1. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old
The main objective was to determine the efficacy of chest physiotherapy in infants aged less than 24months old with acute bronchiolitis. A secondary objective was to determine the efficacy of different techniques of chest physiotherapy (for example, vibration and percussion and passive forced exhalation).
Since the last publication of this review new good-quality evidence has appeared, strengthening the conclusions of the review. Chest physiotherapy does not improve the severity of the disease, respiratory parameters, or reduce length of hospital stay or oxygen requirements in hospitalised infants with acute bronchiolitis not on mechanical ventilation. Chest physiotherapy modalities (vibration and percussion or forced expiratory techniques) have shown equally negative results.
2. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise
To determine the effects of cold-water immersion in the management of muscle soreness after exercise.
There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention. There was insufficient evidence to conclude on other outcomes or for other comparisons. The majority of trials did not undertake active surveillance of pre-defined adverse events. High quality, well reported research in this area is required.
3. Massage, reflexology and other manual methods for pain management in labour
To examine the effects of manual healing methods including massage and reflexology for pain management in labour on maternal and perinatal morbidity.
Massage may have a role in reducing pain, and improving women’s emotional experience of labour. However, there is a need for further research.
4. Physiotherapy versus placebo or no intervention in Parkinson’s disease
To assess the effectiveness of physiotherapy intervention compared with no intervention in patients with PD.
Benefit for physiotherapy was found in most outcomes over the short-term (i.e. < three months), but was only significant for velocity, two- or six-minute walk test, step length, Timed Up & Go, Functional Reach Test, Berg Balance Scale and clinician-rated UPDRS. Most of the observed differences between the treatments were small. However, for some outcomes (e.g. velocity, Berg Balance Scale and UPDRS), the differences observed were at, or approaching, what are considered minimally clinical important changes. The review illustrates that a wide range of approaches are employed by physiotherapists to treat PD.
However, there was no evidence of differences in treatment effect between the different types of physiotherapy interventions being used, though this was based on indirect comparisons. There is a need to develop a consensus menu of ‘best-practice’ physiotherapy, and to perform large well designed randomised controlled trials to demonstrate the longer-term efficacy and costeffectiveness of ‘best practice’ physiotherapy in PD.
5. Treatment for spasticity in amyotrophic lateral sclerosis/motor neuron disease
The objective of this review is to systematically review treatments for spasticity in amyotrophic lateral sclerosis, also known as motor neuron disease.
The single trial performed was too small to determine whether individualized moderate intensity endurance type exercises for the trunk and limbs are beneficial or harmful. No other medical, surgical or alternative treatment and therapy has been evaluated in a randomized fashion in this patient population. More research is needed.
6. Ultrasound and shockwave therapy for acute fractures in adults
To assess the effects of low intensity ultrasound (LIPUS), high intensity focused ultrasound (HIFUS) and extracorporeal shockwave therapies (ECSW) as part of the treatment of acute fractures in adults.
While a potential benefit of ultrasound for the treatment of acute fractures in adults cannot be ruled out, the currently available evidence from a set of clinically heterogeneous trials is insufficient to support the routine use of this intervention in clinical practice. Future trials should record functional outcomes and follow-up all trial participants.
7. Whole-body vibration training for patients with neurodegenerative disease
The aim of this review was to examine the efficacy of WBV to improve functional performance according to basic activities of daily living (ADL) in neurodegenerative diseases. Additionally, we wanted to assess the possible effect on signs and symptoms of the disease, body balance, gait,
muscle performance, quality of life and adverse events.
There is insufficient evidence of the effect of WBV training on functional performance of neurodegenerative disease patients. Also, there is insufficient evidence regarding its beneficial effects on signs and symptoms of the disease, body balance, gait, muscle strength and quality of life compared to other active physical therapy or passive interventions in Parkinson’s disease or multiple sclerosis. More studies assessing other functional tests and accurately assessing safety are needed before a definitive recommendation is established.
Les revues ont été sélectionnées par un comité de lecteurs indépendants.
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