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Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews.

Autores Lake B , Damery S , Jolly K
Revista BMJ open
Año 2022
Enlaces Pubmed DOI

Este artículo incluye 16 Revisiones sistemáticas Revisiones sistemáticas (16 referencias) 1 Estudio primario Estudios primarios (1 referencia)

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BACKGROUND: Elevated body mass index (BMI) in breast cancer survivors (BCS) is associated with cancer recurrence and poorer treatment response. Guidelines recommend 5%-10% weight loss for overweight or obese BCS. OBJECTIVES: To assess effectiveness of lifestyle interventions for female BCS on weight loss, BMI, body composition, health-related quality of life (HRQoL), physical functioning, psychosocial measures, biomarkers. DESIGN: Systematic review of reviews and meta-analyses. SETTING: All clinical settings. PARTICIPANTS: Adult female BCS (active treatment or post-treatment). METHODS: Medline, Embase, CINAHL, PsycINFO, Cochrane Library (including Database of Abstracts of Reviews of Effects) were searched for systematic reviews published in English between 1990 and 2022, with weight, BMI or body fat as primary outcome. Narrative reviews, editorials, letters, conference abstracts were excluded. Review quality was assessed using the Joanna Briggs Institute quality assessment tool. RESULTS: 17 reviews were included. Twelve reported significant reductions in one or more anthropometric outcomes: weight -1.36 kg (95% CI:-2.51 to -0.21) to -3.8 kg (95% CI: -5.6 to -1.9); BMI -0.89 kg/m2 (95% CI: -0.15 to -0.28) to -3.59 kg/m2 (95% CI: -6.29 to 0.89) or body fat -1.6% (95% CI: -2.31 to -0.88) to -2.6% (95% CI not reported). Significant reductions in two or more anthropometric outcomes were reported in 7/12 reviews, with effective interventions comprising aerobic exercise/aerobic exercise plus resistance training (n=5), or diet and exercise with or without counselling (n=2). Significant improvements were also reported for HRQoL (8/11 reviews), mental health (4/7) and physical functioning (2/3). Group interventions comprising aerobic exercise or aerobic exercise plus resistance training were most likely to improve outcomes. CONCLUSIONS: Lifestyle interventions can significantly improve outcomes for BCS. Multimodal interventions are likely to have the greatest impact in reducing weight, BMI and body fat. Further research must define the optimal combination, intensity and duration of effective interventions. PROSPERO REGISTRATION NUMBER: CRD42021283481.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Effectiveness of interventions aimed at improving dietary behaviours among people at higher risk of or with chronic non-communicable diseases: an overview of systematic reviews.

Revista European journal of clinical nutrition
Año 2019
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Este artículo incluye 14 Revisiones sistemáticas Revisiones sistemáticas (14 referencias)

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Programmes that promote dietary behaviour change for the prevention of chronic disease must include components that are rooted in best practice and associated with effectiveness. The purpose of this overview of systematic reviews was to examine the characteristics and dietary behaviour change outcomes of nutrition interventions among populations with or at risk of non-communicable chronic diseases. Systematic reviews of randomised controlled trials (RCTs) testing dietary behaviour change interventions published between January 2006 and November 2015 were identified via searches in Cochrane Library, PubMed, EMBASE and PsycINFO. Quality of reviews were appraised using AMSTAR. Dietary behaviour change and intervention details were extracted and systematically summarised. Fifteen articles met the inclusion criteria. Dietary behaviour changes in response to nutrition interventions were significant in over half of interventions. Reducing dietary fat and increasing fruits and vegetables were the most common behaviour changes. The characteristics of nutrition interventions and their relationship to effectiveness for dietary behaviour change among chronic disease or at-risk populations were reported inconsistently. However, associative evidence exists to support more frequent contacts and the use of specific behaviour change techniques. No clear relationships were found between effectiveness and intervention setting, mode of delivery or intervention provider, although some population-specific relationships were identified. Interventions that promote long-term maintenance of dietary behaviour changes are lacking in the literature. This comprehensive umbrella review identifies specific characteristics of interventions that are associated with effectiveness in interventions that promote dietary behaviour change among different at-risk populations. In order to maximise outcomes, public health, health promotion and healthcare organisations should consider these results in order to inform the development and improvement of nutrition programmes.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Massage for Pain: An Evidence Map.

Revista Journal of alternative and complementary medicine (New York, N.Y.)
Año 2019
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 53 Revisiones sistemáticas Revisiones sistemáticas (53 referencias)

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OBJECTIVES: Massage therapy has been proposed for painful conditions, but it can be difficult to understand the breadth and depth of evidence, as various painful conditions may respond differently to massage. The authors conducted an evidence mapping process and generated an "evidence map" to visually depict the distribution of evidence available for massage and various pain indications to identify gaps in evidence and to inform future research priorities. DESIGN: The authors searched PubMed, Embase, and Cochrane for systematic reviews reporting pain outcomes for massage therapy. The authors assessed the quality of each review using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. The authors used a bubble plot to depict the number of included articles, pain indication, effect of massage for pain, and strength of findings for each included systematic review. RESULTS: The authors identified 49 systematic reviews, of which 32 were considered high quality. Types of pain frequently included in systematic reviews were cancer pain, low back pain, and neck pain. High quality reviews concluded that there was low strength of evidence of potential benefits of massage for labor, shoulder, neck, low back, cancer, arthritis, postoperative, delayed onset muscle soreness, and musculoskeletal pain. Reported attributes of massage interventions include style of massage, provider, co-interventions, duration, and comparators, with 14 high-quality reviews reporting all these attributes in their review. CONCLUSION: Prior reviews have conclusions of low strength of evidence because few primary studies of large samples with rigorous methods had been conducted, leaving evidence gaps about specific massage type for specific pain. Primary studies often do not provide adequate details of massage therapy provided, limiting the extent to which reviews are able to draw conclusions about characteristics such as provider type.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017).

Revista PM & R : the journal of injury, function, and rehabilitation
Año 2017
Enlaces Pubmed DOI PubMed Central www.epistemonikos.org

Este artículo incluye 50 Revisiones sistemáticas Revisiones sistemáticas (50 referencias)

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BACKGROUND: Evidence supports the benefits of exercise for patients with cancer; however, specific guidance for clinical decision making regarding exercise timing, frequency, duration, and intensity is lacking. Efforts are needed to optimize clinical recommendations for exercise in the cancer population. OBJECTIVES: To aggregate information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature. DATA SOURCES: PubMed, CINAHL Plus, Scopus, Web of Science, and EMBASE. STUDY ELIGIBILITY CRITERIA: Systematic reviews and meta-analyses of the impact of movement-based exercise on the adult cancer population. METHODS: Two author teams reviewed 302 abstracts for inclusion with 93 selected for full-text review. A total of 53 studies were analyzed. A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used as a quality measure of the reviews. Information was extracted using the PICO format (ie, participants, intervention, comparison, outcomes). Descriptive findings are reported. RESULTS: Mean AMSTAR score = 7.66/11 (±2.04) suggests moderate quality of the systematic reviews. Exercise is beneficial before, during, and after cancer treatment, across all cancer types, and for a variety of cancer-related impairments. Moderate-to-vigorous exercise is the best level of exercise intensity to improve physical function and mitigate cancer-related impairments. Therapeutic exercises are beneficial to manage treatment side effects, may enhance tolerance to cancer treatments, and improve functional outcomes. Supervised exercise yielded superior benefits versus unsupervised. Serious adverse events were not common. LIMITATIONS: Movement-based exercise intervention outcomes are reported. No analysis of pooled effects was calculated across reviews due to significant heterogeneity within the systematic reviews. Findings do not consider exercise in advanced cancers or pediatric populations. CONCLUSIONS: Exercise promotes significant improvements in clinical, functional, and in some populations, survival outcomes and can be recommended regardless of the type of cancer. Although generally safe, patients should be screened and appropriate precautions taken. Efforts to strengthen uniformity in clinical trial reporting, develop clinical practice guidelines, and integrate exercise and rehabilitation services into the cancer delivery system are needed.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Planes de atención de supervivencia para personas con cáncer colorrectal: ¿reflejan la evidencia de la investigación?

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Autores D'Souza V , Daudt H , Kazanjian A
Revista Current oncology (Toronto, Ont.)
Año 2016
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 8 Revisiones sistemáticas Revisiones sistemáticas (8 referencias)

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En el presente estudio, hemos sintetizado la literatura publicada sobre los aspectos psicosociales de la supervivencia del cáncer colorrectal (crc) para apoyar una actualización de la base probatoria de los planes de supervivencia creados en nuestra jurisdicción. MÉTODOS: Se utilizaron como criterios de búsqueda los temas psicosociales identificados en los crc scps creados por dos iniciativas diferentes en nuestra provincia: calidad de vida (qol), función sexual, fatiga y comportamientos de estilo de vida. Se realizó una revisión general para obtener la mejor evidencia posible. Sólo se incluyeron las revisiones que investigaron los resultados esperados en sobrevivientes crc y aquellos con puntuaciones de calidad metodológica de moderada a alta. RESULTADOS: De 462 informes recuperados, ocho revisiones cumplieron con los criterios de inclusión para la síntesis. De los ocho, seis investigaron los desafíos de los sobrevivientes de crc y dos investigaron el efecto de la actividad física sobre el bienestar de los sobrevivientes. Nuestros resultados indican que los desafíos emocionales y físicos son comunes en los supervivientes de crc y que la actividad física está asociada con beneficios clínicamente importantes para la fatiga y el funcionamiento físico de los supervivientes de CRC. CONCLUSIONES: Los hallazgos de nuestro estudio actualizan la evidencia e indican que las exploraciones existentes en nuestra provincia en relación con los desafíos físicos y emocionales de los supervivientes de crc reflejan la evidencia en el momento de su emisión. Sin embargo, la literatura sobre los riesgos de cáncer específicos de CRC supervivientes es deficiente. Aunque las revisiones sistemáticas se consideran el "estándar de oro" en la síntesis del conocimiento, nuestros hallazgos sugieren que queda mucho por hacer en el área de la investigación de síntesis para guiar mejor la práctica en la supervivencia del cáncer.

Síntesis amplia

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Health benefits of tai chi: What is the evidence?

Revista Canadian Family Physician
Año 2016
Enlaces Pubmed

Este artículo incluye 99 Revisiones sistemáticas Revisiones sistemáticas (99 referencias) 3 Estudios primarios Estudios primarios (3 referencias)

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OBJECTIVE: To summarize the evidence on the health benefits of tai chi.Sources Of Information: A literature review was conducted on the benefits of tai chi for 25 specific conditions, as well as for general health and fitness, to update a 2014 review of systematic reviews. Systematic reviews and recent clinical trials were assessed and organized into 5 different groups: evidence of benefit as excellent, good, fair, or preliminary, or evidence of no direct benefit.Main Message: During the past 45 years more than 500 trials and 120 systematic reviews have been published on the health benefits of tai chi. Systematic reviews of tai chi for specific conditions indicate excellent evidence of benefit for preventing falls, osteoarthritis, Parkinson disease, rehabilitation for chronic obstructive pulmonary disease, and improving cognitive capacity in older adults. There is good evidence of benefit for depression, cardiac and stroke rehabilitation, and dementia. There is fair evidence of benefit for improving quality of life for cancer patients, fibromyalgia, hypertension, and osteoporosis. Current evidence indicates no direct benefit for diabetes, rheumatoid arthritis, or chronic heart failure. Systematic reviews of general health and fitness benefits show excellent evidence of benefit for improving balance and aerobic capacity in those with poor fitness. There is good evidence for increased strength in the lower limbs. There is fair evidence for increased well-being and improved sleep. There were no studies that found tai chi worsened a condition. A recent systematic review on the safety of tai chi found adverse events were typically minor and primarily musculoskeletal; no intervention-related serious adverse events have been reported.CONCLUSION: There is abundant evidence on the health and fitness effects of tai chi. Based on this, physicians can now offer evidence-based recommendations to their patients, noting that tai chi is still an area of active research, and patients should continue to receive medical follow-up for any clinical conditions.

Síntesis amplia

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An evidence map of the effect of Tai Chi on health outcomes.

Revista Systematic reviews
Año 2016
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 100 Revisiones sistemáticas Revisiones sistemáticas (100 referencias)

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BACKGROUND: This evidence map describes the volume and focus of Tai Chi research reporting health outcomes. Originally developed as a martial art, Tai Chi is typically taught as a series of slow, low-impact movements that integrate the breath, mind, and physical activity to achieve greater awareness and a sense of well-being. METHODS: The evidence map is based on a systematic review of systematic reviews. We searched 11 electronic databases from inception to February 2014, screened reviews of reviews, and consulted with topic experts. We used a bubble plot to graphically display clinical topics, literature size, number of reviews, and a broad estimate of effectiveness. RESULTS: The map is based on 107 systematic reviews. Two thirds of the reviews were published in the last five years. The topics with the largest number of published randomized controlled trials (RCTs) were general health benefits (51 RCTs), psychological well-being (37 RCTs), interventions for older adults (31 RCTs), balance (27 RCTs), hypertension (18 RCTs), fall prevention (15 RCTs), and cognitive performance (11 RCTs). The map identified a number of areas with evidence of a potentially positive treatment effect on patient outcomes, including Tai Chi for hypertension, fall prevention outside of institutions, cognitive performance, osteoarthritis, depression, chronic obstructive pulmonary disease, pain, balance confidence, and muscle strength. However, identified reviews cautioned that firm conclusions cannot be drawn due to methodological limitations in the original studies and/or an insufficient number of existing research studies. CONCLUSIONS: Tai Chi has been applied in diverse clinical areas, and for a number of these, systematic reviews have indicated promising results. The evidence map provides a visual overview of Tai Chi research volume and content. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42014009907.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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La medicina complementaria y alternativa para el dolor del cáncer: una visión general de las revisiones sistemáticas.

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Autores Bao Y , Kong X , Yang L , Liu R , Shi Z , Li W , Hua B , Hou W
Revista Evidence-based complementary and alternative medicine : eCAM
Año 2014
Enlaces Pubmed DOI PubMed Central

Este artículo incluye 27 Revisiones sistemáticas Revisiones sistemáticas (27 referencias)

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Fundamento y objetivo. Ahora, con más y más revisiones sistemáticas publicadas de medicina complementaria y alternativa (CAM) en el dolor por cáncer de adultos, es necesario el uso de los métodos de la visión general de revisión sistemática para resumir la evidencia disponible, evaluar el nivel de evidencia, y dar sugerencias para la investigación futura y práctica. Métodos. Se realizó una búsqueda exhaustiva (la Biblioteca Cochrane, PubMed, Embase, y el ISI Web of Knowledge) para identificar todas las revisiones sistemáticas o metaanálisis de CAM en el dolor del cáncer adulto. Y los niveles de evidencia se evaluaron utilizando el enfoque GRADE. Resultados. 27 revisiones sistemáticas fueron incluidos. Con base en la evidencia disponible, podríamos encontrar que las intervenciones psicoeducativas, las intervenciones musicales, la acupuntura más la terapia con medicamentos, la medicina herbal china, más la terapia del cáncer, compuesto Kushen inyección, la reflexología, el licopeno, TENS, qigong, ventosas, cannabis, Reiki, homeopatía (Traumeel), y terapias de artes creativas pueden tener efectos beneficiosos sobre el dolor del cáncer adulto. No se encontraron beneficios de la acupuntura (frente a la terapia de drogas o la acupuntura vergüenza), y los resultados fueron inconsistentes para la terapia de masaje, estimulación nerviosa eléctrica transcutánea (TENS), y Viscum album L más el tratamiento del cáncer. Sin embargo, los niveles de evidencia para estas intervenciones fueron bajos o moderados debido al alto riesgo de sesgo y / o pequeño tamaño de la muestra de los estudios primarios. Conclusión. CAM puede ser beneficioso para aliviar el dolor del cáncer, pero se constató que los niveles de evidencia a ser baja o moderada. Futuro grande y rigor aleatorios se necesitan estudios controlados para confirmar los beneficios de la CAM en el dolor del cáncer adulto.

Síntesis amplia / Scoping review

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Intervenciones de autogestión de las enfermedades crónicas: una revisión sistemática de alcance.

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Revista Clinical rehabilitation
Año 2014
Enlaces Pubmed DOI

Este artículo incluye 50 Estudios primarios Estudios primarios (50 referencias)

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