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NIHR Signal Antidepressants do not help treat depression in people living with dementia
Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term. This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. P...
NIHR Signal 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...
NIHR Signal Robot-assisted arm training after stroke helps people regain some strength and independence
People who have electromechanical or robot-assisted arm rehabilitation after stroke have better arm function and strength as well as finding it easier to complete activities of daily living. Although moderate, the improvements suggest it may be worth considering these interventions as an adjunct to usual therapy. Many people have impaired arm function after a stroke and rehabilitation is often required. Robot-assisted arm training uses devices to support therapeutic movements. Feedback, given b...
NIHR Signal Supervised exercise sessions increase physical activity and fitness of cancer survivors
Aerobic exercise and resistance sessions that include supervision help people living with cancer to meet guideline physical activity levels. Common behaviour change techniques that were shown to increase physical activity are goal setting, graded tasks (e.g. increasing exercise duration or intensity over time), and instruction on how to perform particular exercises. This review update looked at the most effective ways to increase and sustain physical activity for 1,372 sedentary adults living w...
NIHR Signal Steroids rapidly reduce children’s croup symptoms and shorten hospital stays
Corticosteroids reduce symptoms of croup in children within two hours and continue to do so for at least 24 hours. They also cut the amount of time children spend in hospital by 15 hours and reduce return visits or readmissions from about 20% to 10%. This Cochrane review assessed the effectiveness of corticosteroids such as dexamethasone and budesonide compared with placebo. It updates a previous review which concluded that corticosteroids reduce symptoms of croup at six hours. The review also...
NIHR Signal Routine use of a mechanical compression device is no better than manual chest compression in cardiac arrest
Compared with manual compression, mechanical chest compression does not improve survival rates after cardiac arrest. However, in situations where manual compression may be difficult, such as in a moving ambulance, mechanical compression may still be an option. Each minute that a person waits for treatment after a cardiac arrest can make a difference of up to 10% to their chance of survival. Cardiopulmonary resuscitation (CPR) is the crucial first step to keep oxygen circulating to vital organs ...
NIHR Signal Omega-3 supplements do not prevent heart disease, stroke or death
Omega-3 fatty acid supplements from fish oils or plants have little or no effect on the risk of heart disease, stroke or overall death rates. This finding contradicts a widespread belief that omega-3 supplements are protective. Previous evidence in favour of omega-3 supplements is mainly derived from trials at high risk of bias. The better evidence identified in this review does not demonstrate any health benefit. The review provides robust evidence confirming current guidance that omega-3 supp...
NIHR Signal Inducing labour at or after 41 weeks reduces risks to infants
Inducing labour after the due date slightly lowers the risk of stillbirth or infant death soon after birth compared with watchful waiting. But the overall risk is very low. Induced deliveries may reduce admissions to the neonatal intensive care unit. Pregnant women having induced labour are less likely to have a caesarean section than those who wait for labour to begin naturally. They may have a slightly higher chance of needing an assisted vaginal birth (for example, using forceps or vacuum ex...
NIHR Signal People with osteoarthritis can benefit from exercise but may harbour myths about safety
Programmes that show people with osteoarthritis how to exercise safely may slightly improve pain scores, self-belief and social function, but participants also report the myth that discomfort while exercising indicates on-going harm. The review combines evidence from 21 randomised controlled trials evaluating exercise in hip or knee osteoarthritis with 12 studies where people receiving the intervention were interviewed about the impact of exercise on their disease. Participants were men and wom...
NIHR Signal Cognitive behavioural therapy could benefit adults with attention deficit hyperactivity disorder (ADHD)
Cognitive behavioural therapy improves the core symptoms of attention deficit hyperactivity disorder (ADHD) in adults, compared with a range of other treatments. This Cochrane review found a general trend for improvements in inattention, hyperactivity and impulsiveness, especially when therapy was combined with medication. The review included trials that compared cognitive behavioural therapy to other specific interventions or to a range of control conditions, including waiting list and no trea...
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