Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews Quantifying component parts of indirect and direct voice therapy related to different voice disorders. European clinical guidelines for Tourette Syndrome and other tic disorders. Part III: behavioural and psychosocial interventions The effectiveness of attentional bias modification for substance use disorder symptoms in adults: a systematic review Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study The Influence of Voice Volume, Pitch, and Speech Rate on Progressive Relaxation Training: Application of Methods from Speech Pathology and Audiology Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia. Efficacy of low-level laser therapy in temporomandibular disorders: A systematic review Headache and Temporomandibular Disorders: Evidence for Diagnostic and Behavioural Overlap Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation (IC-SMOKE) interventions: a systematic review protocol What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol [Laryngeal electromyography in diagnosis and treatment of voice disorders]. A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity. Efficacy of postural and neck-stabilization exercises for persons with acute whiplash-associated disorders: a systematic review. Effectiveness of manual therapies: the UK evidence report Voice disorders in the general population: prevalence, risk factors, and occupational impact. Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration Technology-adaptable interventions for treating depression in adults with cognitive impairments: protocol for a systematic review Systematic review of cognitive behavioural therapy for the management of headaches and migraines in adults Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol The effectiveness of music on pain among preterm infants in the neonatal intensive care unit: a systematic review Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review.
PURPOSE Health interventions based on theory may be more effective than those that are not . This review of review s synthesizes all published r and omized controlled trial ( RCT ) meta-analytic evidence from the last decade to examine whether theory-based interventions were found to be associated with more effective  adult health behaviour change interventions . METHODS Systematic review s including meta-analyses were identified by search ing Medline , CINAHL , PsycINFO , and CDSR . A narrative synthesis was used to summarize and analyse the evidence . Only review s including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included . RESULTS Of 8,659 articles , nine systematic review s met inclusion criteria . The majority of review s ( n = 8) suggested no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour . Less than half of the RCTs included in the review s reported the use of theory ( 85/183 ) . Two review s suggested interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Method ological and reporting issues limit the conclusions . CONCLUSIONS Theory-based interventions as currently operationalized in systematic review s were not found to be more effective than non-theory-based interventions . Method ological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions . The promotion of theory use may benefit from using a multifaceted argument , rather than a narrow focus of increased effectiveness . Statement of contribution What is already known on this subject ? Theory use is regularly promoted by cl aim ing that it will lead to more effective behaviour change interventions . Theory use has been frequently linked to effectiveness within systematic review s of behaviour change interventions . The theory-effectiveness hypothesis has not been systematic ally examined at the systematic review level . What does this study add ? Theory use as operationalized by systematic review authors was not associated with increased effectiveness within systematic review s examining r and omized controlled trials of behaviour change interventions in adults . Interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Theory use should be promoted using a multifaceted argument , and assertions for increased effectiveness of theory-based interventions should only be used in domains where specific evidence exists to support this cl aim Voice therapy changes how people use and care for their voices .  Speech- language pathologists ( SLPs ) have a multitude of choices from which to modify patient 's vocal behaviors . Six SLPs performed 1461 voice therapy sessions and quantified the percentage of time spent in eight component parts of indirect and four component parts of direct voice therapy across five common voice disorders . Voice therapy data collection forms were prospect ively completed immediately following each therapy visit . The SLPs were free to choose the component parts of voice therapy best suited for their respective patients . Results showed that  direct voice therapy  represented more than 75 % of the treatment time across all voice therapy sessions . In the components of direct voice therapy , there was no statistical difference between percentages of time spent in resonant voice and flow phonation across all voice disorders . However , a significant difference was found for the time spent addressing transfer to conversational speech for muscle tension dysphonia , lesions , and scar than for vocal immobility and atrophy . Interestingly , while SLPs used a more common approach to direct voice therapy across voice disorders , they tended to vary the use of indirect components of therapy across voice disorders with certain components being addressed in greater length for specific voice disorders . Collectively , these results indicate that although SLPs may individualize their approach to indirect voice therapy , when it comes to direct voice therapy , SLPs have a common approach to voice therapy regardless of voice disorder This clinical guideline provides recommendations for the behavioural and psychosocial interventions ( BPI ) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome ( ESSTS ) . A systematic literature search was conducted to obtain an up date on the efficacy of BPI for tics . Relevant studies were identified using computerised search es of the Medline and PsycINFO data bases and the Cochrane Library for the years 1950–2010 . The search identified no meta-analyses , yet twelve ( systematic ) review s and eight r and omised controlled trials provided evidence for the current review . Most evidence was found for habit reversal training ( HRT ) and the available but smaller evidence also supports the efficacy of exposure with response prevention ( ERP ) . Both interventions are considered first line behavioural treatments for tics for both children and adults and should be offered to a patient , taking into account his preference . Treatments that are considered second line or add-on behavioural treatments are  contingency management , function based interventions and relaxation training . Neurofeedback is still experimental . Almost no research was identified that examined the efficacy of psychosocial interventions , e.g. , psychoeducation and group work . Based on clinical practice , this guideline recommends behavioural treatment as first line offer to patients in most cases . It should be embedded within a psychoeducational and supportive context and can be combined with drug treatment Background Attentional bias modification ( ABM ) interventions have been developed to address addiction by reducing attentional bias for substance-related cues . This study provides a systematic review of the effectiveness of ABM interventions in decreasing symptoms of addictive behaviour , taking baseline levels of attentional bias and changes in attentional bias into account . Methods We included r and omised and non-r and omised studies that investigated the effectiveness of ABM interventions in heavy-using adults and treatment-seeking individuals with symptoms of substance use disorder to manipulate attentional bias and to reduce substance use-related symptoms . We search ed for relevant English peer- review ed articles without any restriction for the year of publication using PsycINFO , PubMed , and ISI Web in August 2016 . Study quality was assessed regarding reporting , external validity , internal validity , and power of the study . Results Eighteen studies were included : nine studies reported on ABM intervention effects in alcohol use , six studies on nicotine use , and three studies on opiate use . The included studies differed with regard to type of ABM intervention ( modified dot probe task n = 14 ; Alcohol Attention Control Training Programme n = 4 ) , outcome measures , amount and length of provided sessions , and context ( clinic versus laboratory versus home environment ) . The study quality mostly ranged from low average to high average ( one study scored below the quality cut-off ) . Ten studies reported significant changes of symptoms of addictive behaviour , whereas eight studies found no effect of ABM interventions on symptoms . However , when restricted to multi-session ABM intervention studies , eight out of ten studies found effects on symptoms of addiction . Surprisingly , these effects on symptoms of addictive behaviour showed no straightforward relationship with baseline attentional bias and its change from baseline to post-test . Conclusions Despite a number of negative findings and the diversity of studies , multi-session ABM interventions , especially in the case of alcohol and when the Alcohol Attention Control Training Programme was used , appear to have positive effects on symptoms of addictive behaviour . However , more rigorous well-powered future research in clinical sample s is needed before firm conclusions regarding the effectiveness of ABM interventions can be drawn . Systematic review registration Registration number PROSPERO : Background Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition . The two clinical manifestations of the condition ( sleep and awake bruxism ) are thought to have unrelated aetiologies but are palliated using similar techniques . The lack of a definitive treatment has prompted renewed interest in biofeedback , a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs . This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism ; to assess the efficacy and acceptability of  biofeedback therapy in management of awake bruxism and , separately , sleep bruxism in adults ; and to compare findings between the two variants . Methods A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults . We will search electronic data bases and the grey literature using a predefined search strategy to identify r and omised and non-r and omised studies , technical reports and patents . Search es will not be restricted by language or date and will be exp and ed through contact with authors and experts , and by following up reference lists and citations . Two authors , working independently , will conduct screening of search results , study selection , data extraction and quality assessment and a third will resolve any disagreements . The primary outcomes of acceptability and effectiveness will be assessed using only r and omised studies , segregated by bruxism subtype . A meta- analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met , otherwise the data will be summarized in narrative form . Data from non-r and omised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues . PROSPERO registration number : CRD42013006880 . Discussion Biofeedback is not new , but its place in the clinical management of bruxism remains unclear . New research , and the availability of miniaturized consumer- grade devices , makes a systematic review timely to guide treatment decisions and inform future research For many years all patients with dysphonia referred to in the literature as result ing from non-organic ( functional ) voice disorders were sent to speech therapy .  Medical diagnoses were not taken into account . In our earlier Cochrane review on vocal cord nodules we discovered that evidence -based research in the area of benign voice disorders with dysphonia , and with or without slight benign swellings including nodules on the vocal cords , was lacking at that time . Therefore , a prospect i ve r and omised pilot study based on our Cochrane review has been made on dysphonic patients with non-organic ( function provoked ? ) voice disorders as the basis for further evidence -based studies .Medical treatment was based on the scientific approach that once a micro-organic disorder caused by reflux , infection , allergy or environmental irritatants ( e.g. , dust or noise in the workplace ) was discovered by very careful anamnesis and systematic objective routine analyses and was treated effectively , with documentation , the non-organic voice disorder disappeared , as , e.g. , in the case of a diagnosis and treatment of helicobakter pylori . The reason is that the mucosal swelling/dysfunction of the vocal cords is secondary .In order to try to underst and why the recommendation to all these patients for many years was only voice therapy , which the speech therapists “ felt to be effective ” , up date d voice-hygiene advice ( for posture , accents of the diaphragm , intonation pattern and resonance ) was given by experienced laryngologists , r and omised with the up date d medical diagnosis/therapy in order to eluci date what effect the training might have . No evidence -based studies in the literature document any effect . The crucial point seemed to be that doctors mostly did not examine any other diagnoses other than the “ dysphonia ” and did not dig down to any of the medical reasons when the vocal fold diagnosis of “ non- organic disorders ” was made . This should be changed in the future . This pilot study was based on a comparison of ten dysphonic patients with stroboscopic non- organic ( functional ) voice disorders , where a micro-organic diagnosis was search ed for and treated systematic ally in a medical regime ( for infections , allergies , gastrooesophageal reflux and environmental irritants such as dust , noise , etc . ) versus ten dysphonic patients with stroboscopically confirmed non-organic ( functional ) voice disorders , having only the traditional but optimal voice advice , which we can call medical voice-hygiene advice , including the use of the Accent method . A retrospective group of ten patients treated medically was included , too . A dem and can not be made that the functional group being treated by  r and omisation  with voice advice should also be medically treated at once , the medical approach being the new one . On the other h and , it is strange that no evidence -based research was made before . All patients were measured two times with stored videostroboscopy , a quality -of-life question naire and  phonetograms  with 1-month intervals . All patient groups improved . There was no statistical improvement in favour of the medical group with the voice-related quality -of-life score , also not for the group who received voice-hygiene advice . The geometrical mean values of the phonetogram areas in decibels times semitones were better in all groups , but a statistical difference was not found between the medically treated group and the voice-hygiene advice group . The pilot study showed that both medical treatment and medical voice-hygiene advice had a positive effect on  dysphonia in non-organic ( functional ) voice disorders . There is need of an extensive prospect i ve r and omised trial on dysphonia including vocal cord nodules to find out which treatment should be used for this group of patients . It is suggested that an eventual r and omisation for microsurgical treatment or regular voice therapy should be made after a period of systematic medical diagnosis and treatment including medical voice-hygiene advice Vocal characteristics of therapists , including voice volume , pitch and timbre of speech , and rate of speech have been hypothesized to facilitate the therapeutic process , particularly during procedures like progressive relaxation training ( PRT ) . Very little empirical work , however , has examined the relation between vocal characteristics and treatment process or outcome . The purpose of this study was to examine the role of vocal characteristics during a single session of PRT applying technological innovations devised for speech pathology and audiology setting s for evaluating therapist 's vocal characteristics . Forty-eight high anxious young adult women were r and omly assigned to one of four conditions for training : PRT with the recommended therapist voice ( RV ) that decreased in tone , volume , and rate across the session , PRT with conversational therapist voice during the session ( CV ) , a credible treatment control called systematic self-relaxation ( SR ) , or no treatment control ( NT ) . All subjects participated in a single PRT session during which heart rate , EMG , self-report measures of tension ( SRT ) and anxiety , and treatment credibility ratings were obtained . Results revealed significant reductions in SRT , self-reported anxiety , and heart rate for participants in all groups . Only the RV group displayed significant reductions in EMG when compared with the other three groups . Participants in the RV group also rated the therapist 's voice as “ more facilitating ” of relaxation when compared to the CV group . These results suggest that methods employed for evaluating the quality of vocal characteristics in speech and audiology clinics may be useful for evaluating the quality of therapist 's voice when conducting PRT The objectives of this study were to determine appropriate acoustic and outcome measures for the evaluation of a method of laryngeal manual therapy ( LMT ) used in the treatment of patients with muscle tension dysphonia ( MTD ) . The effects of this technique were also investigated . The study was based on the hypotheses that the vertical position of the larynx in the vocal tract would lower , that the quality of the voice would normalize , and that a reduction in any vocal tract discomfort ( VTD ) would occur after LMT . This was a small , prospect i ve , repeated measures pilot study in which each member of the research team was " blinded " to all other stages of the study and during which all data were anonymized until the final stage of data analysis . Ten subjects presenting with MTD completed outcome measures and provided audiorecordings immediately before , immediately after , and 1 week after LMT . The Kay CSL 4150 was used for signal acquisition and for some acoustic measurements . Spectrographic evaluation was accomplished with Praat . A new perceptual , self-rating scale , the VTD scale , and a new proforma for use by the clinician for palpatory evaluation , were developed for the study . Relative average perturbation during connected speech was significantly reduced after LMT , indicating a reduction in abnormal vocal function . The severity and frequency of VTD was shown to have reduced after LMT . This pilot study showed positive evidence for LMT as a method of therapy in the treatment of hyperfunctional voice disorders . Its effects were shown to be measurable with both acoustical analysis and the VTD scale Purpose : The aim of this systematic review was to assess the efficacy of low-level laser therapy ( LLLT ) in patients with temporom and ibular disorders ( TMDs ) . Methods : Medline search was done from 1997 to 2011 using search terms appropriate to establishing a relation between LLLT and TMD . Only r and omized controlled trials were included in this study . Outcome variables related to pain , muscle tenderness , m and ibular movements , and Electromyographic ( EMG ) activity were considered . Of the 242 articles examined , 13 were finally included in the critical analysis conducted as a part of the present systematic review . Results : Of the 242 titles review ed , only 13 articles were considered eligible . 7 articles showed significant improvement in the study group , whereas 5 showed no significant improvement between the study and control groups . The primary outcome of most of the studies was pain . Other variables considered were muscle tenderness , m and ibular movements ; EMG activity was considered . Conclusion : Our results have shown that LLLT seems to be effective in reducing pain in TMD 's . It may be a treatment option for patients with an interest in a noninvasive , complementary therapy To assess the diagnostic and behavioural overlap of headache patients with temporom and ibular disorders ( TMD ) , individuals recruited from the general population with self-described headaches were compared with non-headache controls . The examination and diagnostic procedures in the Research Diagnostic Criteria ( RDC ) for TMD were applied to both sets of subjects by a blinded examiner . Following their examination , subjects used experience sampling methods to obtain data on pain , tooth contact , masticatory muscle tension , emotional states and stress . Results showed that a significantly higher proportion of the headache patients received an RDC/TMD diagnosis of myofascial pain than non-headache controls . Headache patients also reported significantly more frequent and intense tooth contact , more masticatory muscle tension , more stress and more pain in the face/head and other parts of the body than non-headache controls . These results are similar to those reported for TMD patients and they suggest that headache patients and TMD patients overlap considerably in diagnosis and oral parafunctional behaviours Background Systematic review s of behaviour change interventions for  smoking cessation  vary in scope , quality , and applicability . The current review aims to generate more accurate and useful findings by ( 1 ) a detailed analysis of intervention elements that change behaviour ( i.e. behaviour change techniques ( BCTs ) ) and potential moderators of behaviour change ( i.e. other intervention and sample characteristics ) and ( 2 ) assessing and controlling for variability in support provided to comparison groups in smoking cessation trials . Methods A systematic review will be conducted of r and omized controlled trials of behaviour change interventions for smoking cessation in adults ( with or without pharmacological support ) , with a minimum follow-up of 6 months , published after 1995 . Eligible articles will be identified through the Cochrane Tobacco Addiction Group Specialized Register . Study authors will be asked for detailed descriptions of smoking cessation support provided to intervention and comparison groups . All data will be independently coded by two research ers . The BCT taxonomy v1 ( tailored to smoking cessation interventions ) and template for intervention description and replication criteria will be used to code intervention characteristics . Data collection will further include sample and trial characteristics and outcome data ( smoking cessation rates ) . Multilevel mixed-effects meta-regression models will be used to examine which BCTs and /or BCT clusters delivered to intervention and comparison groups explain smoking cessation rates in treatment arms ( and effect sizes ) and what key moderators of behaviour change are . Predicted effect sizes of each intervention will be computed assuming all interventions are compared against comparison groups receiving the same levels of behavioural support ( i.e. low , medium , and high levels ) . Multi-disciplinary advisory board members ( policymakers , health care providers , and (ex-)smokers ) will provide strategic input throughout the project to ensure the review ’s applicability to policy and practice . Discussion By capturing BCTs in intervention and comparison groups , this systematic review will provide more accurate estimates of the effectiveness of smoking cessation interventions , the most promising BCTs and /or BCT clusters associated with smoking cessation rates in intervention and comparison arms , and important moderators of behaviour change . The results could set new st and ards for conducting meta-analyses of behaviour change interventions and improve research , service delivery , and training in the area of smoking cessation . Systematic review registration PROSPERO Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) INTRODUCTION AND OBJECTIVES Laryngeal electromyography , together with clinical evaluation , is a valuable tool in voice disorder management . It assesses the integrity of laryngeal nerves and muscles , contributing to the diagnosis of many diseases , especially laryngeal movement disorders . Our purpose was to describe the experience of the first Spanish series with laryngeal electromyography in evaluating  voice disorders .  METHODS A prospect i ve study was design ed to evaluate laryngeal movement disorders with laryngeal electromyography . Both the cricothyroid and thyroarytenoid muscles were tested routinely and , in some cases , the posterior cricoarytenoid muscle . The laryngeal electromyography technique and result interpretation were performed by a laryngologist and a neurophysiologist . RESULTS We included 110 patients , with the most common symptom being dysphonia .  Laryngeal electromyography was performed in 85 % of cases . Primary diagnosis before electromyography was laryngeal immobility . Positive predictive value for diagnosis in cases of paralysis was 88 % . CONCLUSIONS Laryngeal electromyography is a useful adjunct , together with clinical evaluation , for diagnosis and management of motion abnormalities in the larynx in patients who present with dysphonia We investigated , on behalf of a large electronics manufacturer , two types of worker training interventions  for their efficacy in preventing unnecessary muscle tension and the symptoms of work-related musculoskeletal disorders . The first intervention , Muscle Learning Therapy ( MLT ) , used electromyographic ( sEMG ) feedback and operant conditioning to decrease muscle tension during complex work tasks . The second intervention used adult learning and cognitive behavioral techniques in small group discussion to advance the worker 's capabilities for symptom and stress management and problem-solving . Workers were r and omly assigned to a control group or one of the two treatment conditions . Prior to training , baseline data were collected using symptom diaries and sEMG recordings of the trapezius and forearm muscles of the left and right arms . The training interventions were conducted for 6 weeks with reinforcement training provided at 18 and 32 weeks post-baseline . Follow-up data were collected after the initial 6-week training period and at 32 weeks , prior to the reinforcement training . Symptom outcomes demonstrated significant differences at 6 weeks , increasing in severity for the control group and declining modestly for the educational group , with little change for the MLT group . These differences were not maintained at further follow-up . The MLT group was consistently effective in reducing muscle tension in the trapezius areas after 6 and 32 weeks , and was partially effective for the forearms . Further testing is recommended of these training interventions , especially with the inclusion of strategic , periodic reinforcement of the worker 's learning PURPOSE We systematic ally review ed r and omized and quasi-r and omized clinical trials in the literature to assess the efficacy of neck stabilization and postural exercises on pain , neck range of motion , and time off work in adults with acute whiplash-associated disorders . METHODS Electronic data bases , reference lists of relevant Cochrane review s , reference lists of studies selected for inclusion , and tables of contents of relevant journals were systematic ally search ed for r and omized and quasi-r and omized controlled trials . Two independent review ers selected studies for inclusion , assessed method ological quality , and extracted data . Because of the heterogeneity of the interventions , a qualitative synthesis was performed using " levels of evidence " as recommended by van Tulder et al. RESULTS Eight studies representing five clinical trials were selected for inclusion . Two trials were grade d as high quality , two as moderate quality , and one as low quality . Many of these studies had mixed results , demonstrating significant differences on some outcome measures but not on others . CONCLUSIONS There is moderate evidence to support the use of postural exercises for decreasing pain and time off work in the treatment of patients with acute whiplash-associated disorders . However , no evidence exists to support the use of postural exercises for increasing neck range of motion . There is conflicting evidence in support of neck stabilization exercises in the treatment of patients with acute whiplash-associated disorders Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions . Methods The conclusions are based on the results of systematic review s of r and omized clinical trials ( RCTs ) , widely accepted and primarily UK and United States evidence -based clinical guidelines , plus the results of all RCTs not yet included in the first three categories . The strength/ quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs . Results By September 2009 , 26 categories of conditions were located containing RCT evidence for the use of manual therapy :  13 musculoskeletal conditions , four types of chronic headache and nine non-musculoskeletal conditions . We identified 49 recent relevant systematic review s and 16 evidence -based clinical guidelines plus an additional 46 RCTs not yet included in systematic review s and guidelines .Additionally , brief references are made to other effective non-pharmacological , non-invasive physical treatments . Conclusions Spinal manipulation/mobilization is effective in adults for : acute , subacute , and chronic low back pain ; migraine and cervicogenic headache ; cervicogenic dizziness ;  manipulation/mobilization is effective for several extremity joint conditions ; and thoracic manipulation/mobilization is effective for acute/subacute neck pain . The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration , and for manipulation/mobilization for mid back pain , sciatica , tension-type headache , coccydynia , temporom and ibular joint disorders , fibromyalgia , premenstrual syndrome , and pneumonia in older adults . Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation , or for Stage 1 hypertension when added to an antihypertensive diet . In children , the evidence is inconclusive regarding the effectiveness for otitis media and enuresis , and it is not effective for infantile colic and asthma when compared to sham manipulation . Massage is effective in adults for  chronic low back pain and chronic neck pain . The evidence is inconclusive for knee osteoarthritis , fibromyalgia , myofascial pain syndrome , migraine headache , and premenstrual syndrome . In children , the evidence is inconclusive for asthma and infantile colic OBJECTIVES Epidemiologic studies of the prevalence and risk factors of voice disorders in the general adult population are rare . The purpose of this investigation was to 1 ) determine the prevalence of voice disorders , 2 ) identify variables associated with increased risk of voice disorders , and 3 ) establish the functional impact of voice disorders on the general population . STUDY DESIGN Cross-sectional telephone survey . METHODS A r and om sample ( n = 1,326 ) of adults in Iowa and Utah was interviewed using a question naire that addressed three areas related to voice disorders : prevalence , potential risk factors , and occupational consequences/effects . RESULTS The lifetime prevalence of a voice disorder was 29.9 % , with 6.6 % of participants reporting a current voice disorder . Stepwise logistic regression identified specific factors that uniquely contributed to increased odds of reporting a chronic voice disorder including sex ( women ) , age ( 40 - 59 years ) , voice use patterns and dem and s , esophageal reflux , chemical exposures , and frequent cold/sinus infections . However , tobacco or alcohol use did not independently increase the odds of reporting of a chronic voice disorder . Voice disorders adversely impacted job performance and attendance , with 4.3 % of participants indicating that their voice had limited or rendered them unable to do certain tasks in their current job . Furthermore , 7.2 % of employed respondents reported that they were absent from work 1 or more days in the past year because of their voice , and 2 % reported more than 4 days of voice-related absence . CONCLUSIONS The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders , factors that contribute to voice disorder vulnerability , and the functional impact of voice problems on the general population Abstract Purpose To evaluate the effectiveness of non-steroidal anti-inflammatory drugs ( NSAIDs ) for the management of neck pain and associated disorders ( NAD ) , whiplash-associated disorders , and non-specific low back pain ( LBP ) with or without radiculopathy . Methods We systematic ally search ed six data bases from 2000 to 2014 . R and om pairs of independent review ers critically appraised eligible systematic review s using the Scottish Intercollegiate Guidelines Network criteria . We included systematic review s with a low risk of bias in our best evidence synthesis . Results We screened 706 citations and 14 systematic review s were eligible for critical appraisal . Eight systematic review s had a low risk of bias . For recent-onset NAD , evidence suggests that intramuscular NSAIDs lead to similar outcomes as combined manipulation and soft tissue therapy . For NAD ( duration not specified ) , oral NSAIDs may be more effective than placebo . For recent-onset LBP , evidence suggests that : ( 1 ) oral NSAIDs lead to similar outcomes to placebo or a muscle relaxant ; and ( 2 ) oral NSAIDs with bed rest lead to similar outcomes as placebo with bed rest . For persistent LBP , evidence suggests that : ( 1 ) oral NSAIDs are more effective than placebo ; and ( 2 ) oral NSAIDs may be more effective than acetaminophen . For recent-onset LBP with radiculopathy , there is inconsistent evidence on the effectiveness of oral NSAIDs versus placebo . Finally , different oral NSAIDs lead to similar outcomes for neck and LBP with or without radiculopathy . Conclusions For NAD , oral NSAIDs may be more effective than placebo . Oral NSAIDs are more effective than placebo for persistent LBP , but not for recent-onset LBP . Different oral NSAIDs lead to similar outcomes for neck pain and LBP Background Depression is a common comorbidity in individuals with cognitive impairment . Those with cognitive impairments face unique challenges in receiving the benefits of many conventional therapies for depression , and may have poorer outcomes in areas such as recovery and quality of life . However , the stigmatization of mental health disorders , cost barriers and physical disabilities may prevent these individuals from seeking mental health care . An online , self-help intervention specifically developed for adults with cognitive deficits and depression may be particularly beneficial to this population . We aim to inform the design of such an intervention through a systematic review by answering the following research question : among adults with cognitive impairment ( including those with acquired brain injuries or neurodegenerative diseases ) , which technology-amenable interventions have been shown to effectively decrease symptoms of depression ? Specifically , psychotherapeutic and /or behavioural interventions that could be delivered in a self-guided , online system will be included . Methods Comprehensive electronic search es will be conducted in MEDLINE , EMBASE , PsycINFO and CINAHL . Additional studies will be obtained through manually search ing the references of relevant systematic review s , contacting primary authors of select articles and tracking conference proceedings and trial registries . Article titles and abstract s will be screened using predefined eligibility criteria , and then judged for their amenability to the proposed self-help , technology-based intervention . The full text of those articles with selected interventions will then be screened to determine final eligibility for inclusion . Included articles will be categorized by intervention type and assessed for risk of bias using the Cochrane Effective Practice and Organization of Care Risk of Bias tool for non-r and omized trials , controlled before-after studies and interrupted time series . The primary outcome will be a change in score on a vali date d depression scale , and adverse events will be documented as a secondary outcome . After data extraction from selected articles , pooling of data and meta- analysis will be conducted if a sufficient pool of studies with comparable methodology and quality are identified . Alternatively , plain language summaries will be developed . The quality of evidence will be assessed using the Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) system . Systematic review registration PROSPERO Aim : This systematic review aim ed to establish if cognitive behavioural therapy ( CBT ) can reduce the physical symptoms of chronic headache and migraines in adults . Methods : Evidence from search es of eight data bases was systematic ally sought , appraised and synthesis ed . Screening of title and abstract s was conducted independently by two review ers . Full papers were screened , data extracted and quality assessed by one review er and checked by a second . Data were synthesis ed narratively by intervention due to the heterogeneity of the studies . The inclusion criteria specified r and omised controlled trials with CBT as an intervention in adults suffering from chronic headaches/migraines not associated with an underlying pathology/medication overuse .  CBT was judged on the basis of authors describing the intervention as CBT . The diagnosis of the condition had to be clinician verified . Studies had to include a comparator and employ headache/migraine-specific outcomes such as patient-reported headache days . Results : Out of 1126 screened titles and abstract s and 20 assessed full papers , 10 studies met the inclusion criteria of the review . Some studies combined CBT with another intervention , as well as employing varying numbers of comparators . CBT was statistically significantly more effective in improving some headaches-related outcomes in CBT comparisons with waiting lists ( three studies ) , in combination with relaxation compared with relaxation only ( three studies ) or antidepressant medication ( one study ) , with no statistically significant differences in three studies . Conclusions : The findings of this review were mixed , with some studies providing evidence in support of the suggestion that people experiencing headaches or migraines can benefit from CBT , and that CBT can reduce the physical symptoms of headache and migraines . However , methodology inadequacies in the evidence base make it difficult to draw any meaningful conclusions or to make any recommendations Background Meeting the needs of the growing number of older people is a challenge for health and social care services . Home-based interventions aim ing to modify health-related behaviours of frail older people have the potential to improve functioning and well-being . Previous review s have focused on whether such interventions are effective , rather than what might make them effective . Recent advances in behavioural science make possible the identification of potential ‘ active ingredients ’ of effective interventions , such as component behaviour change techniques ( BCTs ) , and intended intervention functions ( IFs ; e.g. to educate , to impart skills ) . This paper reports a protocol for a systematic review that seeks to ( a ) identify health behaviour change interventions for older frail people , ( b ) describe the content of these interventions , and ( c ) explore links between intervention content and effectiveness . The protocol is reported in accordance with Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol s ( PRISMA -P ) 2015 guidelines . Methods / design Studies will be identified through a systematic search of 15 electronic data bases , supplemented by citation tracking . Studies will be retained for review where they report r and omised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community setting s , written in English , and either published from 1980 onwards , or , for registered trials only , unpublished but completed with results obtainable from authors . Interventions will be coded for their content ( BCTs , IFs ) and for evidence of effectiveness ( outcome data relating to behavioural and health outcomes ) . Analyses will describe characteristics of all interventions . Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence . The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness . Discussion Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people , and highlight those more associated with positive changes in behaviour and health . Findings from this review will provide a useful basis for underst and ing , developing , and implementing behaviour change interventions in this field . Systematic review registration PROSPERO Review question / objective The objective of this review is to synthesize the best available evidence related to the effectiveness of music as pain relieving method among preterm infants during painful procedures in the neonatal intensive care unit . Review questions are : Among preterm infants in the neonatal intensive care unit , is music effective in reducing pain scores ? physiological pain indicators ? behavioural pain indicators ? hormonal pain indicators ? Background Patients and context Preterm infants ( i.e. babies born at or before 37 gestational weeks ) compose a patient group of the most vulnerable to pain . Infants treated in a neonatal intensive care unit ( NICU ) are exposed to a variety of painful procedures ( e.g. heel prick , iv cannula insertion , endotracheal suctioning ) and to environmental stress ( e.g. noise , light ) . Simons et al.1 , for example , described an average 14 + /‐ 4 painful procedures during the first 2 weeks of life within a period of 24 hours among 151 neonates . Many studies have shown that repeated and sustained pain can have direct and long‐term consequences on the neurological and behavior‐oriented development of the neonates during the rapid development phase of the central nervous system . Pain can cause detectable physiological , behavioral and hormonal changes2,3,4 and contribute to the altered development of the pain system during later childhood and adolescence3,4,50 . Instead , live music such as singing is excellent type of music when it is steady , constant , quiet , soothing and directed to the infants6 . Graven7 emphasizes that recorded sound should not replace human voice exposure in the NICU ; therefore , health care providers should provide ample opportunity for the infant to hear parent 's voices live , such as singing or humming , in interactions between the parent and the infant at the bedside . The AmericanAcademy of Pediatrics Committee on Environmental Health has recommended safe levels of sound8 , and these recommendations have been up date d by an expert team of practitioners . Recommendations specify that continuous sound should not exceed an hourly equivalent sound level of 50 A‐weighted decibels (dBA)7,8,9 , and music as an auditory stimulus not exceed 75 dB in NICU6,8,10 . If earphones or other devices are used , sound sources should be kept at reasonable distances from the infant 's ear , played for brief periods and at levels below 55 dB7 . Music listening can be initiated with or without the involvement of a music therapist . In this review , music can be implemented for premature infants by a music therapist or any health care providers and it will include both recorded and live music . Outcomes Regardless of the type of music , several studies have investigated the short term effects of music on preterm infants , including the improvement in physiological outcomes ( e.g. oxygen saturation , heart rate , respiratory rate , and blood pressure ) , as well as in behavioural state ( e.g. crying , facial expression , body movements ) and pain scores6,11,12,13 . For example , Chou et al. 6 showed that premature infants receiving recorded music , that was the combination of womb sounds and the mother singing , with endotracheal suctioning had significantly higher oxygen saturation than when they did not receive music . Butt & Kisilewsky12 compared recorded music involving both the vocal and instrumental version of Brahms lullaby versus no music , and found that infants older than 31 weeks demonstrated significant reduction in heart rate , behavioral state and pain . In the study of Arnon et al.11 the infants receiving live music , compared with infants receiving recorded music or no music , had significantly reduced heart rate and behavioral scores during the post‐intervention period . Live music comprised of a lullaby sang by the female voice with frame drum and an accompanying harp . The same music was played by a tape recorder . Live music showed significant benefits , whereas no statistically significant changes were found for the recorded music and control groups . Teckenberg‐Jansson et al.13 indicated that music therapy combined with kangaroo care  decreased the pulse , slowed down the respiration and increased the transcutaneous oxygen saturation in preterm infants . The musical instruments used were a lyre and a female human voice , which hummed or sang . There is evidence that music has also positive consequences on long‐term outcomes , including length of hospitalization , weight gain , and non‐nutritive sucking10,13,14,15 . For example , in the study of Caine16 the preterm infants received music stimulation which consisted of recorded vocal music ( including lullabies and children 's music ) and routine auditory stimulation . Exposure to the music stimulation had many positive effects on preterm infants , such as it increased daily average weight , formula and caloric intake , and significantly reduced total hospital stays and stress behaviors for the experimental group . In addition , according to Lubetzky et al.10 exposure to music by Mozart significantly lowered energy expenditure among healthy preterm infants . Hartling et al.17 have published a systematic review on the efficacy of music for medical indicators in term and preterm neonates . Nine r and omized trials ( 1989‐2006 ) were included . According to the results of this review music may have positive effects on physiological parameters and behavioral states , and may reduce pain and improve oral feeding rates among the premature infants . The effects of music were evaluated during medical procedures ( circumcision , heel prick ) and for other indicators . In addition , Cignacco et al.18 conducted a systematic literature review on the efficacy of non‐pharmacological interventions in the management of procedural pain in preterm and term neonates during the period from 1984 to 2004 . According to this review there was no clear evidence that the method of music could have a pain‐alleviating effect on neonates . In the Cochrane Library , one systematic review is also available up to year of 2011 concerning  non‐pharmacological  management of infants and young children ( preterm , neonate , older up to three years ) during procedural pain19 , but this review did not consider music as an intervention . To date , there is also one meta‐ analysis published by St and ley20 concerning the efficacy of music therapy  for premature infants during the period from 1950 to 1999 . It concluded that music was beneficial for many outcomes among the preterm infants in the NICU . However , the results of this review were limited by the poor method ological quality of the included studies , and unclear reporting on the phases of review . In our systematic review , studies published in 2000 and after will be considered for inclusion in the review . The number of the RCT 's concerning the effectiveness of music  among the preterm infants in NICU is especially increased during the last few years , and these studies have not included in the previous systematic review s and meta‐ analysis BACKGROUND  Tension-type headache ( TTH ) is a disease with a great incidence on quality of life and with a significant socioeconomic impact . OBJECTIVES The aim of this review is to determine the effectiveness of physical therapy by using manual therapy ( MT ) for the relief of TTH . DATA SOURCES A review was done identifying r and omized controlled trials through search es in MEDLINE , PEDro , Cochrane and CINAHL ( January 2002 - April 2012 ) . STUDY SELECTION English- language studies , with adult patients and number of subjects not under 11 , diagnosed with episodic tension-type headache ( ETTH ) and chronic tension-type headache ( CTTH ) were included . DATA EXTRACTION Initial search was undertaken with the words Effectiveness , Tension-type headache , and Manual therapy ( 39 studies ) . In addition , a search which included terms related to treatments such as physiotherapy , physical therapy , spinal manipulation was performed ( 25 studies ) . RESULTS From the two search es 9 studies met the inclusion criteria and were analysed finding statistically significant results : 1 ) myofascial release , cervical traction , neck muscles trigger points in cervical thoracic muscles and stretching ; 2 ) Superficial heat and massage , connective tissue manipulation and vertebral Cyriax mobilization ; 3 ) cervical or thoracic spinal manipulation and cervical chin-occipital manual traction ; 4 ) massage , progressive relaxation and gentle stretching , program of active exercises of shoulder , neck and pericranial muscles ; 5 ) massage , passive rhythmic mobilization techniques , cervical , thoracic and lumbopelvic postural correction and cranio-cervical exercises ; 6 ) progressive muscular relaxation combined with joint mobilization , functional , muscle energy , and strain/counterstrain techniques , and cranial osteopathic treatment ; 7 ) massage focused on relieving myofascial trigger point activity ; 8) pressure release and muscle energy in suboccipital muscles ; 9 ) combination of mobilizations of the cervical and thoracic spine , exercises and postural correction . All studies used a combination of different techniques and none analyzed treatments separately , also all the studies have assessed aspects related to TTH beyond frequency and intensity of pain . CONCLUSIONS The findings from these studies showed evidence that physiotherapy with articulatory MT , combined with cervical muscle stretching and massage are effective for this disease in different aspects related with TTH . No evidence was found of the effectiveness of the techniques applied separately
Specific " active ingredients " for therapeutic change were not identified .
PURPOSE A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders ( MTVD ) .