Proprioceptive neuromuscular facilitation training reduces pain and disability in individuals with chronic low back pain: A systematic review and meta-analysis.

BACKGROUND: and purpose: Although proprioceptive neuromuscular facilitation (PNF) exercises are used in rehabilitation practice, their effects in patients with low back pain (LBP) remain unclear. This study aimed to investigate the efficacy of PNF training for pain and disability in patients with LBP. METHODS: In this systematic review, we searched five databases from the earliest date available to October 2020. Three comparisons were performed: PNF versus control, PNF versus core strengthening, and PNF versus conventional physical therapy. RESULTS: Sixteen studies met the eligibility criteria (722 patients). PNF training improved pain (standardized mean difference [SMD]: -2.6; 95% confidence interval [CI]: -4.2 to -0.9, n = 174) and disability (SMD: -3.29; 95% CI: -5.3 to -1.3, n = 144) compared to the control. PNF training also yielded a greater benefit for pain reduction (mean difference [MD]: -1.8, 95% CI: -2.2 to -0.3, n = 177) and disability improvement (MD: -6.6, 95% CI: -9.3 to -3.8, n = 113) than did core strengthening. CONCLUSION: PNF training seems to be a useful strategy for decreasing pain and improving disability in patients with LBP. However, the quality of evidence for the outcomes of both pain and disability was low to moderate.

Effects of isokinetic muscle strengthening on muscle strength, mobility, and gait in post-stroke patients: a systematic review and meta-analysis.

OBJECTIVE:: To investigate whether isokinetic muscle strengthening improves muscle strength, mobility, and gait in post-stroke patients. METHODS:: We searched for randomized controlled trials at PubMed/Medline, SciELO, PEDro, and Cochrane Central Register of Controlled Trials, from the earliest date available to June 2018. Randomized controlled trials that examined the effects of isokinetic muscle strengthening versus other rehabilitation interventions or control in post-stroke patients were included. Study quality was evaluated using the PEDro scale. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I2 test. RESULTS:: In total, 13 studies (347 patients) focusing on the use of isokinetic in rehabilitation following stroke were included. All trials were of low-to-moderate quality. Isokinetic muscle strengthening improved muscle strength WMD 0.8 (95% CI: 0.2, 1.4; N = 96), mobility WMD -2.03 seconds (95% CI: -2.9, -1.1; N = 111) and gait speed WMD 0.9 m/s (95% CI: 0.05, 1.8; N = 87). CONCLUSION:: Isokinetic muscle strengthening seems to be a useful strategy for improving muscle strength, mobility, and gait in post-stroke patients.

Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis.

AIM: We performed a systematic review with a meta-analysis to examine the efficacy of stabilization exercises versus general exercises or manual therapy in patients with low back pain. DESIGN: We searched MEDLINE, Cochrane Controlled Trials, Scielo, and CINAHL (from the earliest date available to November 2014) for randomized controlled trials that examined the efficacy of stabilization exercises compared to general exercises or manual therapy on pain, disability, and function in patients with low back pain. Weighted mean differences (WMD) and 95% confidence intervals were calculated. RESULTS: Eleven studies met the inclusion criteria (413 stabilization exercises patients, 297 general exercises patients, and 185 manual therapy patients). Stabilization exercises may provide greater benefit than general exercise for pain reduction and improvement in disability. Stabilization exercise improved pain with a WMD of -1.03 (95% CI: -1.29 to -0.27) and improved disability with a WMD of -5.41 (95% CI: -8.34 to -2.49). There were no significant differences in pain and disability scores among participants in the stabilization exercise group compared to those in the manual therapy group. CONCLUSIONS: Stabilization exercises were as efficacious as manual therapy in decreasing pain and disability and should be encouraged as part of musculoskeletal rehabilitation for low back pain.

Comparative study of functional capacity and quality of life among obese and non-obese elderly people with knee osteoarthritis.

INTRODUCTION: The association between osteoarthritis (OA) and obesity can lead to a reduced functional capacity, compromising the quality of life (QoL) of the elderly. OBJECTIVE: To compare the functional capacity and QoL of obese and non-obese older adults with knee OA. METHODS: The sample consisted of 35 subjects with OA divided into two groups, obese and non-obese subjects, according to their body mass index. To assess functional capacity, performance tests such as Timed Up and Go (TUG), gait speed test, and the six-minute walk test (6 MWT) were carried out. To assess QoL, WOMAC and SF-36 questionnaires were administered. We performed descriptive and inferential statistics using SPSS software version 20.0. RESULTS: Elderly patients with OA were divided into two groups (obese, n=16; non-obese, n=19). Socio-demographic characteristics were similar between groups (p>0.05). The obese group showed a worst performance in TUG, brisk walking speed and 6 MWT. A more severe pain was found in the following items: "performing heavy housework chores", "going down stairs", "bending to floor" and "getting up from bed" in the obese group (p<0.05). In addition, the obese group had more difficulty to perform tasks for the following items: "going down stairs", "rising from a chair", "standing" and "getting on/off toilet" (p<0.05). There was no statistically significant difference in the assessed domains of SF-36 between groups (p>0.05). CONCLUSION: OA associated with obesity caused a negative impact on functional capacity; however, quality of life scores were low, and no difference in obese and non-obese subjects was found.

Comparative study of functional capacity and quality of life among obese and non-obese elderly people with knee osteoarthritis / Estudo comparativo da capacidade funcional e qualidade de vida entre idosos com osteoartrite de joelho obesos e não obesos

ABSTRACT Introduction: The association between osteoarthritis (OA) and obesity can lead to a reduced functional capacity, compromising the quality of life (QoL) of the elderly. Objective: To compare the functional capacity and QoL of obese and non-obese older adults with knee OA. Methods: The sample consisted of 35 subjects with OA divided into two groups, obese and non-obese subjects, according to their body mass index. To assess functional capacity, performance tests such as Timed Up and Go (TUG), gait speed test, and the six-minute walk test (6 MWT) were carried out. To assess QoL, WOMAC and SF-36 questionnaires were administered. We performed descriptive and inferential statistics using SPSS software version 20.0. Results: Elderly patients with OA were divided into two groups (obese, n = 16; non-obese, n = 19). Socio-demographic characteristics were similar between groups (p > 0.05). The obese group showed a worst performance in TUG, brisk walking speed and 6 MWT. A more severe pain was found in the following items: “performing heavy housework chores”, “going down stairs”, “bending to floor” and “getting up from bed” in the obese group (p < 0.05). In addition, the obese group had more difficulty to perform tasks for the following items: “going down stairs”, “rising from a chair”, “standing” and “getting on/off toilet” (p < 0.05). There was no statistically significant difference in the assessed domains of SF-36 between groups (p > 0.05). Conclusion: OA associated with obesity caused a negative impact on functional capacity; however, quality of life scores were low, and no difference in obese and non-obese subjects was found.

RESUMO Introdução: A associação entre osteoartrite (OA) e obesidade pode gerar redução da capacidade funcional e comprometer a qualidade de vida (QV) de idosos.Objetivo Comparar a capacidade funcional e a QV entre idosos com OA no joelho, obesos e não obesos.A amostra foi constituída por 35 idosos com OA divididos em dois grupos, obesos e não obesos, de acordo com o índice de massa corporal. Para avaliação da capacidade funcional foram feitos testes de desempenho, como Timed Up and Go (TUG), velocidade da marcha e teste de caminhada de seis minutos (TC6). Para avaliação da QV foram aplicados os questionários WOMAC e SF-36. Foi feita estatística descritiva e inferencial com o uso do software SPSS versão 20.0. Métodos: Os idosos com OA foram divididos em dois grupos (obesos, n = 16) e (não obesos, n = 19). As características sociodemográficas foram similares entre os grupos (p > 0,05). Foi observada redução de desempenho no TUG, velocidade da marcha rápida e TC6, com maior intensidade de dor nos itens: “executar tarefas domésticas pesadas”, “descer escadas”, “curvar-se em direção ao chão” e “levantar-se da cama” no grupo dos obesos (p < 0,05). Além disso, o grupo de obesos apresentou maior dificuldade ao executar tarefas para os itens: “descer escadas”, “levantar da cadeira”, “ficar de pé” e “sentar/levantar do vaso sanitaria” (p < 0,05). Não foi observada diferença estatisticamente significativa nos domínios avaliados do SF-36 entre os grupos (p > 0,05). Conclusão: A OA associada à obesidade impactou negativamente a capacidade functional. Entretanto, os escores de QV foram baixos sem diferença para obesos e não obesos.