Objectives. To systematically review and meta-analyze the effectiveness of yoga for reducing blood pressure in adults with hypertension and to assess the modifying influences of type and length of yoga intervention and type of comparison group. Methods. Academic Search Premier, AltHealthWatch, BIOSIS/Biological Abstracts, CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, PsycARTICLES, Natural Standard, and Web of Science databases were screened for controlled studies from 1966 to March 2013. Two authors independently assessed risk of bias using the Cochrane Risk of Bias Tool. Results. All 17 studies included in the review had unclear or high risk of bias. Yoga had a modest but significant effect on systolic blood pressure (SBP) (−4.17 [−6.35, −1.99], P = 0.0002) and diastolic blood pressure (DBP) (−3.62 [−4.92, −1.60], P = 0.0001). Subgroup analyses demonstrated significant reductions in blood pressure for (1) interventions incorporating 3 basic elements of yoga practice (postures, meditation, and breathing) (SBP: −8.17 mmHg [−12.45, −3.89]; DBP: −6.14 mmHg [−9.39, −2.89]) but not for more limited yoga interventions; (2) yoga compared to no treatment (SBP: −7.96 mmHg [−10.65, −5.27]) but not for exercise. Conclusion. Yoga can be preliminarily recommended as an effective intervention for reducing blood pressure. Additional rigorous controlled trials are warranted to further investigate the potential benefits of yoga.
Several motion analysis systems are used by researchers to quantify human motion and to perform accurate surgical procedures. The Optotrak 3020 is one of these systems and despite its widespread use there is not any published information on its precision and repeatability. We used a repeated measures design study to evaluate the precision and repeatability of the Optotrak 3020 by measuring distance and angle in three sessions, four distances and three conditions (motion, static vertical, and static tilted). Precision and repeatability were found to be excellent for both angle and distance although they decreased with increasing distance from the sensors and with tilt from the plane of the sensors. Motion did not have a significant effect on the precision of the measurements. In conclusion, the measurement error of the Optotrak is minimal. Further studies are needed to evaluate its precision and repeatability under human motion conditions.
Overground physical therapy gait training for chronic stroke patients with mobility deficits.
Objective To investigate the role of thoracic spine manipulation (TSM) on pain and disability in the management of mechanical neck pain (MNP). Data sources Electronic databases PubMed, CINAHL, Pedro, Embase, AMED, the Cochrane Library, and clinicaltrials.gov were searched in January 2018. Study selection Eligible studies were completed RCTs, written in English, had at least 2 groups with one group receiving TSM, had at least one measure of pain or disability, and included patients with MNP of any duration. The search identified 1717 potential articles, with 14 studies meeting inclusion criteria. Study appraisal and synthesis methods Methodological quality was evaluated independently by two authors using the guidelines published by the Cochrane Collaboration. Pooled analyses were analyzed using a random-effects model with inverse variance methods to calculate mean differences (MD) and 95% confidence intervals for pain (VAS 0-100mm, NPRS 0-10pts; 0 = no pain) and disability (NDI and NPQ 0–100%; 0 = no disability). Results Across the included studies, there was increased risk of bias for inadequate provider and participant blinding. The GRADE approach demonstrated an overall level of evidence ranging from very low to moderate. Meta-analysis that compared TSM to thoracic or cervical mobilization revealed a significant effect favoring the TSM group for pain (MD -13.63; 95% CI: -21.79, -5.46) and disability (MD -9.93; 95% CI: -14.38, -5.48). Meta-analysis that compared TSM to standard care revealed a significant effect favoring the TSM group for pain (MD -13.21; 95% CI: -21.87, -4.55) and disability (MD -11.36; 95% CI: -18.93, -3.78) at short-term follow-up, and a significant effect for disability (MD -4.75; 95% CI: -6.54, -2.95) at long-term follow-up. Meta-analysis that compared TSM to cervical spine manipulation revealed a non-significant effect (MD 3.43; 95% CI: -7.26, 14.11) for pain without a distinction between immediate and short-term follow-up. Limitations The greatest limitation in this systematic review was the heterogeneity among the studies making it difficult to assess the true clinical benefit, as well as the overall level of quality of evidence. Conclusions TSM has been shown to be more beneficial than thoracic mobilization, cervical mobilization, and standard care in the short-term, but no better than cervical manipulation or placebo thoracic spine manipulation to improve pain and disability. Trial registration PROSPERO CRD42017068287
: We found insufficient evidence to determine whether overground physical therapy gait training benefits walking function in individuals with chronic stroke, although limited evidence suggests potential benefits for some performance variables. High-quality randomized controlled trials are needed to replicate and extend these findings.
The FT test is a reliable and valid measure for screening for physical disability, frailty, and functional mobility. It can determine which older adults have physical disabilities and/or functional dependence and hence may be useful in assessing readiness for independent living. Inclusion of the FT test at initial evaluation may reveal the presence of these conditions and address the safety of older adults in the community.
Our community-based group exercise program was safe, feasible, and appears to be effective. While some measures showed no improvement, there was no evidence of decline. This is an important outcome for persons with progressive neurological disorders, and suggests community-based group exercise is a promising option for people with PD.
Background and Purpose-Overground gait training can be defined as a physical therapists' observation and cueing of the patient's walking pattern along with related exercises, but does not include high-technology aids such as functional electric stimulation or body weight support. This systematic review investigated the effects of overground physical therapy gait training on walking ability for chronic stroke patients with mobility deficits. Methods-A comprehensive literature search was performed as per the Cochrane group guidelines. Only randomized controlled trials that compared overground physical therapy gait training to a placebo intervention or no treatment for chronic stroke patients with mobility deficits were included. Results-Nine studies involving 499 participants matched the inclusion criteria and had moderate methodological quality.Results were mixed with no significant effect on the primary variable, gait function. Small effects for several performance variables were found: gait speed increased by 0.07 meters per second (95% confidence interval [CI]ϭ0.05 to 0.10) based on 7 studies with 396 participants, timed up-and-go (TUG) test improved by 1.81 seconds (95% CIϭϪ2.29 to Ϫ1.33) based on 3 studies and 118 participants, and 6-minute-walk test (6MWT) increased by 26.06 meters (95% CIϭ7.14 to 44.97) based on 4 studies with 181 participants. No significant differences in adverse events were found. Conclusions-There is insufficient evidence to determine whether overground gait training directly benefits broad measures of gait function. Results from recent studies, however, suggest that specific training protocols may provide limited benefits for more uni-dimensional performance variables like gait speed, TUG test, and 6MWT. (Stroke. 2009;40:e627-e628.)
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