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Sélection Cochrane pour les physiothérapeutes: JANVIER (Issue 1, 2012)

Rédigé par le Jeudi 2 Février 2012



Sélection Cochrane pour les physiothérapeutes: JANVIER (Issue 1, 2012)
Voici la sélection de JANVIER (Issue 1, 2012) des titres des nouvelles revues systématiques Cochrane publiées ou mises à jour en rapport avec la pratique des kinésithérapeutes / physiothérapeutes:

1- Conservative management for postprostatectomy urinary incontinence

Objectives
To assess the effects of conservative management for urinary incontinence after prostatectomy

Authors' conclusions
The value of the various approaches to conservative management of postprostatectomy incontinence after radical prostatectomy remains uncertain. It seems unlikely that men benefit from one-to-one pelvic floor muscle training therapy after transurethral resection of the prostate (TURP). Long-term incontinence may be managed by external penile clamp, but there are safety problems.

2- Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty

Objectives
The aim of this review is to determine the effectiveness of continuous passive motion therapy for preventing thrombosis in patients after total knee arthroplasty (TKA).

Authors' conclusions
There is not enough evidence from the available RCTs to conclude that CPM reduces VTE after TKA. We cannot assess the effect of CPM on death because no such events occurred amongst the participants of these trials.

3- Ergonomic positioning or equipment for treating carpal tunnel syndrome

Objectives
To assess the effects of ergonomic positioning or equipment compared with no treatment, a placebo or another non-surgical intervention in people with CTS

Authors' conclusions
There is insufficient evidence from randomised controlled trials to determine whether ergonomic positioning or equipment is beneficial or harmful for treating carpal tunnel syndrome

4- Exercise interventions for smoking cessation

Objectives
To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone.

Authors' conclusions
Only one of the 15 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.

5- Interventions for preventing weight gain after smoking cessation

Objectives
To systematically review the effect of:
(1) Interventions targeting post-cessation weight gain on weight change and smoking cessation.
(2) Interventions designed to aid smoking cessation that may also plausibly affect weight on post-cessation weight change.

Authors' conclusions
Although some pharmacotherapies tested to limit PCWG show evidence of short-term success, other problems with them and the lack of data on long-term efficacy limits their use. Weight management education only, is not effective and may reduce abstinence. Personalised weight management support may be effective and not reduce abstinence, but there are too few data to be sure. One study showed a VLCD increased abstinence but did not prevent WG in the longer term. CBT to accept WG did not limit PCWG and may not promote abstinence in the long term. Exercise interventions significantly reduced weight in the long term, but not the short term. More studies are needed to clarify whether this is an effect of treatment or a chance finding. Bupropion, fluoxetine, NRT and varenicline reduce PCWG while using the medication. Although this effect was not maintained one year after stopping smoking, the evidence is insufficient to exclude a modest long-term effect. The data are not sufficient to make strong clinical recommendations for effective programmes to prevent weight gain after cessation.

6- Non-drug therapies for lower limb muscle cramps therapies for lower limb muscle cramps

Objectives
To assess the effects of non-drug, non-invasive treatments for lower limb cramp.

Authors' conclusions
There is limited evidence on which to base clinical decisions regarding the use of non-drug therapies for the treatment of lower limb muscle cramp. Serious methodological limitations in the existing evidence hinder clinical application. There is an urgent need to carefully evaluate many of the commonly recommended and emerging non-drug therapies in well designed randomised controlled trials.

7- Therapeutic ultrasound for carpal tunnel syndrome

Objectives
To review the effects of therapeutic ultrasound compared with no treatment, placebo or another non-surgical intervention in people with CTS.

Authors' conclusions
There is only poor quality evidence from very limited data to suggest that therapeutic ultrasound may be more effective than placebo for either short- or long-term symptom improvement in people with CTS. There is insufficient evidence to support the greater benefit of one type of therapeutic ultrasound regimen over another or to support the use of therapeutic ultrasound as a treatment with greater efficacy compared to other non-surgical interventions for CTS, such as splinting, exercises, and oral drugs. More methodologically rigorous studies are needed to determine the effectiveness and safety of this intervention for CTS.

8- Yoga for epilepsy

Objectives
To assess the efficacy of yoga in the treatment of people with epilepsy.

Authors' conclusions
No reliable conclusions can be drawn regarding the efficacy of yoga as a treatment for epilepsy. Further studies are needed.

Ces revues ont été sélectionnées par un comité de lecteurs indépendants.

Retrouvez la lettre d'information et les titres des revues en ligne sur le site du centre Cochrane français


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