Interventions for increasing ankle joint dorsiflexion: a systematic review and meta‐analysis
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Abstract Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta‐analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non‐surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Results Twenty‐three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Conclusions Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non‐surgical interventions, thus further research in this area is warranted.Keywords:
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Introduction Information retrieval for systematic reviews (SRs) should include sensitive searches in several bibliographic databases. In addition to standard databases (i.e., MEDLINE, Embase and CENTRAL), researchers might consider subject-specific ones. In the fields of nursing and midwifery, a SR would typically include CINAHL as a subject-specific database. The aim of this study was to analyze the number and relevance of references retrieved from CINAHL in six SRs on maternal care. Methods We conducted a retrospective analysis of six SRs (e.g., benefit of intrapartum ultrasound or one-to-one care during labor). The study type was limited to randomized controlled trials (RCTs) in all but three SRs. In all cases, MEDLINE, Embase, CENTRAL and CINAHL were searched for primary studies. Further information sources (e.g., study registries and reference lists of SRs) were also considered. The proportion of the additional number of hits and studies included from CINAHL as well as the corresponding number of participants were calculated. Results Overall, the reviewers screened 12,013 references from bibliographic databases and identified forty relevant studies. CINAHL contained 2,643 (22 percent) of the references. In five out of six SRs, no additional studies were identified in CINAHL. In the remaining SR on birthing positions, the reviewers included thirteen RCTs of which one was a feasibility study with 68 participants indexed only in CINAHL. This corresponds to 0.9 percent of the women participating in all thirteen RCTs (n = 7,861). However, this study was cited in a journal article on a subsequent RCT that was identified and included via MEDLINE and ClinicalTrials.gov. Conclusions It is not necessary to search CINAHL in SRs on maternal care if standard databases and further information sources are considered. An additional study from CINAHL was included in one out of six SRs, a small feasibility study that could have been identified without CINAHL via a subsequent RCT.
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There is no standardized method reported in the literature to measure ROM of the ankle after a total ankle arthroplasty, which limits the possibility to compare results from the various ankle designs. It seems that most of the measurements are a combination of ankle and midfoot motion, not the tibiotalar joint. A protocol was developed to accurately measure the true tibiotalar and midfoot motion before and after an ankle replacement. Lateral radiographs were taken of the ankle with the patient in a weightbearing position, and measurements were done along fixed landmarks. In this study, the tibiotalar, midfoot, and combined ROM were measured preoperative and 1 year postoperative in a standardized, reproducible fashion. The preoperative tibiotalar ROM was 18.5 degrees and combined ankle and midfoot motion 25.1 degrees. The true tibiotalar motion after an Agility total ankle arthroplasty was 23.4 degrees, and the combined ankle and midfoot motion was 31.3 degrees. The average improvement in ROM in the tibiotalar joint was approximately 5 degrees, and combined ROM was 6.1 degrees. Preoperative ROM proved to be the main factor determining the eventual postoperative ROM. It is possible to accurately measure the true ankle and the midfoot motion and those measurements should be used when reporting on the results of ankle replacements. Total ankle arthroplasty resulted in a statistically significant, but clinically less than expected, increase in ROM.
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瞄准：承担质的研究的 metasynthesis 理解健康和与煽动性的肠疾病(IBD ) 住在一起的人的社会需要。方法：系统的搜索策略识别了探索与煽动性的肠疾病住在一起的现象的质的研究。数据库经由 OVID 平台包括了 MEDLINE， PsychInfo， EMBASE， CINAHL 和英国护理索引。质的搜索过滤器从篱笆数据库(http://www.urmc.rochester.edu/hslt/miner/digital_library/tip_sheets/Cinahl_eb_filters.pdf ) 被改编。探索健康和与煽动性的肠疾病住在一起的人的社会需要的质的实验研究被选择。学习资格和数据抽取独立地为质的研究用批评估价技巧计划被完成。研究被分析并且 synthesised 使用 metasynthesis 方法论。从研究的主题允许普通翻译进与煽动性的肠疾病住在一起的影响的新解释。结果：1395 研究，六出版研究和一篇未出版的论文完成了包括标准。合成的第一次重复识别了 16 个主题，第二重复 synthesised 这些进三主要第二顺序构造：由疾病耽搁了；住在疾病的一个世界并且与生活摔跤。由疾病耽搁了是不能自制，病人由于害怕显示的行为，和这在个人上有的影响的害怕，例如聚会隔离并且错过生活事件。所有这些服务从正常生活拉病人回来。住在疾病的一个世界是与一个长期的条件和这些效果的害怕住在一起的长期的效果。与生活摔跤是继续的战斗繁荣，继续正常生活的推。结论：metasynthesis 提供与 IBD 住在一起的一个全面代表。不能自制的 unmistakeable 负担被暴露，它的进行中的效果被表明。与 IBD 住在一起的联合全面影响是这些病人与住在一起的紧张：推并且拉：损害生活，与 IBD 住在一起的人在整个他们的生活经历经常的冲突，他们推正常但是 IBD 拉他们回来。不能自制的害怕和是的个人的行为的影响结果，要求进一步质的询问。
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The cumulative index to Nursing and Allied Health Literature (CINAHL) is a useful research tool for accessing articles of interest to nurses and health care professionals. More than 2,800 journals are indexed by CINAHL and can be searched easily using assigned subject headings. Detailed instructions about conducting, combining, and saving searches in CINAHL are provided in this article. Establishing an account at EBSCO further allows a nurse to save references and searches and to receive e-mail alerts when new articles on a topic of interest are published.
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The search was conducted by a librarian in PubMed, and then translated to EMBASE Elsevier, CINAHL Complete and Agricola via EBSCOHost, Web of Science Core Collection and Web of Science Dissertations & Theses Index, and Google Scholar.
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Nurses, allied health professionals, clinicians, and researchers increasingly use online access to evidence in the course of patient care or when conducting reviews on a particular topic. Qualitative research has an important role in evidence-based health care. Online searching for qualitative studies can be difficult, however, resulting in the need to develop search filters. The objective of this study was to develop optimal search strategies to retrieve qualitative studies in CINAHL for the 2000 publishing year. The authors conducted an analytic survey comparing hand searches of journals with retrievals from CINAHL for candidate search terms and combinations. Combinations of search terms reached peak sensitivities of 98.9% and peak specificities of 99.5%. Combining search terms optimized both sensitivity and specificity at 94.2%. Empirically derived search strategies combining indexing terms and textwords can achieve high sensitivity and high specificity for retrieving qualitative studies from CINAHL.
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The aim of this systematic review was to identify the reported barriers to regular exercise among adults either at high risk or already diagnosed with type 2 diabetes (T2D), because of the importance of exercise in the prevention of T2D. We searched the MEDLINE, Cinahl and PsycINFO databases. All potentially relevant articles were reviewed by two researchers, and 67 titles were found, of which 13 papers met inclusion criteria. Internal and external barriers to exercise were identified among adults either at high risk of T2D or already diagnosed. Internal barriers were factors which were influenced by the individual's own decision-making, and external barriers included factors which were outside of the individual's own control. It is important for counselling to identify the internal and external barriers to regular exercise. In this way, the content of counselling can be developed, and solutions to the barriers can be discussed and identified. Further research on the barriers to regular exercise is needed.
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Objective The aim of this analysis was to perform a meta-analysis evaluating gender difference of delayed healing risk in patients with venous leg ulcers. Methods We searched the PubMed and Web of Knowledge from their inception to 4 July 2015. The meta-analysis of pooled odds ratio and 95% confidence interval for venous leg ulcers healing risk were calculated. Results Twelve studies with 4453 patients were included in the meta-analysis. The pooled odds ratio for healing rate stratified by gender was 1.055 (95% CI 0.955–1.165; Z = 1.05, p = 0.292) by fix-effects model. The Begg's test (z = 2.67, p = 0.007), the Egger's test (t = 4.00, p = 0.003), and asymmetric funnel plot suggested there was significant publication bias. Subgroup analysis showed the pooled odds ratios were 1.048 (95% CI 0.945–1.162; Z = 0.88, p = 0.376) in prospective studies and 1.439 (95% CI 0.757–2.736; Z = 1.11, p = 0.266) in retrospective studies. Sensitivity analyses by only pooled adjusted odds ratios showed the pooled odds ratio was 1.049 (95% CI 0.946–1.163; Z = 0.91, p = 0.365), which indicated the results of meta-analysis were robust. Meta-regression analysis showed the healing rate odds ratio stratified by gender was not related with healing rate (t = 0.73, p = 0.484). Conclusion Our meta-analysis indicates that no gender difference existed for delayed healing in venous leg ulcers. Our results may be also useful in developing a risk score for failure of venous leg ulcers to heal.
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This paper compares the journal coverage of the British Nursing Index (BNI) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). The main objectives are to assess whether BNI is a useful source of UK publications and to consider the implications for information professionals.Lists of the journals indexed in BNI and CINAHL, CINAHL Plus and CINAHL Complete were compared. The date coverage and article entry date of a selection of UK nursing journals were also compared.One hundred and fifty-nine journals are uniquely indexed in BNI compared with the basic version of CINAHL. Eighty-one journals are uniquely indexed in BNI compared with all versions of CINAHL. Fifty-one of these journals are UK publications. Most of the selected UK nursing journals have earlier start and entry dates in CINAHL than BNI.BNI is smaller than CINAHL, and BNI indexes a relatively small number of unique journals. An information professional with access to CINAHL Plus or CINAHL Complete could reasonably not search BNI for a nursing topic, particularly if the topic is not UK specific. UK nursing research is more likely to benefit from using BNI, although the acquisition of BNI by ProQuest could impact this finding.
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