sclerosis, there was no evidence of a short-term or long-term effect on body balance, gait, muscle performance or quality of life", "categories": [] }, { "article_id": 286, "title": "Effectiveness of physical therapy interventions in reducing fear of falling among individuals with neurological diseases: a systematic review and meta-analysisSelect", "summary": "Effectiveness of physical therapy interventions in reducing fear of falling among individuals with neurological diseases: a systematic review and meta-analysis Abou L, Alluri A, Fliflet A, Du Y, Rice LA Archives of Physical Medicine and Rehabilitation 2021 Jan;102(1):132-154 systematic review OBJECTIVE: To summarize the effectiveness of physical therapy (PT) interventions to reduce fear of falling (FOF) among individuals living with neurological diseases. DATA SOURCES: PubMed, PEDro, Scopus, Web of Science, PsycINFO, CINAHL, and SPORTDiscus were searched from inception until December 2019. STUDY SELECTION: Clinical trials with either the primary or secondary aim to reduce FOF among adults with neurological diseases were selected. DATA EXTRACTION: Potential papers were screened for eligibility and data extracted by two independent researchers. Risk of bias was assessed by the Cochrane risk of bias tool for randomized clinical trials and the NIH Quality Assessment Tool for pre-post studies. A meta-analysis was performed among trials presenting with similar clinical characteristics. The Grading Recommendations, Assessment, Development and Evaluation -- GRADE was used to rate the overall quality of evidence. RESULTS: Sixty-one trials, 3,954 participants were included in the review and 53 trials, 3,524 participants in the meta-analysis. The included studies presented, in general, with a low to high risk of bias. A combination of gait and balance training was found to be significantly more effective compared to gait training alone in reducing FOF among individuals with Parkinson's disease (PD) (mean difference (MD) 11.80, 95% CI 8.22 to 15.38; p < 0.001). Home-based exercise and leisure exercise demonstrated significant improvement in reducing FOF over usual care in multiple sclerosis (MS) (MD 15.27, 95% CI 6.15 to 24.38, p = 0.001). No statistically significant between-groups differences were reported among individuals with stroke and spinal cord injury (SCI). The overall quality of evidence presented in this review ranges from very low to moderate according to the assessment with the GRADE approach. CONCLUSION: Gait with lower limb training combined with balance training is effective in reducing FOF in individuals with PD. Also, home-based or leisure exercise is effective among individuals with MS. However, due to several limitations of the included studies, further research is needed to examine the effectiveness of FOF intervention among individuals with neurological diseases. Full text (sometimes free) may be available at these link(s): helpDOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/61919", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Elsevier BV", "container_title": "Archives of Physical Medicine and Rehabilitation", "authors": [ { "author_id": 151996, "given_name": "Libak", "family_name": "Abou", "ORCID": "http://orcid.org/0000-0001-6404-7623", "country": "US" }, { "author_id": 270859, "given_name": "Aditya", "family_name": "Alluri", "ORCID": null, "country": null }, { "author_id": 313457, "given_name": "Alexander", "family_name": "Fliflet", "ORCID": null, "country": null }, { "author_id": 172426, "given_name": "Yiting", "family_name": "Du", "ORCID": "http://orcid.org/0000-0002-0003-5786", "country": null }, { "author_id": 151999, "given_name": "Laura A.", "family_name": "Rice", "ORCID": "http://orcid.org/0000-0003-3902-1151", "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Effectiveness", "physical therapy interventions", "fear", "individuals", "neurological diseases", "a systematic review", "meta-analysisSelect" ], "doi": "10.1016/j.apmr.2020.06.025", "access": "restricted", "takeaways": " A combination of gait and balance training was found to be significantly more effective compared to gait training alone in reducing FOF among individuals with Parkinson's disease (PD) Gait with lower limb training combined with balance training is effective in reducing fear of falling in individuals with PD . Home-based exercise and leisure exercise demonstrated significant improvement in reducing FF over usual care in multiple sclerosis .", "categories": [ { "category_id": 18, "category_description": "Search terms: telerehabilitation, physical therapy, virtual reality, gamification, neurostimulation, cognitive training, spasticity, motor control.\n\nSuggested by Alejandro Carrabs", "category_name": "Physical therapy and Telerehabilitation", "category_slug": "physical-therapy-and-telerehabilitation", "category_terms": [ "telerehabilitation", "physical therapy", "virtual reality", "gamification", "neurostimulation", "cognitive training", "spasticity", "motor control" ], "article_count": 178 } ] }, { "article_id": 272, "title": "Rehabilitation for people with multiple sclerosis: an overview of Cochrane reviews (Cochrane review) [with consumer summary]Select", "summary": "BACKGROUND: Multiple sclerosis (MS) is a major cause of chronic, neurological disability, with a significant long-term disability burden, often requiring comprehensive rehabilitation. OBJECTIVES: To systematically evaluate evidence from published Cochrane reviews of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS (pwMS), to improve patient outcomes, and to highlight current gaps in knowledge. METHODS: We searched the Cochrane Database of Systematic Reviews up to December 2017, to identify Cochrane reviews that assessed the effectiveness of organised rehabilitation interventions for pwMS. Two reviewers independently assessed the quality of included reviews, using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) tool, and the quality of the evidence for reported outcomes, using the GRADE framework. MAIN RESULTS: Overall, we included 15 reviews published in the Cochrane Library, comprising 164 randomised controlled trials (RCTs) and four controlled clinical trials, with a total of 10,396 participants. The included reviews evaluated a wide range of rehabilitation interventions, including: physical activity and exercise therapy, hyperbaric oxygen therapy (HBOT), whole-body vibration, occupational therapy, cognitive and psychological interventions, nutritional and dietary supplements, vocational rehabilitation, information provision, telerehabilitation, and interventions for the management of spasticity. We assessed all reviews to be of high to moderate methodological quality, based on R-AMSTAR criteria. Moderate-quality evidence suggested that physical therapeutic modalities (exercise and physical activities) improved functional outcomes (mobility, muscular strength), reduced impairment (fatigue), and improved participation (quality of life). Moderate-quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation, and interventions that provided information improved patient knowledge. Low-quality evidence suggested that neuropsychological interventions, symptom-management programmes (spasticity), whole body vibration, and telerehabilitation improved some patient outcomes. Evidence for other rehabilitation modalities was inconclusive, due to lack of robust studies. AUTHORS' CONCLUSIONS: The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit, although the certainty of evidence varies across the different types of interventions evaluated by the reviews. Structured, multidisciplinary rehabilitation programmes and physical therapy (exercise or physical activities) can improve functional outcomes (mobility, muscle strength, aerobic capacity), and quality of life. Overall, the evidence for many rehabilitation interventions should be interpreted cautiously, as the majority of included reviews did not include data from current studies. More studies, with appropriate design, which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge.", "link": "https://search.pedro.org.au/search-results/record-detail/56062", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 241318, "given_name": "Bhasker", "family_name": "Amatya", "ORCID": null, "country": null }, { "author_id": 241319, "given_name": "Fary", "family_name": "Khan", "ORCID": null, "country": null }, { "author_id": 241320, "given_name": "Mary", "family_name": "Galea", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Rehabilitation", "people", "multiple sclerosis", "an overview", "Cochrane reviews", "Cochrane review", "consumer" ], "doi": "10.1002/14651858.CD012732.pub2", "access": "open", "takeaways": " Multiple sclerosis (MS) is a major cause of chronic, neurological disability, with a significant long-term disability burden . We searched Cochrane Database of Systematic Reviews up to December 2017, to identify Cochrane reviews that assessed the effectiveness of organised rehabilitation interventions for pwMS . Overall, the evidence for many rehabilitation interventions should be interpreted cautiously, as the majority of included reviews did not include data from current studies .", "categories": [] }, { "article_id": 289, "title": "Exercise therapy for multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Exercise therapy for multiple sclerosis (Cochrane review) [with consumer summary] Rietberg MB, Brooks D, Uitdehaag BMJ, Kwakkel G Cochrane Database of Systematic Reviews 2004;Issue 3 systematic review BACKGROUND: No intervention has proven effective in modifying long-term disease prognosis in multiple sclerosis (MS) but exercise therapy is considered to be an important part of symptomatic and supportive treatment for these patients. OBJECTIVES: To assess the effectiveness of exercise therapy for patients with MS in terms of activities of daily living and health-related quality of life. SEARCH STRATEGY: We searched the Cochrane MS Group Specialised Register (searched: March 2004), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library issue 2, 2004), Medline (from 1966 to March 2004), Embase (from 1988 to March 2004), CINAHL (from 1982 to March 2004), PEDro (from 1999 to March 2004). Manual search in the journal 'Multiple Sclerosis' and screening of the reference lists of identified studies and reviews. We also searched abstracts published in proceedings of conferences. SELECTION CRITERIA: Randomised controlled trials (RCTs) that reported on exercise therapy for adults with MS, not presently experiencing an exacerbation; outcomes that include measures of activity limitation or health-related quality of life or both. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and methodological quality of the included trials. Disagreements were resolved by discussion. The results were analysed using a best-evidence synthesis based on methodological quality. MAIN RESULTS: Nine high-methodological-quality RCTs (260 participants) met the inclusion criteria. Six trials focussed on comparison of exercise therapy versus no exercise therapy, whereas three trials compared two interventions that both met our definition of exercise therapy. Best evidence synthesis showed strong evidence in favour of exercise therapy compared to no exercise therapy in terms of muscle power function, exercise tolerance functions and mobility-related activities. Moderate evidence was found for improving mood. No evidence was observed for exercise therapy on fatigue and perception of handicap when compared to no exercise therapy. Finally, no evidence was found that specific exercise therapy programmes were more successful in improving activities and participation than other exercise treatments. No evidence of deleterious effects of exercise therapy was described in included studies. AUTHORS' CONCLUSIONS: The results of the present review suggest that exercise therapy can be beneficial for patients with MS not experiencing an exacerbation. There is an urgent need for consensus on a core set of outcome measures to be used in exercise trials. In addition, these studies should experimentally control for 'dose' of treatment, type of MS and should include sufficient contrast between experimental and control groups. Full text (sometimes free) may be available at these link(s): helpPubMed Central DOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/14622", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Cold Spring Harbor Laboratory", "container_title": "", "authors": [], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Exercise therapy", "multiple sclerosis", "(Cochrane review", "consumer" ], "doi": null, "access": "unknown", "takeaways": " Exercise therapy for multiple sclerosis (Cochrane review) [with consumer summary] Rietberg MB, Brooks D, Uitdehaag BMJ, Kwakkel G Cochrane Database of Systematic Reviews 2004 .", "categories": [] }, { "article_id": 282, "title": "Multidisciplinary rehabilitation for adults with multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Multidisciplinary rehabilitation for adults with multiple sclerosis (Cochrane review) [with consumer summary] Khan F, Turner-Stokes L, Ng L, Kilpatrick T, Amatya B Cochrane Database of Systematic Reviews 2007;Issue 2 systematic review BACKGROUND: Multidisciplinary (MD) rehabilitation is an important component of symptomatic and supportive treatment for multiple sclerosis (MS), but evidence base for its effectiveness is yet to be established. OBJECTIVES: To assess the effectiveness of organized MD rehabilitation in adults with MS. To explore rehabilitation approaches that are effective in different settings and the outcomes that are affected. SEARCH METHODS: We searched the Cochrane Multiple Sclerosis Group's Trials Register (25 February 2011), PEDro (1990 to 2011), the Cochrane Rehabilitation and Related Therapies Field trials Register, the National Health Service National Research Register (NRR) and relevant journals were handsearched. No language restrictions were applied. SELECTION CRITERIA: Randomized controlled trials (RCT) and controlled clinical trials (CCT) that compared MD rehabilitation with routinely available local services or lower levels of intervention; or trials comparing interventions in different settings or at different levels of intensity. DATA COLLECTION AND ANALYSIS: Three reviewers selected trials and rated theirmethodological quality independently. A 'best evidence' synthesis based onmethodological quality was performed. Trials were grouped in terms of setting and type of rehabilitation and duration of patient follow up. MAIN RESULTS: Ten trials (9 RCTs and 1 CCT) (954 participants and 73 caregivers) met the inclusion criteria. Eight RCTs scored well; while one RCT and one CCT scored poorly on the methodological quality assessment. Despite no change in the level of impairment, there was 'strong evidence' to support inpatient MD rehabilitation in producing short-term gains at the levels of activity (disability) and participation in patients with MS. There is 'moderate evidence' to support inpatient or outpatient rehabilitation programmes (compared with control wait-list groups) in improving disability; and bladder related activity and participation outcomes up to 12 months following MD rehabilitation intervention. For outpatient and home-based rehabilitation programmes there was 'limited evidence' for shortterm improvements in symptoms and disability with high intensity programmes, which translated into improvement in participation and quality of life. For low intensity programmes conducted over a longer period there was 'strong evidence' for longer-term gains in quality of life; and also 'limited evidence' for benefits to carers. Although some studies reported potential for cost-savings, there is no convincing evidence regarding the long-term cost-effectiveness of these programmes. It was not possible to suggest best 'dose' of therapy or supremacy of one therapy over another. This review highlights the limitations of RCTs in rehabilitation settings and need for better designed randomized and multiple centre trials. AUTHORS' CONCLUSIONS: MD rehabilitation programmes do not change the level of impairment, but can improve the experience of people with MS in terms of activity and participation. Regular evaluation and assessment of these persons for rehabilitation is recommended. Further research into appropriate outcome measures, optimal intensity, frequency, cost and effectiveness of rehabilitation therapy over a longer time period is needed. Future research in rehabilitation should focus on improving methodological and scientific rigour of clinical trials. Full text (sometimes free) may be available at these link(s): helpDOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/18223", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Springer Science and Business Media LLC", "container_title": "Neurological Sciences", "authors": [], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Multidisciplinary rehabilitation", "adults", "multiple sclerosis", "(Cochrane review", "consumer" ], "doi": null, "access": "unknown", "takeaways": " Multidisciplinary (MD) rehabilitation is an important component of symptomatic and supportive treatment for multiple sclerosis . Despite no change in the level of impairment, there was 'strong evidence' to support inpatient MD rehabilitation in producing short-term gains at the levels of activity (disability) and participation .", "categories": [] }, { "article_id": 274, "title": "Interventions for preventing falls in people with multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Interventions for preventing falls in people with multiple sclerosis (Cochrane review) [with consumer summary] Hayes S, Galvin R, Kennedy C, Finlayson M, McGuigan C, Walsh CD, Coote S Cochrane Database of Systematic Reviews 2019;Issue 11 systematic review BACKGROUND: Multiple sclerosis (MS) is one of the most prevalent diseases of the central nervous system with recent prevalence estimates indicating that MS directly affects 2.3 million people worldwide. Fall rates of 56% have been reported among people with MS in a recent meta-analysis. Clinical guidelines do not outline an evidence-based approach to falls interventions in MS. There is a need for synthesised information regarding the effectiveness of falls prevention interventions in MS. OBJECTIVES: The aim of this review was to evaluate the effectiveness of interventions designed to reduce falls in people with MS. Specific objectives included comparing: (1) falls prevention interventions to controls and; (2) different types of falls prevention interventions. SEARCH METHODS: We searched the Trials Register of the Cochrane Multiple Sclerosis and Rare Diseases of the CNS Group, Cochrane Central Register of Controlled Trials (2018 issue 9); Medline (PubMed) (1966 to 12 September 2018); Embase (Embase.com) (1974 to 12 September 2018); Cumulative Index to Nursing and Allied Health Literature (EBSCOhost) (1981 to 12 September 2018); Latin American and Caribbean Health Science Information Database (Bireme) (1982 to 12 September 2018); ClinicalTrials.gov; and World Health Organization International Clinical Trials Registry Platform; PsycINFO (1806 to 12 September 2018; and Physiotherapy Evidence Database (1999 to 12 September 2018). SELECTION CRITERIA: We selected randomised controlled trials or quasi-randomised trials of interventions to reduce falls in people with MS. We included trials that examined falls prevention interventions compared to controls or different types of falls prevention interventions. Primary outcomes included: falls rate, risk of falling, number of falls per person and adverse events. DATA COLLECTION AND ANALYSIS: Two review authors screened studies for selection, assessed risk of bias and extracted data. We used a rate ratio (RaR) and 95% confidence interval to compare falls rate between groups. For risk of falling, we used a risk ratio (RR) and 95% CI based on the number of fallers in each group. MAIN RESULTS: A total of 839 people with MS (12 to 177 individuals) were randomised in the 13 included trials. The mean age of the participants was 52 years (36 to 62 years). The percentage of women participants ranged from 59% to 85%. Studies included people with all types of MS. Most trials compared an exercise intervention with no intervention or different types of falls prevention interventions. We included two comparisons: (1) Falls prevention intervention versus control and (2) Falls prevention intervention versus another falls prevention intervention. The most common interventions tested were exercise as a single intervention, education as a single intervention, functional electrical stimulation and exercise plus education. The risk of bias of the included studies mixed, with nine studies demonstrating high risk of bias related to one or more aspects of their methodology. The evidence was uncertain regarding the effects of exercise versus control on falls rate (RaR of 0.68; 95% CI 0.43 to 1.06; very low-quality evidence), number of fallers (RR of 0.85; 95% CI 0.51 to 1.43; low-quality evidence) and adverse events (RR of 1.25; 95% CI 0.26 to 6.03; low-quality evidence). Data were not available on quality of life outcomes comparing exercise to control. The majority of other comparisons between falls interventions and controls demonstrated no evidence of effect in favour of either group for all primary outcomes. For the comparison of different falls prevention interventions, the heterogeneity of intervention types across studies prohibited the pooling of data. In relation to secondary outcomes, there was evidence of an effect in favour of exercise interventions compared to controls for balance function with a SMD of 0.50 (95% CI 0.09 to 0.92), self-reported mobility with a SMD of 16.30 (95% CI 9.34 to 23.26) and objective mobility with a SMD of 0.28 (95% CI 0.07 to 0.50). Secondary outcomes were not assessed under the GRADE criteria and results must be interpreted with caution. AUTHORS' CONCLUSIONS: The evidence regarding the effects of interventions for preventing falls in MS is sparse and uncertain. The evidence base demonstrates mixed risk of bias, with very low to low certainty of the evidence. There is some evidence in favour of exercise interventions for the improvement of balance function and mobility. However, this must be interpreted with caution as these secondary outcomes were not assessed under the GRADE criteria and as the results represent data from a small number of studies. Robust RCTs examining the effectiveness of multifactorial falls interventions on falls outcomes are needed. Full text (sometimes free) may be available at these link(s): helpPubMed Central DOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/59246", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 287176, "given_name": "Sara", "family_name": "Hayes", "ORCID": null, "country": null }, { "author_id": 237029, "given_name": "Rose", "family_name": "Galvin", "ORCID": null, "country": null }, { "author_id": 313459, "given_name": "Catriona", "family_name": "Kennedy", "ORCID": null, "country": null }, { "author_id": 236845, "given_name": "Marcia", "family_name": "Finlayson", "ORCID": null, "country": null }, { "author_id": 242210, "given_name": "Christopher", "family_name": "McGuigan", "ORCID": null, "country": null }, { "author_id": 313460, "given_name": "Cathal D", "family_name": "Walsh", "ORCID": null, "country": null }, { "author_id": 237031, "given_name": "Susan", "family_name": "Coote", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Interventions", "people", "multiple sclerosis", "consumer" ], "doi": "10.1002/14651858.CD012475.pub2", "access": "unknown", "takeaways": "", "categories": [] }, { "article_id": 279, "title": "Non pharmacological interventions for spasticity in multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Non pharmacological interventions for spasticity in multiple sclerosis (Cochrane review) [with consumer summary] Amatya B, Khan F, La Mantia L, Demetrios M, Wade DT Cochrane Database of Systematic Reviews 2013;Issue 2 systematic review BACKGROUND: Spasticity is commonly experienced by people with multiple sclerosis (MS), and it contributes to overall disability in this population. A wide range of non pharmacological interventions are used in isolation or with pharmacological agents to treat spasticity in MS. Evidence for their effectiveness is yet to be determined. OBJECTIVES: To assess the effectiveness of various non pharmacological interventions for the treatment of spasticity in adults with MS. SEARCH METHODS: A literature search was performed using the Specialised Register of the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Review Group on using the Cochrane MS Group Trials Register which among other sources, contains CENTRAL, Medline, Embase, CINAHL, LILACS, PEDro in June 2012. Manual searching in the relevant journals and screening of the reference lists of identified studies and reviews were carried out. Abstracts published in proceedings of conferences were also scrutinised. SELECTION CRITERIA: Randomised controlled trials (RCTs) that reported non pharmacological intervention/s for treatment of spasticity in adults with MS and compared them with some form of control intervention (such as sham/placebo interventions or lower level or different types of intervention, minimal intervention, waiting list controls or no treatment; interventions given in different settings), were included. DATA COLLECTION AND ANALYSIS: Three review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool for best-evidence synthesis. A meta-analysis was not possible due to methodological, clinical and statistical heterogeneity of included studies. MAIN RESULTS: Nine RCTs (n = 341 participants, 301 included in analyses) investigated various types and intensities of non pharmacological interventions for treating spasticity in adults with MS. These interventions included: physical activity programmes (such as physiotherapy, structured exercise programme, sports climbing); transcranial magnetic stimulation (Intermittent Theta Burst Stimulation (iTBS), repetitive transcranial magnetic stimulation (rTMS)); electromagnetic therapy (pulsed electromagnetic therapy; magnetic pulsing device), Transcutaneous Electrical Nerve Stimulation (TENS); and Whole Body Vibration (WBV). All studies scored 'low' on the methodological quality assessment implying high risk of bias. There is 'low level' evidence for physical activity programmes used in isolation or in combination with other interventions (pharmacological or non pharmacological), and for repetitive magnetic stimulation (iTBS/rTMS) with or without adjuvant exercise therapy in improving spasticity in adults with MS. No evidence of benefit exists to support the use of TENS, sports climbing and vibration therapy for treating spasticity in this population. AUTHORS' CONCLUSIONS: There is 'low level' evidence for non pharmacological interventions such as physical activities given in conjunction with other interventions, and for magnetic stimulation and electromagnetic therapies for beneficial effects on spasticity outcomes in people with MS. A wide range of non pharmacological interventions are used for the treatment of spasticity in MS, but more robust trials are needed to build evidence about these interventions. Full text (sometimes free) may be available at these link(s): helpDOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/34946", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 241318, "given_name": "Bhasker", "family_name": "Amatya", "ORCID": null, "country": null }, { "author_id": 241319, "given_name": "Fary", "family_name": "Khan", "ORCID": null, "country": null }, { "author_id": 231047, "given_name": "Loredana", "family_name": "La Mantia", "ORCID": "http://orcid.org/0000-0002-5447-1612", "country": null }, { "author_id": 252674, "given_name": "Marina", "family_name": "Demetrios", "ORCID": null, "country": null }, { "author_id": 252676, "given_name": "Derick T", "family_name": "Wade", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Non pharmacological interventions", "spasticity", "multiple sclerosis", "consumer" ], "doi": "10.1002/14651858.CD009974.pub2", "access": "restricted", "takeaways": " Spasticity is commonly experienced by people with multiple sclerosis and contributes to overall disability in this population . Wide range of non pharmacological interventions are used in isolation or with pharmacological agents to treat spasticity in MS . No evidence of benefit exists to support the use of TENS, sports climbing and vibration therapy .", "categories": [ { "category_id": 18, "category_description": "Search terms: telerehabilitation, physical therapy, virtual reality, gamification, neurostimulation, cognitive training, spasticity, motor control.\n\nSuggested by Alejandro Carrabs", "category_name": "Physical therapy and Telerehabilitation", "category_slug": "physical-therapy-and-telerehabilitation", "category_terms": [ "telerehabilitation", "physical therapy", "virtual reality", "gamification", "neurostimulation", "cognitive training", "spasticity", "motor control" ], "article_count": 178 } ] }, { "article_id": 281, "title": "Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis (Cochrane review) [with consumer summary] Khan F, Ng L, Turner-Stokes L Cochrane Database of Systematic Reviews 2009;Issue 1 systematic review BACKGROUND: Multiple sclerosis is a neurological disease that frequently affects adults of working age, resulting in a range of physical, cognitive and psychosocial deficits that impact on workforce participation. Although, the literature supports vocational rehabilitation (VR) approaches in persons with multiple sclerosis (pwMS), the evidence for its effectiveness is yet to be established. OBJECTIVES: To evaluate the effectiveness of VR programs compared to alternative programs or care as usual on return to work, workability and employment in pwMS; to evaluate the cost effectiveness of these programs. SEARCH METHODS: We searched the Cochrane Multiple Sclerosis Group's Trials Register (February 2011), PEDro (1990 to 2011), ISI Science Citation Index (1981 to 2011) the Cochrane Rehabilitation and Related Therapies Field trials Register and the National Health Service National Research Register. SELECTION CRITERIA: Randomized and controlled clinical trials, including before-after controlled trials, that compare VR rehabilitation with alternative intervention such as standard or a lesser form of intervention or wait list controls. DATA COLLECTION AND ANALYSIS: Two reviewers selected trials and rated their methodological quality independently. A 'best evidence' synthesis was performed, based on methodological quality. Trials were grouped in terms of type and setting of VR programs. MAIN RESULTS: Two trials (one RCT and one CCT) (total 80 participants) met the review criteria. Both trials scored poorly on the methodological quality assessment. There was 'insufficient evidence' for VR programs for (a)'competitive employment', in altering rates of job retention, changes in employment, improvement in rates of re-entry into the labour force; (b) for altering 'work ability' by improving participants' confidence in the accommodation request process, or employability maturity or job seeking activity. No evidence could be assimilated for changes in proportions of persons in supported employment or on disability pensions, nor for cost-effectiveness. AUTHORS' CONCLUSIONS: There was inconclusive evidence to support VR for pwMS. However, the review highlights some of the challenges in providing VR for pwMS. Clinicians need to be aware of vocational issues, and to understand and manage barriers for maintaining employment. Proactive and timely VR programs should incorporate practical solutions to deal with work disability, workplace accommodation and educate employers, and the wider community. Liaison with policy makers is imperative for government initiatives that encourage work focused VR programs. Future research in VR should focus on improving methodological and scientific rigour of clinical trials; on the development of appropriate and valid outcome measures; and on cost effectiveness of VR programs. Full text (sometimes free) may be available at these link(s): helpPubMed Central DOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/22189", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 241319, "given_name": "Fary", "family_name": "Khan", "ORCID": null, "country": null }, { "author_id": 241370, "given_name": "Louisa", "family_name": "Ng", "ORCID": null, "country": null }, { "author_id": 241372, "given_name": "Lynne", "family_name": "Turner-Stokes", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Effectiveness", "vocational rehabilitation intervention", "the return", "work", "employment", "persons", "multiple sclerosis", "consumer" ], "doi": "10.1002/14651858.CD007256.pub2", "access": "open", "takeaways": " Multiple sclerosis is a neurological disease that frequently affects adults of working age . Literature supports vocational rehabilitation (VR) approaches in persons with multiple sclerosis (pwMS) But evidence for its effectiveness is yet to be established .", "categories": [] }, { "article_id": 285, "title": "Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis [with consumer summary]Select", "summary": "Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis [with consumer summary] \\n\\n\\t\\n\\t\\n\\t\\tMoss-Morris R, Harrison AM, Safari R, Norton S, van der Linden ML, Picariello F, Thomas S, White C, Mercer T\\n\\t\\n\\t\\n\\t\\tBehaviour Research and Therapy 2021 Feb;137:103464\\n\\t\\n\\t\\n\\t\\tsystematic review\\n\\t\\n\\t\\n\\t\\t\\n\\t\\t\\n\\t\\t\\tFatigue is a common and highly debilitating symptom of multiple sclerosis (MS). This meta-analytic systematic review with detailed narrative synthesis examined randomised-controlled (RCTs) and controlled trials of behavioural and exercise interventions targeting fatigue in adults with MS to assess which treatments offer the most promise in reducing fatigue severity/impact. Medline, Embase and PsycINFO electronic databases, amongst others, were searched through to August 2018. Thirty-four trials (12 exercise, 16 behavioural and 6 combined; n = 2,434 participants) met inclusion criteria. Data from 31 studies (n = 1,991 participants) contributed to the meta-analysis. Risk of bias (using the Cochrane tool) and study quality (GRADE) were assessed. The pooled (SMD) end-of-treatment effects on self-reported fatigue were: exercise interventions (n = 13) -0.84 (95% CI -1.20 to -0.47); behavioural interventions (n = 16) -0.37 (95% CI -0.53 to -0.22); combined interventions (n = 5) -0.16 (95% CI -0.36 to 0.04). Heterogeneity was high overall. Study quality was very low for exercise interventions and moderate for behavioural and combined interventions. Considering health care professional time, subgroup results suggest web-based cognitive behavioural therapy for fatigue, balance and/or multicomponent exercise interventions may be the cost-efficient therapies. These need testing in large RCTs with long-term follow-up to help define an implementable fatigue management pathway in MS. With permission from Excerpta Medica Inc.Full text (sometimes free) may be available at these link(s): helpDOI PubMed publisher", "link": "https://search.pedro.org.au/search-results/record-detail/59262", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Elsevier BV", "container_title": "Behaviour Research and Therapy", "authors": [ { "author_id": 330859, "given_name": "Reza", "family_name": "Safari", "ORCID": "http://orcid.org/0000-0001-5434-8844", "country": "GB" }, { "author_id": 244919, "given_name": "Rona", "family_name": "Moss-Morris", "ORCID": null, "country": null }, { "author_id": 313464, "given_name": "Anthony M.", "family_name": "Harrison", "ORCID": null, "country": null }, { "author_id": 252819, "given_name": "Sam", "family_name": "Norton", "ORCID": null, "country": null }, { "author_id": 288314, "given_name": "Marietta L.", "family_name": "van der Linden", "ORCID": null, "country": null }, { "author_id": 202596, "given_name": "Federica", "family_name": "Picariello", "ORCID": "http://orcid.org/0000-0002-2532-3290", "country": null }, { "author_id": 193532, "given_name": "Sarah", "family_name": "Thomas", "ORCID": "http://orcid.org/0000-0002-9501-9091", "country": null }, { "author_id": 252817, "given_name": "Claire", "family_name": "White", "ORCID": null, "country": null }, { "author_id": 252814, "given_name": "Tom", "family_name": "Mercer", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Which behavioural and exercise interventions", "fatigue", "the most promise", "multiple sclerosis", "A systematic review", "narrative synthesis", "meta-analysis", "consumer" ], "doi": "10.1016/j.brat.2019.103464", "access": "restricted", "takeaways": " A systematic review with narrative synthesis and meta-analysis [with consumer summary] examined randomised-controlled (RCTs) and controlled trials of behavioural and exercise interventions targeting fatigue in adults with MS . Thirty-four trials (12 exercise, 16 behavioural and 6 combined; n = 2,434 participants) met inclusion criteria .", "categories": [] }, { "article_id": 284, "title": "Occupational therapy for multiple sclerosis (Cochrane review) [with consumer summary]Select", "summary": "Occupational therapy for multiple sclerosis (Cochrane review) [with consumer summary] Steultjens EMJ, Dekker J, Bouter LM, Cardol M, van de Nes JCM, van den Ende CHM Cochrane Database of Systematic Reviews 2003;Issue 3 systematic review BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: We searched the Cochrane MS Group trials register (January 2003), the Cochane Central Register of Controlled Trials (the Cochrane Library issue 4, 2002), Medline (January 2003), Embase (December 2002), CINAHL (December 2002), AMED (December 2002), SciSearch (December 2002) and reference lists of articles. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the methodological quality of the included trials. Disagreements were resolved by discussion. A list proposed by Van Tulder 1997 was used to assess the methodological quality. For outcome measures, we calculated standardized mean differences. We analysed the results using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: One randomized clinical trial was identified and two other included studies were a controlled clinical trial and a study with a pre-post test design. The three studies involved 271 people in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counseling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counseling reported non-significant results. AUTHORS' CONCLUSIONS: On basis of this review no conclusions can be stated whether or not occupational therapy improves outcomes in MS patients. The lack of (randomized controlled) efficacy studies in most intervention categories of occupational therapy demonstrates an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients, including the characteristics and needs of these patients, is necessary to develop a research agenda for efficacy studies. Full text (sometimes free) may be available at these link(s): helpDOI PubMed PDF locatorpublisher", "link": "https://search.pedro.org.au/search-results/record-detail/9626", "published_date": "2021-03-06T10:52:00Z", "sources": [ "PEDro" ], "teams": [ { "id": 1, "name": "Team Gregory" } ], "subjects": [ { "subject_name": "Multiple Sclerosis", "description": null } ], "publisher": "Wiley", "container_title": "Cochrane Database of Systematic Reviews", "authors": [ { "author_id": 241358, "given_name": "Esther EMJ", "family_name": "Steultjens", "ORCID": null, "country": null }, { "author_id": 241360, "given_name": "Joost J", "family_name": "Dekker", "ORCID": null, "country": null }, { "author_id": 241361, "given_name": "Lex M", "family_name": "Bouter", "ORCID": null, "country": null }, { "author_id": 241364, "given_name": "Mieke M", "family_name": "Cardol", "ORCID": null, "country": null }, { "author_id": 241365, "given_name": "Els CHM", "family_name": "Van den Ende", "ORCID": null, "country": null }, { "author_id": 241367, "given_name": "Jos", "family_name": "van de Nes", "ORCID": null, "country": null } ], "relevant": null, "ml_prediction_gnb": false, "ml_prediction_lr": false, "ml_prediction_lsvc": false, "discovery_date": "2021-03-06T10:52:00Z", "noun_phrases": [ "Occupational therapy", "multiple sclerosis", "(Cochrane review", "consumer" ], "doi": "10.1002/14651858.CD003608", "access": "open", "takeaways": " Multiple sclerosis (MS) patients referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity . Primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform .", "categories": [] } ] }