Objective: The aim of this systematic review with meta-analysis was to describe the status on the effects of physical scar treatments on pain, pigmentation, pliability, pruritus, scar thickening, and surface area. Design: Systematic review and meta-analysis. Subjects: Adults with any kind of scar tissue. Interventions: Physical scar management versus control or no scar management. Outcome measures: Pain, pigmentation, pliability, pruritus, surface area, scar thickness. Results: The overall results revealed that physical scar management is beneficial compared with the control treatment regarding the management of pain (p = 0.012), pruritus (p < 0.001), pigmentation (p = 0.010), pliability (p < 0.001), surface area (p < 0.001), and thickness (p = 0.022) of scar tissue in adults. The observed risk of bias was high for blinding of participants and personnel (47%) and low for other bias (100%). Conclusions: Physical scar management demonstrates moderate-to-strong effects on improvement of scar issues as related to signs and symptoms. These results show the importance of specific physical management of scar tissue.

Zusammenfassung Hintergrund Die Akademisierung der Gesundheitsberufe führte in der Physiotherapie zu einem Wechsel von primär erfahrungsbasiertem zu evidenzbasiertem Arbeiten. Obwohl das Konzept der evidenzbasierten Praxis (EBP) in der Physiotherapie weitgehend akzeptiert ist, zeigen sich Probleme bei der Umsetzung in die Praxis. Ziel Identifikation potentieller Barrieren und unterstützender Faktoren für die Umsetzung der evidenzbasierten Praxis in der Physiotherapie. Methode Anhand eines Onlinefragebogens mit 49 Fragen wurden Physiotherapeut*innen (n = 138) zur evidenzbasierten Praxis befragt. Die Resultate des Fragebogens wurden deskriptiv wiedergegeben. Ergebnisse Physiotherapeut*innen mit Masterabschluss arbeiten im Arbeitsalltag evidenzbasierter als Physiotherapeut*innen mit anderen Abschlüssen und zeigen eine höhere Bereitschaft, evidenzbasierte Praxis anwenden zu wollen. Unsicherheiten wurden vorwiegend beim Formulieren von Fragestellungen sowie bei der Suche und kritischen Bewertung von wissenschaftlichen Artikeln festgestellt. Eine Aus- oder Weiterbildung zur evidenzbasierten Praxis führt zu mehr Sicherheit bei deren Anwendung. Klinische Entscheidungswege basieren vorwiegend auf der eigenen Praxiserfahrung, dem Befinden von Patient*innen und auf Informationen aus Fachzeitschriften. Zeitmangel, sich während der Arbeit weiterzubilden, stellt die Hauptbarriere dar. Zusammengefasste Forschungsergebnisse publiziert auf einem evidenzbasierten Internetportal, per E-Mail-Versand oder in einer Fachzeitschrift sind die meistgenannten Förderfaktoren für die Anwendung evidenzbasierter Praxis. Schlussfolgerung Fach- und Hochschulen sowie Arbeitgeber*innen spielen eine wichtige Rolle bei der Vermittlung von Kenntnissen und der Umsetzung von evidenzbasierter Praxis in der Physiotherapie.

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Post-exercise cold-water immersion (CWI) is a widely accepted recovery strategy for maintaining physical performance output. However, existing review articles about the effects of CWI commonly pool data from very heterogenous study designs and thus, do rarely differentiate between different muscles, different CWI-protocols (duration, temperature, etc.), different forms of activating the muscles before CWI, and different thickness of the subcutaneous adipose tissue. This systematic review therefore aimed to investigate the effects of one particular post-exercise CWI protocol (10°C for 10 min) on intramuscular temperature changes in the quadriceps femoris muscle while accounting for skinfold thickness. An electronic search was conducted on PubMed, LIVIVO, Cochrane Library, and PEDro databases. Pooled data on intramuscular temperature changes were plotted with respect to intramuscular depth to visualize the influence of skinfold thickness. Spearman's rho (rs) was used to assess a possible linear association between skinfold thickness and intramuscular temperature changes. A meta-analysis was performed to investigate the effect of CWI on pre-post intramuscular temperature for each measurement depth. A total of six articles met the inclusion criteria. Maximum intramuscular temperature reduction was 6.40°C with skinfold thickness of 6.50 mm at a depth of 1 cm, 4.50°C with skinfold thickness of 11.00 mm at a depth of 2 cm, and only 1.61°C with skinfold thickness of 10.79 mm at a depth of 3 cm. However, no significant correlations between skinfold thickness and intramuscular temperature reductions were observed at a depth of 1 cm (rs = 0.0), at 2 cm (rs = −0.8) and at 3 cm (rs = −0.5; all p &gt; 0.05). The CWI protocol resulted in significant temperature reductions in the muscle tissue layers at 1 cm (d = −1.92 [95% CI: −3.01 to −0.83] and 2 cm (d = −1.63 [95% CI: −2.20 to −1.06]) but not at 3 cm (p &lt; 0.05). Skinfold thickness and thus, subcutaneous adipose tissue, seems to influence temperature reductions in the muscle tissue only to a small degree. These findings might be useful for practitioners as they demonstrate different intramuscular temperature reductions after a specific post-exercise CWI protocol (10°C for 10 min) in the quadriceps femoris muscle.

Patellafemoral joint diseases are commonly treated from physiotherapists. Patellar mobilisations can be performed either manually, but automated, passive continuous mobilisation devices are popular and frequently used in the clinical practice. The Patello device is a new developed product, but its effectiveness has not been verified yet. The purpose of this pilot-study was to investigate the effects of this passive continuous motion device (CPMD) on patellar cranial-caudal translation. Nine healthy participants (mean age: 36.0±10.74 yrs, mean height: 172.7±8.1 cm, mean mass: 72.4±8.6 kg) volunteered for this study. The participants’ right knee was investigated and placed at a flexion angle of 45° inside the device. The Patella bone was fixed to the device with two pincers to ensure full contact. A total of 50 repetitions, with a constant mobilisation speed, was conducted and the degree of translation was assessed after 1, 10, 20, 30 and 50 repetitions. The results of this pilot-study indicate, that the CPMD was effective to translate the patella within the trochlear groove after 1 (mean translation: 0.819cm, p<0.001), up to 50 repetitions (mean translation: 0.774 cm, p<0.001) compared to baseline. No significant differences (p>0.05) were observed between the repetitions. In conclusion, the CPMD proved to be effective to mobilize the patellar bone in a healthy population. Further studies should investigate the possible effects of passive continuous mobilisations in a clinical setting.