Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisLocomotor training for walking after spinal cord injury.
Locomotor training for walking is used in rehabilitation after spinal cord injury (SCI) and might help to improve walking. ⋯ There is insufficient evidence from RCTs to conclude that any one locomotor training strategy improves walking function more than another for people with SCI. Research in the form of large RCTs is needed to address specific questions about the type of locomotor training which might be most effective in improving walking function of people with SCI.
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Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychotherapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. ⋯ Exercise seems to improve depressive symptoms in people with a diagnosis of depression, but when only methodologically robust trials are included, the effect sizes are only moderate and not statistically significant. Further, more methodologically robust trials should be performed to obtain more accurate estimates of effect sizes, and to determine risks and costs. Further systematic reviews could be performed to investigate the effect of exercise in people with dysthymia who do not fulfil diagnostic criteria for depression.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisPin site care for preventing infections associated with external bone fixators and pins.
Metal pins are used to apply skeletal traction or external fixation devices in the management of orthopaedic fractures. These pins protrude through the skin (described as 'percutaneous') and the way in which they are treated after insertion may affect the incidence of pin site infection. This review set out to summarise the evidence on the effect of pin site care on infection rates. ⋯ There is insufficient evidence for a particular strategy of pin site care which minimises infection rates. Adequately powered randomised trials are required to examine the effects of different pin care regimens and co interventions such as antibiotic use and other extraneous factors must be controlled in the study designs.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisTherapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease.
Despite the high incidence of muscle weakness in individuals with amyotrophic lateral sclerosis (ALS) or motor neuron disease (MND), the effects of exercise in this population are not well understood. ⋯ The only studies detected were too small to determine to what extent strengthening exercises for people with ALS are beneficial, or whether exercise is harmful. There is a complete lack of randomised or quasi-randomised clinical trials examining aerobic exercise in this population. More research is needed.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisContinuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters.
Complications associated with peripherally placed percutaneous central venous catheters (PCVC) in neonates include mechanical complications (catheter thrombosis, occlusion or dislodgement) and infection. Strategies to prevent catheter thrombosis and occlusion include the use of heparin. However, heparin is known to be associated with complications such as bleeding and thrombocytopenia. ⋯ None of these studies was powered to evaluate a lower incidence rate of adverse events. If this therapy is adopted in routine practice, monitoring of side effects is indicated.