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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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①
Synopsis:
Ninety-seven patients with symptomatic acetabular labral tears and limited osteoarthritis (Tönnis grades 0-2) were randomized to receive either hip arthroscopy with postoperative physical therapy (SPT) (n=52) or physical therapy alone (PTA) (n=45).Patients in the PTA group who experienced unsatisfactory improvement were allowed to cross over to surgery after completing at least 14 weeks of PT (CO group, n=32).The primary outcomes were the International Hip Outcome Tool-33 (iHOT-33) and the modified Harris Hip Score (mHHS) at 24 months.Secondary outcomes included additional patient-reported outcome measures (PROMs) and pain scores.Overall, the results demonstrated that SPT led to superior improvements in functional outcomes and pain reduction compared to PTA in both the intention-to-treat and modified as-treated analyses.Additionally, patients who crossed over to surgery experienced similar postoperative outcomes to those who underwent initial surgery. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
One hundred sixty-four patients with moderate to severe symptomatic medial knee osteoarthritis were randomized to receive flat flexible shoes (n=82) or stable supportive shoes (n=82) for at least six hours daily over six months.The primary outcomes were changes in walking pain (measured on an 11-point numerical rating scale) and physical function (assessed by the Western Ontario and McMaster Universities Osteoarthritis Index).Secondary outcomes included additional pain measures, physical activity, and quality of life.At six months, 161 participants (98%) completed primary outcome assessments.The results showed that stable supportive shoes led to significantly greater reductions in walking pain than flat flexible shoes (mean difference, 1.1 units; 95% CI, 0.5 to 1.8; P=0.001), but there was no significant difference in function improvement between groups (mean difference, 2.3 units; 95% CI, −0.9 to 5.5; P=0.167).Quality of life and ipsilateral hip pain also favored stable supportive shoes.More adverse events were reported with flat flexible shoes. These findings suggest...
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Level 1 RCT
4%
Progressive Stepped Exercise Program in Patients With Knee Osteoarthritis for Pain and Functionality
①
Synopsis:
Three hundred forty-five patients with symptomatic knee osteoarthritis were randomized to receive either a stepped exercise program (STEP-KOA) (n=230) or an arthritis education (AE) control intervention (n=115).The STEP-KOA intervention involved a progressive three-step approach: an internet-based exercise program (step 1), followed by biweekly physical activity coaching (step 2) for non-responders, and in-person physical therapy (step 3) for those still not meeting response criteria.The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, with secondary outcomes including objective physical function tests and self-reported physical activity.Outcomes were assessed at 3, 6, and 9 months.Overall, the study found that at 9 months, the STEP-KOA group demonstrated a greater improvement in WOMAC scores compared to the AE group, but there were no significant differences in objective physical function tests or self-reported physical activity. The findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Twenty-eight randomized controlled trials including 2,296 patients with osteoarthritis undergoing total knee or hip arthroplasty were included in this systematic review and meta-analysis comparing prehabilitation vs.usual care.Pooled outcomes of interest included self-reported function, pain, health-related quality of life (HRQoL), and performance-based measures of strength, range of motion (ROM), balance, and functional mobility.Prehabilitation demonstrated significant improvements in function, pain, HRQoL, strength, ROM, and functional mobility postoperatively.However, no significant effect was observed for balance. High risk of...
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Level 1 Meta Analysis
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Synopsis:
Fifty-seven patients with displaced type II distal clavicle fractures were randomized to receive either operative treatment (n=27) or non-operative treatment (n=30).The primary outcome of interest was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at two years.Secondary outcomes included union rates, re-operation rates, satisfaction with shoulder appearance, and return to activities.Outcomes were assessed at one and two years.Overall, the results revealed no significant difference in DASH scores between the two groups at two years, indicating excellent function in both groups.However, 48% of the operative group required hardware removal, while 20% of the non-operative group required surgical intervention due to non-union.Union rates were comparable at two years. These findings suggest...
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Conference Report
3%
①
Synopsis:
Fourteen randomized controlled trials including 1,341 patients with hand osteoarthritis were included in this systematic review and meta-analysis comparing exercise-based rehabilitation versus nonexercise intervention or no intervention.Pooled outcomes of interest included pain, function, stiffness, grip strength, pinch strength, and quality of life.In the immediate term (<24 weeks), exercise-based rehabilitation demonstrated improvements in pain, function, stiffness, and grip strength, but no significant effect on pinch strength or quality of life.However, long-term benefits (≥24 weeks) were not observed. The findings suggest...
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Level 1 Meta Analysis
3%
Synopsis:
Nine randomized controlled trials (RCTs) including 1,104 patients undergoing fracture fixation were analyzed in this meta-analysis comparing NSAIDs to a control group for pain management.The primary outcome was radiographic nonunion.The pooled results showed that 8.9% of patients receiving NSAIDs experienced nonunion, compared to 3.9% in the control group.A subgroup analysis indicated that short-term NSAID use (<2 weeks) was still associated with an increased risk of nonunion.No cases of nonunion were observed in pediatric patients (p > 0.99). These findings suggest...
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Conference Report
3%
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures were randomized to receive either open reduction and plate fixation (n=36) or functional bracing (n=34).The primary outcome of interest was the DASH score at three months.Secondary outcomes included health-related quality of life (HRQoL), pain scores, shoulder/elbow range of motion, complications, and return to activity over one year.Overall, the results revealed that surgery led to superior functional outcomes at three months (mean DASH 24.5 vs.39.4; MD 15.0, p=0.006) and improved HRQoL and pain scores over the first six months.Surgery also resulted in better shoulder and elbow mobility and a higher rate of return to sport.However, by one year, there were no significant differences between groups. These findings suggest...
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Conference Report
3%
①
Synopsis:
This systematic review and meta-analysis included 24 randomized controlled trials with 1711 participants diagnosed with sciatica due to lumbar disc herniation.It compared surgical treatment, primarily discectomy, to non-surgical treatments and epidural steroid injections.The primary outcomes assessed were leg pain and disability, while secondary outcomes included adverse events, back pain, quality of life, and treatment satisfaction.The pooled results indicated that discectomy provided moderate reductions in leg pain in the short term, with diminishing benefits over time.Effects on disability were smaller, showing only minor improvements.The long-term outcomes revealed no significant differences between surgical and non-surgical treatments. These findings suggest...
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Level 1 Meta Analysis
2%
①
Synopsis:
One hundred patients with isolated traumatic meniscal tears were randomized to receive either arthroscopic partial meniscectomy (n=49) or standardized physical therapy with an option for delayed surgery (n=51).The primary outcome was the IKDC score at 24 months.Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS), pain levels (NRS), Lysholm score, Western Ontario Meniscal Evaluation Tool (WOMET), Tegner activity level, and patient satisfaction with knee function.Follow-ups occurred at baseline, 3, 6, 9, 12, and 24 months.Overall, the study found no significant difference in IKDC scores between the two groups at 24 months.Additionally, 59% of patients in the physical therapy group did not undergo delayed surgery. These findings suggest...
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Level 1 RCT