Erratum: A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.

[This corrects the article DOI: 10.1142/s1013702520500122.].

A systematic review and meta-analysis on the efficacy of physiotherapy intervention in management of lumbar prolapsed intervertebral disc.

OBJECTIVE: The objective of this meta-analysis and systematic review is to analyze the efficacy of physiotherapy interventions in management of lumbar prolapsed intervertebral disc (PIVD). METHOD: Randomized controlled trials (RCTs) were searched in PubMed and Cochrane Library using related keywords and advanced option, from commencement to January 2019. Quality of researches was assessed by PEDro scoring. Risk of bias and homogeneity were assessed using Cochrane risk of bias tool and I2value, respectively. Meta-analysis of included study was done using "Review manager (Software, version 5.3)." RESULTS: Eleven RCTs were included in this systematic review. Six RCTs were excluded from meta-analysis due to insufficient data availability. Meta-analysis reveals significant decrease in pain (P = 0.001, mean difference (MD) -0.91; 95% confidence interval (CI) -0.35 to -1.48) and disability (P < 0.0001; MD -5.76; 95%CI; -3.18 to -8.34) with moderate heterogeneity (I2=40%; P = 0.17, I2=54%; P = 0.09, respectively). There was non-significant improvement in straight leg raise (SLR), P = 0.07; MD 7.96; 95%CI; -0.59-16.51 with moderate heterogeneity (I2=56%; P = 0.11). CONCLUSION: Physiotherapy interventions are effective in management of lumbar PIVD. Physiological and biomechanical factors such as correction of the displaced disc, opening of the foramina, increase in intervertebral space, and reduction in herniation size with negative intradiscal pressure may be possible mechanisms.

A Systematic Review and Meta-analysis on Efficacy of Exercise on Posture and Balance in Patients Suffering from Diabetic Neuropathy.

BACKGROUND: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% patients suffering from diabetes. There is the involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability. OBJECTIVE: The aim of this study is to assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus. METHODS: Mean changes in Timed Up and Go test (TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on the PEDro Rating scale. The risk of bias was assessed by the Cochrane collaboration tool of risk of bias. Included studies had a low risk of bias. Sixteen RCT's were included for the meta-analysis. RESULTS: Results of meta-analysis showed that there was a statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I2 = 84%, p < 0.00001) in the experimental group as compared to control group. There was a statistically significant difference in Berg Balance Scale scores and heterogeneity of I2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I2 = 100%, p =0.01 and eyes closed, heteogeneity I2 = 0%, p =0.01). Sensitivity analysis causes a change in heterogeneity. CONCLUSION: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training, etc. have a significant effect on improving balance and posture in diabetic neuropathy.

A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.

BACKGROUND: Spinal pain or misalignment is a very common disorder affecting a significant number of populations resulting in substantial disability and economic burden. Various manual therapeutic techniques such as spinal manipulations and mobilizations can be used to treat and manage pain and movement dysfunctions such as spinal mal-alignments and associated complications. These manual therapeutic techniques can affect the cardiovascular parameters. OBJECTIVE: The objective of this systematic review and meta-analysis is to assess the effect of spinal manipulation and mobilization on cardiovascular parameters. METHODS: We conducted a systematic review and meta-analysis to assess the effects of spinal mobilization and manipulation on cardiovascular responses. Mean changes in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Quality of the included studies was assessed by PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. RESULTS: Results of meta-analysis showed that there was statistically significant decrease in SBP ( MD =- 4 . 56 , 95% CI =- 9 . 20 , 0.08; p ≤ 0 . 05 ) with moderate heterogeneity ( I 2 = 75 % , p < 0 . 0002 ) in experimental group as compared to control group. There was statistically non-significant decrease in DBP ( MD =- 1 . 96 , 95% CI =- 4 . 60 , 0.69; p = 0 . 15 ) with high heterogeneity ( I 2 = 91 % , p < 0 . 00001 ), Change HR was statistically non-significant ( MD =- 0 . 24 , 95% CI =- 3 . 59 , 3.11; p = 0 . 89 ) with moderate heterogeneity ( I 2 = 60 % , p = 0 . 01 ). Exclusion of short duration studies in sensitivity analysis revealed a statistically significant change in DBP ( MD =- 0 . 94 , 95% CI =- 1 . 85 , - 0 . 03 ; p = 0 . 04 ). However, the result was statistically non-significant for HR after sensitivity analysis. CONCLUSION: Spinal manipulations and mobilizations may result in significant decrease of systolic as well as diastolic Blood Pressure.

Marker-assisted identification of restorer gene(s) in iso-cytoplasmic restorer lines of WA cytoplasm in rice and assessment of their fertility restoration potential across environments.

Iso-cytoplasmic restorers possess the same male sterile cytoplasm as the cytoplasmic male sterile (CMS) lines, thereby minimizing the potential cyto-nuclear conflict in the hybrids. Restoration of fertility of the wild abortive CMS is governed by two major genes namely, Rf3 and Rf4. Therefore, assessing the allelic status of these restorer genes in the iso-cytoplasmic restorers using molecular markers will not only help in estimating the efficiency of these genes either alone or in combination, in fertility restoration in the hybrids in different environments, but will also be useful in determining the efficacy of these markers. In the present study, the efficiency of molecular markers in identifying genotypes carrying restorer allele of the gene(s) Rf3 and Rf4, restoring male fertility of WA cytoplasm in rice was assessed in a set of 100 iso-cytoplasmic rice restorers using gene linked as well as candidate gene based markers. In order to validate the efficacy of markers in identifying the restorers, a sub-set of selected 25 iso-cytoplasmic rice restorers were crossed with four different cytoplasmic male sterile lines namely, IR 79156A, IR 58025A, Pusa 6A and RTN 12A, and the pollen and spikelet fertility of the F1s were evaluated at three different locations. Marker analysis showed that Rf4 was the predominant fertility restorer gene in the iso-cytoplasmic restorers and Rf3 had a synergistic effect on fertility restoration. The efficiency of gene based markers, DRCG-RF4-14 and DRRM-RF3-10 for Rf4 (87%) and Rf3 (84%) genes was higher than respective gene-linked SSR markers RM6100 (80%) and RM3873 (82%). It is concluded that the gene based markers can be effectively used in identifying fertility restorer lines obviating the need for making crosses and evaluating the F1s. Though gene based markers are more efficient, there is a need to identify functional polymorphisms which can provide 100% efficiency. Three iso-cytoplasmic restorers namely, PRR 300, PRR 363 and PRR 396 possessing both Rf4 and Rf3 genes and good fertility restoration have been identified which could be used further in hybrid rice breeding.