The aim of this study was to systematically review randomized clinical trials comparing the treatment of individuals with overactive bladder syndrome through the use of behavioral therapy versus drug therapy. A systematic electronic search of MEDLINE via PubMed, Embase, and Cochrane Library was performed, including studies indexed until August 2019. Five randomized clinical trials were included. The studies presented a high risk of bias. There was no significant difference between the evaluated treatments. Thus, behavioral therapy and drug therapy also promote the improvement of the symptoms of overactive bladder syndrome, and the behavioral therapy does not have significant adverse effects reported. Due to the high risk of bias in included studies, data should be interpreted with caution. Future studies with more comprehensive protocols may change the effect estimates of behavioral therapy on overactive bladder syndrome.
The stretching with thermotherapies associated have been related in the literature as a way to increase the range of motion (ROM), but still are not consensus about this efficacy and cost-effectiveness. The muscle stretching is a useful technique in rehabilitation and in physical activities programs, either to gain or maintain the flexibility, as a recovery of musculoskeletal and joint injuries. Objective: To determine the effects of thermotherapies associated to flexibility training in ROM of knee extension in healthy adults. Method: The search strategy was conducted in main databases, as Cochrane Library, LILACS, PEDro, PUBMED/ Medline, Scopus and Web of Science. The searches were done in 2016, and renewed in 2023, in order to achieve new publications along this time. Were selected only randomized clinical trials that have executed a training of hamstrings stretching, associated or not with one or more thermotherapies in healthy young adults, as long as the outcome was knee extension ROM. Only papers in Portuguese or English were assessed. To evaluate risk of bias was used the Cochrane Collaboration’s Risk of Bias Tool, and the methodological quality assessment was rated following the PEDro Scale. Results: Eight articles were included, totalizing 260 participants. The papers showed low methodological quality, and uncertain risk of bias. Only chronic effect of local warming and cryotherapy plus stretching showed a statistically significant difference versus control group. However, the thermotherapy action associated with stretching is still unclear, once the results suggest that even without the thermotherapy there are ROM increases. Conclusion: The stretching is effective in knee extension ROM improvement in healthy adults, with or without thermotherapy. New studies with higher methodological rigor and standardized protocols are needed.
Background: Stretching is an effective strategy used mainly to reduce muscle stiffness, and increase both flexibility and Range of Motion. Aim: To compare the effects of different thermotherapy modalities associated with static stretching on peak torque (PT) of knee flexor muscles. Methods: This study compared a sample of 34 healthy men, aged between 20 and 30 years, with active knee range of motion (ROM) ≤160 degrees. They were subjected to three sessions of static stretching of the hamstrings, either with or without a thermotherapy modality. The order of interventions was randomized for one of the groups: isolated stretching (IS), stretching with heat (SH), and stretching with cold (SC). The concentric and eccentric PTs were assessed pre and post-intervention. Results: In the comparison of PT among different measures, there was a significant decrease in eccentric and concentric PT of knee flexor muscles in IS, in eccentric PT of knee flexor muscles in SH, and in eccentric and concentric PT of knee flexors in SC groups. Conclusion: Regardless of the use of thermotherapy, one single session of static stretching resulted in decreased PT of knee flexor muscles. This is probably due to the effects of stretching, such as the immediate change of the elastic component of the muscle-tendon unit, which leads to a deficit in acute force production.
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