ABSTRACT
OBJECTIVE: To study the relationships between weight, leisure time physical activity (PA), and the onset and persistence of neck pain in adults with nonspecific neck pain (NSNP). DESIGN: Etiology and prognosis systematic review. LITERATURE SEARCH: Five databases (PubMed, Scopus, Embase, Cochrane Library, PsycINFO) were searched from January 2010 to November 2021. STUDY SELECTION CRITERIA: Case-control or cohort studies assessing the relationship between the onset and the persistence of NSNP, weight, and leisure time PA in healthy adults or adults with NSNP at baseline. DATA SYNTHESIS: Use of the "vote counting based on direction of effects" and qualitative synthesis. RESULTS: Nine articles were included (20 350 participants, range 86-11 391), four on the onset and five on the persistence of NSNP. Methodological quality varied from poor to good according to the Newcastle-Ottawa Scale. For the onset and the persistence of NSNP, there was very low certainty evidence for modest associations suggesting a decreased risk with higher levels of leisure time PA and an increased risk in people with overweight and obesity. CONCLUSION: The risk for onset and persistence of NSNP may be lower in more active people and higher in people with overweight and obesity. Results should be interpreted cautiously and should not be generalized to populations other than workers. J Orthop Sports Phys Ther 2022;52(12):777-791. Epub: 12 August 2022. doi:10.2519/jospt.2022.11137.
Subject(s)
Neck Pain , Overweight , Adult , Humans , Obesity , Leisure Activities , ExerciseABSTRACT
Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands.Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation.Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5.Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6-8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes.Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.
