Torn Achilles tendons have similar outcomes if treated with or without surgery
Outcomes for ruptured Achilles tendons appear similar irrespective of the choice of intervention. This systematic review and meta-analysis found that while the risk of re-rupture with corrective surgery was small at 2.3%, with conservative management (immobilisation in a cast), the rate was only 3.9%.
The complication rate at 4.9% was three times higher in those who had surgery.
Nearly all of the included studies were observational in this review, and no information was provided on the severit...
Long-term exercise programmes reduce falls and injuries in older adults
Older people who participate in year-long exercise programmes fall less and are less likely to be injured if they do fall. Exercise does not increase or decrease their risk of hospitalisation.
The people aged 60 or over (average age 73 years) who were included in this review took part in supervised training programmes. Typically, about half of people at this age can fall at least once a year. These programmes combined aerobic, strength and balance training, exercising at a moderate intensity fo...
Transcutaneous electrical stimulation (TENS) may help lower limb spasticity after stroke
Transcutaneous electrical stimulation (TENS) delivered alongside standard physical therapies could reduce spasticity in the lower limbs following a stroke.
Spasticity is a muscle control disorder characterised by tight muscles. It is common after stroke and accounts for significant disability. TENS is often used to treat pain and can affect nervous stimulation of the muscles.
The main evidence in this systematic review came from five trials which suggested that TENS combined with other physica...
No additional weight-loss reported from a lifestyle programme for people with psychosis
For adults with psychosis, such as schizophrenia, who are taking antipsychotic medication, a carefully designed 12-month group diet and exercise programme did not lead to clinically important weight loss after 12 months. The programme was compared with those receiving usual care including written lifestyle advice. Intervention and usual care groups each lost half a kilo on average, with no measurable changes in diet or physical activity.
People with schizophrenia are twice as likely to be overw...
Standing desks with a support package reduce time sitting at work
An office-based intervention involving a height-adjustable workstation and instruction package reduced the amount of time spent sitting. Workers sat for around 60 to 90 minutes less per day at six and 12 months compared with the control group.
Sitting for long periods is a risk factor for ill health even in people meeting recommended levels of physical activity. Reducing time sitting at work could have health and economic benefits, but the evidence is limited. This trial was fairly small, invol...
Aerobic exercise is an effective treatment for depression
A systematic review shows aerobic exercise improves clinically diagnosed major depression compared with antidepressants or treatment as usual. Previous reviews found conflicting evidence of benefit. The new review only included the trials thought to have the most applicable results.
This meant that trials recruiting people who might not have a clinical diagnosis of depression or through media adverts were not considered. Also, studies were only included if they featured aerobic exercise –...
Home-based cardiac rehabilitation for heart failure has high rates of participation
Home-based cardiac rehabilitation for people with heart failure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation, 90% remained in the programme – more than double average attendance rate for hospital-based rehabilitation. The average cost was estimated at £418 per participant which is within the National Health Service tariff for cardiac rehabilitation in England of £477 per patient.
This NIHR-funded trial included 216 par...
Pelvic floor muscle training can improve symptoms of urinary incontinence
Two-thirds of women with any type of urinary incontinence who have pelvic floor muscle training see improvement or cure compared with only a third of women who receive no treatment or inactive treatments. It is even more effective for women with stress incontinence, with three-quarters of women reporting improvement or resolution of symptoms, such as episodes of leakage.
This systematic review included 31 trials and 1,817 women with any type of incontinence; stress, urgency or mixed urinary inc...
Diet and exercise can reduce the risk of developing diabetes during pregnancy
Diet and exercise are effective ways of preventing the development of diabetes during pregnancy, known as gestational diabetes.
Gestational diabetes is becoming more common and is associated with poorer outcomes for mother and baby. Diet, physical activity and weight are modifiable risk factors, but trials published to date have shown inconsistent results.
This systematic review pooled 47 trials and found that any form of lifestyle intervention reduced the risk of gestational diabetes by 23%, ...
Complications following hip or knee surgery are more likely for people with long-term illness, but benefits are still worthwhile
People with long-term illness are just as likely to benefit from knee or hip surgery as those without. However, they are more likely to have complications following surgery and to be readmitted within three months.
This study reviewed data from 70 studies to determine the chance of short-term harms and long-term benefits linked to 11 different co-existing health conditions (such as diabetes and cancer) following hip and knee replacement. Short-term outcomes included surgical complications, infe...