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You are viewing the most viewed ACE Reports by Physiotherapists over the last 30 days in all specialties.
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②
Synopsis:
186 patients with a severe lateral ankle sprain (type III) were randomized to treatment to 3 weeks of rigid immobilization with a walking boot followed by 3 weeks of immobilization with a functional brace, or to a functional brace for 6 weeks.The purpose was to compare these two conservative treatment methods for outcomes in pain, function, and ankle stability up to 12 weeks after the injury.AOFAS scores were better for the first 6 weeks in patients receiving the functional brace, and pain and comfort outcomes also benefited within the first few weeks from using a functional brace. By 12 weeks,...
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Author verified Level 2 RCT
7%
Synopsis:
One hundred twenty-seven patients undergoing outpatient total hip arthroplasty with the direct anterior (DA) approach were prospectively randomized and compared to fifty-one patients undergoing outpatient total hip arthroplasty with the direct lateral (DL) approach.The primary outcome of interest was the overall cost from a Canadian healthcare payer perspective.Secondary outcomes included costs from a societal perspective, encompassing patient-incurred costs, productivity losses, and informal care.Cost data were collected during hospitalization and via patient-reported diaries after discharge.Overall, the results of the study revealed no significant differences in healthcare payer costs (DA: $7910.19 vs DL: $7847.17, p=0.80) or societal costs (DA: $14657.21 vs DL: $14581.21, p=0.96). These findings suggest...
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Conference Report
6%
Functional brace improves early function and is more cost-effective than casting in Achilles rupture
①
Synopsis:
High quality evidence has revealed that non-operative management of acute Achilles tendon rupture achieves optimal outcomes in most patients.Among non-operative treatment options, the most commonly used are functional bracing (walking boot with heel wedges) and casting in equinus position.There has been a recent move towards early mobilization and more use of functional bracing over casts in a number of different areas, and it is unclear if there is a benefit in favour of either strategy in the context of Achilles tendon ruptures.In this study, the authors randomized patients to plaster cast versus functional bracing, and performed an accompanying economic evaluation.They found that patients treated with functional brace had significantly better functional scores at eight weeks, and that bracing was dominant from a cost-effectiveness perspective, with modest savings and slightly better utility. There was no...
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Level 1 RCT
3%
②
Synopsis:
76 patients with Dupuytren's contracture and a palpable nodule were randomized to one of four groups; 0.25mg collagenase clostridium histolyticum (CCH) injection, 0.40mg CCH injection, 0.60mg CCH injection, or placebo injection.Patients were assessed over 8-week follow-up nodule size and hardness, pain, patient satisfaction, and investigator-rated improvement.After 8 weeks, reduction in nodule size was significantly greater in the 0.40mg and 0.60mg CCH groups compared to placebo, and reduction in nodule hardness was significantly greater in the 0.25mg, 0.40mg, and 0.60mg CCH groups compared to placebo. Composite responder rate...
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Level 2 RCT
3%
①
Synopsis:
Forty-six patients with postoperative shoulder pain following rotator cuff repair (RCR) surgery and active MTrPs were randomized to receive either MTrP-DN plus multimodal rehabilitation (n=23) or sham dry needling (S-DN) plus multimodal rehabilitation (n=23).The primary outcome was the Numeric Pain Rating Scale (NPRS) for shoulder pain, while secondary outcomes included the Shoulder Pain and Disability Index (SPADI), shoulder ROM, and strength measures.These outcomes were assessed at baseline and after 4 weeks of intervention.Overall, the study found no statistically significant differences between the groups for the primary or secondary outcomes.Within-group improvements were observed in both groups, but the effect size of adding MTrP-DN was small. The main findings...
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Level 1 RCT
3%
①
Synopsis:
Twenty-nine patients with Schatzker I–IV tibial plateau fractures were randomized to receive either immediate weight-bearing as tolerated (n=19) or a six-week non-weight-bearing rehabilitation protocol (n=20).Both groups followed the same exercise program.The primary outcome of interest was spatiotemporal gait parameters.Secondary outcomes included Tinetti Performance Oriented Mobility Assessment (POMA) gait and balance scores, hip strength, and fall risk classification.Outcomes were assessed three months after surgery.Overall, the results revealed significant improvements in step length, stride length, velocity, single limb stance time, and Tinetti scores in the immediate weight-bearing group. Immediate weight-bearing was...
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Level 1 RCT
2%
Faster return to work, but no other differences with early vs. delayed mobilization in Achilles tear
①
Synopsis:
Achilles tendon ruptures can be treated both operatively and non-operatively.With either technique, patients can be either be immobilized initially, or allowed some weight-bearing and range of motion, otherwise known as "Early" or "Functional" rehabilitation.While early mobilization may have benefits in terms of return to activity and function, it is unclear whether it is also associated with adverse events.In this study, the authors assessed 14 randomized controlled trials which compared these protocols. Overall, on a...
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Level 1 Meta Analysis
2%
①
Synopsis:
10 randomized controlled trials (555 patients) that compared the effect of exercise on bone mineral density (BMD) in middle-aged and older men against a control were included in this meta-analysis.Outcomes of interest included changes in lumbar spine BMD, femoral neck BMD, total hip BMD, and trochanter BMD. All outcomes favored...
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Level 1 Meta Analysis
2%
①
Synopsis:
Eighty patients with single-level cervical spondylosis were randomized to receive uncovertebral joint fusion (UJF) (n=40) or end plate space fusion (ESF) (n=40).The primary outcome was the fusion rate at 3 months postoperatively.Secondary outcomes included complications and patient-reported outcomes (JOA, NDI, VAS-arm, and VAS-neck scores).Outcomes were assessed at 3, 6, and 12 months.Overall, the results revealed significantly higher early fusion rates in the UJF group at both 3 months (66.7% vs.13.2%, p < 0.0001) and 6 months (94.1% vs.66.7%, p = 0.006), with no significant difference at 12 months.PROMs and complication rates were comparable between groups. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52).The primary outcome was total blood loss.Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events.Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months.Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes...
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Level 1 RCT