Decisions about the use of therapeutic interventions, whether for individuals or entire healthcare systems, should be based on the totality of the available evidence. The notion that evidence can be reliably or usefully placed in 'hierarchies' is illusory. Rather, decision makers need to exercise judgement about whether (and when) evidence ...

During the last five years a large number of randomised controlled clinical trials (RCTs) have been published on the efficacy of acupuncture in different conditions. In most of these studies verum is compared with sham acupuncture. In general both verum and sham have been found to be effective, and often ...

Some studies indicate that small intestinal bacterial overgrowth (SIBO), as measured by hydrogen breath tests (HBT), is more prevalent in patients with irritable bowel syndrome (IBS) vs. matched controls without IBS. Although the data are conflicting, this observation has led to the hypothesis that SIBO may be a primary cause ...

STUDY DESIGN: Randomized Clinical Trial. INTRODUCTION: Hand exercises have been recommended as treatment for hand osteoarthritis (OA) but research evidence is sparse. PURPOSE OF THE STUDY: To investigate effects of daily 16-week home-based hand exercise among persons with hand OA. METHODS: Forty-six older adults completed a crossover trial with washout ...

BACKGROUND: Syndromes characterized by chronic, medically unexplained fatigue, effort- and stress-intolerance, and widespread pain are highly prevalent in medicine. RESULTS: In chronic fatigue syndrome (CFS) and fibromyalgia (FM), various perpetuating factors may impair patients' quality of life and functioning and impede recovery. Although cognitive-behavioral and graded-exercise therapy are evidence-based treatments, ...

OBJECTIVES: To review within a prescribed evidence-based framework (1) the relationship between intermittent or lifelong physical activity and the subsequent onset or progression of osteoarthritis (OA) in later life and (2) the effect of structured exercise routines on the management of OA in the elderly. DATA SOURCES: A systematic literature ...

Physical therapy is common following a knee surgery. With rising healthcare costs there is debate as to the appropriateness of outpatient physical therapy following such interventions. Many of the existing controlled trials have concluded that there is no benefit to subjects that receive supervised physical therapy when compared to subjects ...

BACKGROUND: Limited information is available about general practitioners' knowledge, attitude and practice in treating osteoarthritis. This study sought to better understand GPs' management of mild to moderate osteoarthritis in Hong Kong. METHODS: A cross sectional survey of GPs using a structured questionnaire mailed in three stages. RESULTS: A total of ...

The development of high-precision radiation therapy delivery technology has expedited a burgeoning interest in ultrabrief, intensified treatment courses that yield tumoricidal effects of unprecedented potency. Whereas novel medical treatments that provide enhanced clinical benefits can be associated with escalated risks of toxicity, it is absolutely essential for radiation oncologists to ...

The incidence of heart failure (HF) is increasing as the population ages. Pharmacotherapy is an important component of treatment and yields significant improvements in survival and quality of life. In recent decades, exercise has gradually become accepted as an intervention beneficial to patients with HF, but more information is needed ...

SSc can be associated with a high morbidity and mortality. Due to the complexity and heterogeneity of the disease, a composite response measure that will capture differing organ involvements and patient-reported outcomes is desirable. Recently, with participation of the Scleroderma Clinical Trial Consortium, a standardized core set of items were ...

Background:Parkinson's disease is a progressive and degenerative disease of the basal ganglia of the brain. Four major signs of this disease are: bradykinesia, tremor, rigidity and postural instability. Postural instability is the main cause of falling in these patients.Despite the importance of the role of the exercise therapy in reducing ...

Recommendations for lower extremity osteoarthritis (OA) and exercise have been primarily based on knee studies. To provide more targeted recommendations for the hip, we gathered evidence for the efficacy of exercise for hip OA from randomized controlled trials. A bibliographic search identified trials that were randomized, controlled, completed by >or=60% ...

BACKGROUND: Exercise therapy is considered an important component of the treatment of arthritis. The efficacy of exercise therapy has been reviewed in adults with rheumatoid arthritis but not in children with juvenile idiopathic arthritis (JIA). OBJECTIVES: To assess the effects of exercise therapy on functional ability, quality of life and ...

STUDY DESIGN: Systematic literature review. OBJECTIVE: To evaluate the quality and scope of recently published systematic reviews on the topic of patellofemoral pain syndrome (PFPS) and to provide an overview of their findings. BACKGROUND: PFPS is a commonly treated condition. There is a large body of literature on conservative nonpharmacological ...

OBJECTIVE: Brainwave entrainment (BWE), which uses rhythmic stimuli to alter brainwave frequency and thus brain states, has been investigated and used since the late 1800s, yet many clinicians and scientists are unaware of its existence. We aim to raise awareness and discuss its potential by presenting a systematic review of ...

Physical therapists have an important role in the management of clinical knee osteoarthritis (OA) through designing and supervising exercise programs. This study explored whether their current use of therapeutic exercise for patients with this condition is in line with recent recommendations. A cross-sectional survey was conducted with a random sample ...

Earlier studies of the effect of 6 weeks of the Shaker Exercise have shown significant increase in UES opening and anterior excursion of larynx and hyoid during swallowing in patients with upper esophageal sphincter (UES) dysfunction, resulting in elimination of aspiration and resumption of oral intake. This effect is attributed ...

PURPOSE OF REVIEW: Bicarbonate therapy for severe lactic acidosis remains a controversial therapy. RECENT FINDINGS: The most recent 2008 Surviving Sepsis guidelines strongly recommend against the use of bicarbonate in patients with pH at least 7.15, while deferring judgment in more severe acidemia. We review the mechanisms causing lactic acidosis ...

For more than 40 years, electrical stimulation procedures for unilateral recurrent laryngeal nerve paresis (URLNP) therapy have been proposed. However, it is unclear whether electrical stimulation therapy is effective for URLNP patients. In this study we compare the outcome of traditional voice exercise treatment (VE) with electrical stimulation-supported voice exercise ...

ONTARGET has established the efficacy of the angiotensin receptor blocker (ARB) telmisartan to slow disease progression and delay or prevent morbid events in patients with atherosclerosis. Although the study failed to confirm additive efficacy of telmisartan and the angiotensin-converting-enzyme (ACE) inhibitor ramipril, caution should be exercised in assuming that the ...

OBJECTIVE: To investigate the effects of proprioceptive exercise rehabilitation and taping techniques on proprioceptive measures in chronic functional ankle instability (FAI). DESIGN: Literature review. DATA SOURCES: Keyword search of the AMED, CINAHL, Medline, PEDro and SPORTDiscus online databases from January 1985 to February 2007. Also reference lists of articles obtained ...

OBJECTIVE: In evaluating the effectiveness of fibromyalgia (FM) therapies, it is important to assess the impact of those therapies on the full array of domains considered important by both clinicians and patients. The objective of this research was to identify and prioritize the key clinically relevant and important domains impacted ...

OBJECTIVE: To characterize the current usage of intra-articular corticosteroid injections (IACI) by pediatric rheumatologists and the perceived disadvantages of and obstacles to IACI therapy. METHODS: We mailed a 32-item questionnaire to pediatric rheumatologists in the United States and Canada (n=201) to assess treatment strategies for the initial treatment of monoarthritis ...

This article focuses on the impact of increased duration of exercise therapy on functional recovery after stroke. A comprehensive literature search using multiple databases was used to identify all relevant randomized controlled trials. Their quality was reviewed by two independent assessors, and a narrative systematic review and meta-analysis was completed. ...

PURPOSE: Convergence insufficiency (CI) is a common binocular vision disorder. However, there is a lack of consensus regarding the treatment most appropriate for CI. The aim of the study was to investigate the treatment for CI by surveying the ophthalmologists regarding the most common treatment modalities used in India. MATERIALS ...

OBJECTIVE: To describe wavefront-guided (WFG) LASIK for the primary treatment of low to moderate levels of myopia and astigmatism and to examine the evidence on the safety and effectiveness of the procedure in comparison with conventional LASIK. METHODS: Literature searches conducted in 2004, 2005, 2006, and 2007 retrieved 209 unique ...

To date the effects of physical therapy or exercise in headaches has hardly been analysed. Conflicting results in previous studies might be due to the low number of clinical trials plus an indiscriminate application of different techniques. As different pathogenic mechanisms seem to be involved in each headache, the most ...

OBJECTIVE: The purpose of this study was to evaluate the isolated and associated effects of estrogen therapy (estradiol valerate 1 mg/d orally) and physical exercise (moderate aerobic exercise, 3 h/wk) on health-related quality of life (HRQOL) and menopausal symptoms among women who had undergone hysterectomy. DESIGN: A 6-month, randomized, double-blind, ...

Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative disease of the motor system. Bulbar symptoms such as dysphagia and dysarthria are frequent features of ALS and can result in reductions in life expectancy and quality of life. These dysfunctions are assessed by clinical examination and by use of instrumented ...

OBJECTIVE: This study examined the effects of facial exercises associated either with mirror or electromyogram (EMG) biofeedback with respect to complications of delayed recovery in Bell's palsy. PATIENTS: Patients with unilateral idiopathic facial palsy were included in this review. INTERVENTIONS: Facial exercises associated with mirror and/or EMG biofeedback as treatment. ...

This chapter summarizes current evidence from recently published systematic reviews of land- and water-based exercise therapies for musculoskeletal conditions. The aim is to present an overview of the evidence and highlight gaps where more research is still needed. This is not a systematic review, but a systematic search of the ...

BACKGROUND: Some migraine patients find that regular exercise helps in reducing the frequency of headache attacks. In addition, exercise in migraine is recommended from many headache experts. However, most of these recommendations refer to some anecdotal reports or observational studies in literature stating that regular exercise can reduce the frequency ...

Lower extremity lymphedema is an important medical issue which causes morbidity and is frequently seen by dermatologists. The subject has not been adequately addressed in dermatologic literature for many years. Primary lymphedema is caused by an inherent malfunction of the lymph-carrying channel, in which no direct outside cause can be ...

While it seems intuitively appealing to promote participation in regular exercise in the management of irritable bowel syndrome, limited randomised controlled trial evidence exists to support this recommendation. We examined the feasibility and effects of an exercise intervention upon quality of life and irritable bowel symptoms using a randomised controlled ...

Alopecia universalis often responds poorly to standard therapies. We report how a novel treatment option, alefacept, was successfully used in the management of a 21-year-old woman with alopecia universalis. The patient responded with complete regrowth of scalp and body hair after a single 12-week treatment course of alefacept. In addition, ...

PURPOSE/OBJECTIVES: To determine the effect of aerobic and strength resistance training and epoetin alfa (EPO) therapy on transfusions, stem cell collections, transplantation recovery, and multiple myeloma treatment response. DESIGN: Randomized clinical trial. SETTING: A myeloma research and therapy center in the south central United States. SAMPLE: 135 patients with multiple ...

Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials. Drug therapy is a key component of an individual patient's management plan, particularly in ...

Since the introduction of oxygen as a therapeutic agent 70 years ago, much has been learned regarding the detrimental effects of hypoxemia and the beneficial impact of oxygen therapy. It is projected that there are close to 800,000 patients receiving long-term oxygen therapy (LTOT) in the United States, at a ...

OBJECTIVE: To evaluate the effect of robot-mediated therapy on arm dysfunction post stroke. DESIGN: A series of single-case studies using a randomized multiple baseline design with ABC or ACB order. Subjects (n = 20) had a baseline length of 8, 9 or 10 data points. They continued measurement during the ...

PURPOSE OF REVIEW: To review studies of various physical therapy programs in ankylosing spondylitis and identify their benefits and potential indications in the treatment of this disease. RECENT FINDINGS: Various exercise and physical therapy programs have been evaluated in clinical studies. Home exercise programs have been shown to improve symptoms, ...

CONTEXT: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients ...

Parkinson's disease (PD) is a neurodegenerative disorder affecting the physical, psychological, social, and functional status of individuals. Exercise programs may be an effective strategy to delay or reverse functional decline for people with PD and a large body of empirical evidence has emerged in recent years. The objective is to ...

Exercise has been proposed as an adjunct intervention for substance use disorders due to its many benefits in terms of mental and physical health. This study investigated the association between completion of exercise-related activities and substance use disorders treatment outcome in a sample of 187 participants undergoing intensive outpatient treatment ...

RATIONALE: In this study, information was gathered from five disciplines on their usual management methods for fibromyalgia (FM) in order to asses whether treatment regimens have changed in the Netherlands during a period of 6 years. In addition, insight was gained into the therapeutic motives of the professionals. METHOD: A ...

OBJECTIVES: Repeated Waon therapy, which uses a far infrared-ray dry sauna system, improved the vascular endothelial function and the cardiac function in patients with chronic heart failure. In patients with chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH) is associated with a poor prognosis. We investigated whether repeated Waon therapy ...

To investigate the efficacy of a combination therapy on gluteal muscle contracture, 286 definitely diagnosed patients were subjected to surgical treatment, and then functional exercises and physical therapy. The patients with severe symptoms were asked to have a set of specially-designed functional exercises. All the patients were followed up for ...

Physical inactivity is increasing in virtually all developed and developing countries and is estimated to cause 2 million deaths worldwide annually. Conversely, regular exercise contributes to the primary and secondary prevention of cardiovascular disease, improves wellness, attenuates age-related decline and reduces risk of premature death. However, it is widely believed ...

We compared the short-term effects of Stanger bath therapy and conventional exercises on spinal mobility, functional capacity, disease activity, and quality of life with conventional exercise alone in ankylosing spondylitis (AS) patients. A total of 58 patients with a diagnosis of AS according to the modified New York criteria were ...

BACKGROUND: Genetic variants of the enzyme that metabolizes warfarin, cytochrome P-450 2C9 (CYP2C9), and of a key pharmacologic target of warfarin, vitamin K epoxide reductase (VKORC1), contribute to differences in patients' responses to various warfarin doses, but the role of these variants during initial anticoagulation is not clear. METHODS: In ...