Revisiones sistemáticas relacionados a este tópico

loading
19 Referencias (19 articles) loading Revertir Estudificar

Revisión sistemática

No clasificado

Cargando información sobre las referencias
OBJECTIVE: To identify the best evidence on the efficacy of non-pharmacological interventions in reducing fatigue in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and to summarise their safety in the identified studies to inform European Alliance of Associations for Rheumatology recommendations for the management of fatigue in people with I-RMDs. METHODS: Systematic review of randomised controlled trials (RCTs) including adults with I-RMDs conducted according to the Cochrane Handbook. Search strategy ran in Medline, Embase, Cochrane Library, CINAHL Complete, PEDro, OTseeker and PsycINFO. Assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. Data were pooled in meta-analyses. RESULTS: From a total of 4150 records, 454 were selected for full-text review, 82 fulfilled the inclusion criteria and 55 RCTs were included in meta-analyses. Physical activity or exercise was efficacious in reducing fatigue in rheumatoid arthritis (RA) (standardised mean differences (SMD)=-0.23, 95% CI=-0.37 to -0.1), systemic lupus erythematosus (SLE) (SMD=-0.54, 95% CI=-1.07 to -0.01) and spondyloarthritis (SMD=-0.94, 95% CI=-1.23 to -0.66); reduction of fatigue was not significant in Sjögren's syndrome (SMD=-0.83, 95% CI=-2.13 to 0.47) and systemic sclerosis (SMD=-0.66, 95% CI=-1.33 to 0.02). Psychoeducational interventions were efficacious in reducing fatigue in RA (SMD=-0.32, 95% CI=-0.48 to -0.16), but not in SLE (SMD=-0.19, 95% CI=-0.46 to 0.09). Follow-up models in consultations (SMD=-0.05, 95% CI=-0.29 to 0.20) and multicomponent interventions (SMD=-0.20, 95% CI=-0.53 to 0.14) did not show significant reductions of fatigue in RA. The results of RCTs not included in the meta-analysis suggest that several other non-pharmacological interventions may provide a reduction of fatigue, with reassuring safety results. CONCLUSIONS: Physica activity or exercise and psychoeducational interventions are efficacious and safe for managing fatigue in people with I-RMDs.

Revisión sistemática

No clasificado

Revista Rheumatology advances in practice
Año 2023
Cargando información sobre las referencias
OBJECTIVES: This systematic review describes the extent to which PROGRESS-Plus equity factors were considered in the eligibility criteria of trials of exercise interventions for adults with RA. METHODS: Electronic databases were searched for published (Cinahl, Embase, Medline, Physiotherapy Evidence Database), unpublished (Opengrey) and registered ongoing (International Standard Randomized Controlled Trial Number registry) randomized controlled trials (RCTs) of exercise interventions for adults with RA. Two authors independently performed study selection and quality assessment (Cochrane risk of bias tool). RESULTS: A total of 9696 records were identified. After screening, 50 trials were included. All trials had either some concerns or high risk of bias and reported at least one PROGRESS-Plus equity factor within the eligibility criteria; this included place of residence, personal characteristics (age and disability), language, sex, social capital, time-dependent factors or features of relationship factors. Where reported, this equated to exclusion of 457 of 1337 potential participants (34%) based on equity factors. CONCLUSION: This review identified the exclusion of potential participants within exercise-based interventions for people with RA based on equity factors that might affect health-care opportunities and outcomes. This limits the generalizability of results, and yet this evidence is used to inform management and service design. Trials need to optimize participation, particularly for people with cardiovascular conditions, older adults and those with cognitive impairments. Reasons for exclusions need to be justified. Further research needs to address health inequalities to improve treatment accessibility and the generalizability of research findings. PROSPERO REGISTRATION: CRD42021260941.

Revisión sistemática

No clasificado

Revista Sleep medicine reviews
Año 2023
Cargando información sobre las referencias
This systematic review aimed to systematically investigate the literature on the effectiveness of exercise and physical activity programs on fatigue and sleep in people with arthritis. For that, seven databases were searched for relevant randomized controlled trials. After the searches, 36 studies investigating 2281 participants were included. Risk of bias assessments were done by two independent reviewers using the Cochrane Risk of Bias tool 2. Random-effects meta-analyses were performed, and the Grading of Recommendations Assessment, Development and Evaluation framework was used to judge the certainty of evidence. The evidence on benefits of exercise and physical activity programs on fatigue and sleep parameters in people with osteoarthritis and psoriatic arthritis was either lacking or inconclusive. There was very low to low certainty evidence for a slight benefit of exercise and physical activity programs on fatigue at short-term in people with ankylosing spondylitis and rheumatoid arthritis. However, the evidence was very uncertain for the medium- and long-term as well as for any sleep parameters. The results indicate that exercise and physical activity programs may offer some benefits on fatigue for people with arthritis in the short-term, although the best type of exercise remains uncertain. The available evidence on improvements in sleep was insufficient to draw strong conclusions. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Revisión sistemática

No clasificado

Autores Huang J , Wang D , Wang J
Revista Evidence-based complementary and alternative medicine : eCAM
Año 2021
Cargando información sobre las referencias
Objectives. This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations. Methods. A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs. Results. A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions. Conclusions. We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

Revisión sistemática

No clasificado

Autores Wen Z , Chai Y
Revista Medicine
Año 2021
Cargando información sobre las referencias
BACKGROUND: We aimed to assess the efficacy of resistance exercise in rheumatoid arthritis (RA) in randomized controlled trials (RCTs). METHOD: PubMed, the Cochrane Library, and Embase were searched according to the index words to identify eligible RCTs, and relevant literature sources were also searched. The latest search was done in August 2019. Odds ratios (OR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze the main outcomes. RESULT: Seventeen RCTs were included in the meta-analysis with 512 patients in the resistance exercise group and 498 patients in the control group. The results showed that compared with the control group, resistance exercise significantly decreased disease activity score in 28 joints (DAS-28) scores (standard mean difference [SMD].: -0.69, 95% CI.: -1.26 to -0.11), reduced erythrocyte sedimentation rate (ESR) (SMD.: -0.86, 95% CI.: -1.65 to -0.07), and shortened the time of 50 ft. walking (SMD.: -0.64, 95% CI.: -0.99 to -0.28). No significant difference was observed in visual analog scale (VAS) scores (SMD.: -0.61, 95% CI.: -1.49-0.27) and health assessment questionnaire (HAQ) scores (weighted mean difference: -0.10, 95% CI.: -0.26-0.06). CONCLUSION: Resistance exercise showed reducing DAS-28 score, ESR score, and the time of 50 ft. walking in RA patients compared with the control group. However, high quality multicenter RCTs with larger sample sizes to confirm the conclusion.

Revisión sistemática

No clasificado

Revista The Cochrane database of systematic reviews
Año 2019
Cargando información sobre las referencias
BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease that results in joint deformity and immobility of the musculoskeletal system. The major goals of treatment are to relieve pain, reduce inflammation, slow down or stop joint damage, prevent disability, and preserve or improve the person's sense of well-being and ability to function. Tai Chi, interchangeably known as Tai Chi Chuan, is an ancient Chinese health-promoting martial art form that has been recognized in China as an effective arthritis therapy for centuries. This is an update of a review published in 2004. OBJECTIVES: To assess the benefits and harms of Tai Chi as a treatment for people with rheumatoid arthritis (RA). SEARCH METHODS: We updated the search of CENTRAL, MEDLINE, Embase, and clinical trial registries from 2002 to September 2018. SELECTION CRITERIA: We selected randomized controlled trials and controlled clinical trials examining the benefits (ACR improvement criteria or pain, disease progression, function, and radiographic progression), and harms (adverse events and withdrawals) of exercise programs with Tai Chi instruction or incorporating principles of Tai Chi philosophy. We included studies of any duration that included control groups who received either no therapy or alternate therapy. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: Adding three studies (156 additional participants) to the original review, this update contains a total of seven trials with 345 participants. Participants were mostly women with RA, ranging in age from 16 to 80 years, who were treated in outpatient settings in China, South Korea, and the USA. The majority of the trials were at high risk of bias for performance and detection bias, due to the lack of blinding of participants or assessors. Almost 75% of the studies did not report random sequence generation, and we judged the risk of bias as unclear for allocation concealment in the majority of studies. The duration of the Tai Chi programs ranged from 8 to 12 weeks.It is uncertain whether Tai Chi-based exercise programs provide a clinically important improvement in pain among Tai Chi participants compared to no therapy or alternate therapy. The change in mean pain in control groups, measured on visual analog scale (VAS 0 to 10 score, reduced score means less pain) ranged from a decrease of 0.51 to an increase of 1.6 at 12 weeks; in the Tai Chi groups, pain was reduced by a mean difference (MD) of -2.15 (95% confidence interval (CI) -3.19 to -1.11); 22% absolute improvement (95% CI, 11% to 32% improvement); 2 studies, 81 participants; very low-quality evidence, downgraded for imprecision, blinding and attrition bias.There was very low-quality evidence, downgraded for, blinding, and attrition, that was inconclusive for an important difference in disease activity, measured using Disease Activity Scale (DAS-28-ESR) scores (0 to 10 scale, lower score means less disease activity), with no change in the control group and 0.40 reduction (95% CI -1.10 to 0.30) with Tai Chi; 4% absolute improvement (95% CI 11% improvement to 3% worsening); 1 study, 43 participants.For the assessment of function, the change in mean Health Assessment Questionnaire (HAQ; 0 to 3 scale, lower score means better function) ranged from 0 to 0.1 in the control group, and reduced by MD 0.33 in the Tai Chi group (95% CI -0.79 to 0.12); 11% absolute improvement (95% CI 26% improvement to 4% worsening); 2 studies, 63 participants; very low-quality evidence, downgraded for imprecision, blinding, and attrition. We are unsure of an important improvement, as the results were inconclusive.Participants in Tai Chi programs were less likely than those in a control group to withdraw from studies at 8 to 12 weeks (19/180 in intervention groups versus 49/165 in control groups; risk ratio (RR) 0.40 (95% CI 0.19 to 0.86); absolute difference 17% fewer (95% CI 30% fewer to 3% fewer); 7 studies, 289 participants; low-quality evidence, downgraded for imprecision and blinding.There were no data available for radiographic progression. Short-term adverse events were not reported by group, but in two studies there was some narrative description of joint and muscle soreness and cramps; long-term adverse events were not reported. AUTHORS' CONCLUSIONS: It is uncertain whether Tai Chi has any effect on clinical outcomes (joint pain, activity limitation, function) in RA, and important effects cannot be confirmed or excluded, since all outcomes had very low-quality evidence. Withdrawals from study were greater in the control groups than the Tai Chi groups, based on low-quality evidence. Although the incidence of adverse events is likely to be low with Tai Chi, we are uncertain, as studies failed to explicitly report such events. Few minor adverse events (joint and muscle soreness and cramps) were described qualitatively in the narrative of two of the studies. This updated review provides minimal change in the conclusions from the previous review, i.e. a pain outcome.

Revisión sistemática

No clasificado

Revista Physical Therapy Reviews
Año 2017
Cargando información sobre las referencias
Antecedentes: La fatiga es un síntoma importante de la artritis reumatoide (AR) y la necesidad de intervenciones eficaces es evidente. Se ha demostrado que los programas basados ​​en la actividad física (AP) mejoran la fatiga reportada por el paciente en otras condiciones a largo plazo. OBJETIVOS: Investigar la efectividad de las intervenciones de PA para reducir la fatiga en adultos con AR y para identificar los componentes clave de las intervenciones efectivas de AP. Métodos: Los métodos se basaron en una revisión sistemática Cochrane anterior para intervenciones no farmacológicas para la fatiga en la AR. Las siguientes bases de datos electrónicas se registraron hasta octubre de 2016: Registro Cochrane Central de Ensayos Controlados (CENTRAL); MEDLINE; EMBASE; AMED; CINAHL; PsycINFO; Índice de Citas de Ciencias Sociales; Web de la Ciencia; Disertación Abstracts International; Registro actual de ensayos controlados; El Archivo Nacional de Registro de Investigaciones; La base de datos de la cartera UKCRN. Se incluyeron ensayos controlados aleatorios que evaluaron las intervenciones de AP en personas con AR con fatiga autoinformada como medida de resultado. Resultados: Ocho estudios cumplieron los criterios de inclusión. Los resultados indicaron un pequeño efecto beneficioso de la AP sobre la fatiga de la RA. El tipo, frecuencia, duración e intensidad de PA variaron entre los estudios. Los métodos de entrega incluyeron programas de grupo supervisado y ejercicio doméstico sin supervisión. La información sobre la adherencia general a las intervenciones de AP fue limitada. CONCLUSIONES: Existe alguna evidencia del potencial de la AP para ser eficaz en la reducción de los síntomas de la fatiga de la AR. Sin embargo, pocas intervenciones en los estudios incluidos fueron diseñadas para manejar la fatiga de la AR. Estos hallazgos sugieren que se necesita más trabajo para identificar la intervención óptima de PA para el tratamiento de la fatiga que satisface las necesidades de las personas con AR.

Revisión sistemática

No clasificado

Revista Physical therapy
Año 2017
Cargando información sobre las referencias
Antecedentes: El Tai chi se recomienda para afecciones musculoesqueléticas, sin embargo, la evidencia de su eficacia clínica es incierta. OBJETIVO: Determinar si el tai chi es beneficioso para los resultados clínicos en personas con dolor musculoesquelético. FUENTES DE DATOS: Siete bases de datos EMBASE, PEDro, AMED, MEDLINE, CINAHL, Sport Discus y el Registro Cochrane Central de Ensayos Controlados. SELECCIÓN DE ESTUDIOS: Se incluyeron ensayos controlados aleatorios de tai chi para personas con una afección musculoesquelética crónica. EXTRACCIÓN DE DATOS: Dos revisores extrajeron los datos y evaluaron el riesgo de sesgo. Se calcularon las diferencias de medias estandarizadas y los intervalos de confianza del 95% (IC) para los ensayos individuales y se calcularon los tamaños de los efectos agrupados utilizando un modelo de efectos aleatorios. SÍNTESIS DE LOS DATOS: Se identificaron 15 estudios entre personas con osteoartritis (80%), dolor de espalda (13%) y cefalea (7%). Utilizando el enfoque GRADE, encontramos una evidencia de calidad moderada de que el tai chi es más eficaz que ningún tratamiento o atención habitual a corto plazo en el dolor (SMD -0.66 (-0.85, -0.48)) y discapacidad (SMD -0.66 (-0.85, 0,46)). La evidencia de otros resultados fue de baja o muy baja calidad y había poca información sobre los efectos a largo plazo. Así, mientras que el número de publicaciones en esta área ha aumentado, el rigor no lo ha hecho, lo que dificulta nuestra capacidad para proporcionar recomendaciones fiables para la práctica clínica. LIMITACIONES: La evidencia proporcionada en esta revisión está limitada por ensayos con tamaños de muestra pequeños, baja calidad metodológica y falta de evaluación a largo plazo. CONCLUSIONES: Para que el tai chi sea recomendado como una intervención eficaz, se necesitan ensayos de mayor calidad con tamaños de muestra grandes que evalúen el tai chi en comparación con otros tratamientos basados ​​en la evidencia a corto y largo plazo.

Revisión sistemática

No clasificado

Revista Scientific reports
Año 2016
Cargando información sobre las referencias
Varios estudios informaron que el Tai Chi mostró efectos potenciales para el dolor crónico, pero su papel sigue siendo controvertido. Esta revisión evaluó la evidencia con respecto a los efectos del Tai Chi para las condiciones de dolor crónico. 18 ensayos controlados aleatorios se incluyeron en nuestra revisión. Los resultados agregados han indicado que el Tai Chi mostró evidencia positiva sobre el alivio inmediato del dolor crónico por osteoartritis (diferencia de medias estandarizada [DME], -0,54; intervalos de confianza del 95% [IC], -0,77 a -0,30; P <0,05). La duración válida de la práctica del Tai Chi para la osteoartritis puede ser superior a 5 semanas. Y hubo algunas evidencias beneficiosas con respecto a los efectos del Tai Chi en el alivio inmediato del dolor crónico del dolor lumbar (SMD, -0,81; IC del 95%; -1,11 a -0,52; P <0,05) y osteoporosis (SMD, -0,83; IC del 95%, -1,37 a -0,28, P = 0,003). Por lo tanto, los médicos pueden considerar el Tai Chi como una medicina complementaria y alternativa viable para las condiciones de dolor crónico.

Revisión sistemática

No clasificado

Autores Park M , Song R
Revista Journal of Korean Academy of Nursing
Año 2013
Cargando información sobre las referencias
PROPÓSITO: Este estudio se realizó para analizar los efectos del Tai Chi sobre los factores de riesgo relacionados con las caídas a través de meta-análisis de ensayos clínicos aleatorios publicados en Inglés y coreano, entre 2000 y 2010. MÉTODOS: El uso de base de datos relacionada salud y búsqueda manual de referencias y Google, se recogieron 28 estudios aleatorios de tesis doctoral y artículos revisados ​​por pares publicados. El metanálisis versión completa 2.0 se utilizó para el análisis. RESULTADOS: Los tamaños del efecto para Tai Chi durante 3 meses fueron significativas con ES = 0,54 para el equilibrio estático, ES = 0,24 para el equilibrio dinámico, ES = 0,69 para el equilibrio medido por la escala, y ES = 0,40 para la flexibilidad, ES = 0,48 para la fuerza muscular , ES = 0,71 para las AVD, y ES = 0,37 por miedo a caer. Además, los tamaños del efecto de Tai Chi durante 6 meses fueron significativas para la mayoría de las variables relacionadas con las caídas. Los datos de 6 meses para la flexibilidad no se analizó desde que se publicó sólo un estudio. CONCLUSIÓN: El análisis de los estudios de ensayos clínicos aleatorizados indican que el Tai Chi es eficaz para mejorar el equilibrio, la flexibilidad, la fuerza muscular, las actividades de la vida diaria, y el miedo de caer cuando se aplica durante 3 o 6 meses. Los resultados proporcionan la evidencia objetiva de aplicar el Tai Chi como una intervención preventiva otoño.