B. PEDro indexes 39,000+ reports (and 30,000+ trials with complete ratings)
We are pleased to announce that PEDro has just achieved two new milestones for the amount of evidence. There are now 39,000+ reports of trials, reviews and guidelines indexed on PEDro. The number of trials with complete ratings now exceeds 30,000.
C. Systematic reviews should only be updated to improve the certainty of evidence, duplication should be avoided
A recent editorial published in the Journal of Physiotherapy explored issues around the updating systematic reviews. The Cochrane Collaboration's Panel for Updating Guidance for Systematic Reviews Group defines an update as a new edition of an existing review that can include new methods, new analyses or new data. Updates should only be performed in order to improve the certainty of the evidence, by changing the findings or credibility of the review. Unnecessary updates should be avoided because they are a duplication of effort, add to volume of evidence which needs to be considered, and could cause confusion because of differing conclusions. One way to avoid this duplication of effort is for the protocols of systematic reviews to be registered prospectively. Two databases which provide for registration of systematic reviews are PROSPERO and the Cochrane Database of Systematic Reviews.
D. Registration of protocols for systematic reviews should be encouraged
This survey of systematic reviews evaluating physiotherapy interventions was conducted to estimate the proportion of reviews that have a registered protocol, compare the methodological quality of registered and unregistered reviews, and calculate the prevalence of outcome reporting bias in registered reviews. A random sample of 150 systematic reviews published in 2015, written in English, Italian, Portuguese or Spanish, and indexed in the PEDro evidence resource were evaluated. Protocol registration was determined by searching the full-text of the reviews, searching protocol registries (PROSPERO and Cochrane Database of Systematic Reviews), and contacting authors. Two independent raters evaluated methodological quality using the AMSTAR checklist and extracted data about the methods used from both the reviews and registered protocols. Only 19% (n=29) of reviews were registered. Registered reviews demonstrated significantly higher methodological quality (median 8/11) than unregistered reviews (median 5/11). One-third (n=9) of the registered reviews demonstrated discrepancies between the protocol and review results, with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (relative risk 1.16; 95% confidence interval 0.63 to 2.12). A low proportion of physiotherapy systematic reviews are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration.
E. Systematic review found that physical activity improves social functioning in older people
This recent systematic review evaluates the effects of physical activity interventions on social functioning, isolation and support in community-dwelling older people. This appears to be the first review to address this question. The protocol for this review was prospectively registered on PROSPERO. The main outcomes were loneliness, social isolation, social support, social networks, and social functioning (a subdomain of health-related quality of life). The review identified 38 randomised controlled trials (5,288 participants) that compared a physical activity intervention to a non-physical activity or control (sedentary) intervention. 26 of the trials had a low risk of bias. A small significant positive effect favouring physical activity intervention was found for social functioning (standardised mean difference 0.30; 95% confidence interval 0.12 to 0.49), but no effect was found for loneliness, social isolation, social support, or social networks. There were sufficient trials to explore the influence of different subgroups on social functioning. The strongest effects were obtained for physical activity interventions provided in isolation, in populations with a medical condition, in the group exercise setting, and when delivered by a medical healthcare provider. Possible mechanisms underlying the social health effects of physical activity are discussed in the article.
Shvedko A, et al. Physical activity interventions for treatment of social isolation, loneliness or low social support in older adults: a systematic review and meta-analysis of randomised controlled trials. Psychol Sport Exerc 2018 Jan;34:128-137
F. Browse the latest research with PEDro Evidence in your inbox
Over 8,000 physiotherapists have signed up to receive PEDro Evidence in your inbox feeds. Subscribers can select from 15 areas of physiotherapy practice. To date, the most popular feeds are musculoskeletal, orthopaedics, chronic pain, and sports. Subscribers receive email messages (one for each area of practice) containing the latest research each time PEDro is updated (currently once per month). The number of articles varies from about 2 per month for the whiplash feed to about 50 per month for the musculoskeletal feed.
The Evidence in your inbox messages contain links to guidelines, reviews and trials (ranked by method). This allows subscribers to browse through the latest high-quality clinical research in their area of practice. This is ideal for clinicians wanting to optimise treatment or choose an article for a journal club.