Abstract
Acupuncture for Treating Overactive Bladder in Adults
There is a growing body of literature suggesting that acupuncture treatment may help relieve symptoms of overactive bladder. This review found 15 randomized controlled trials (1395 participants) testing acupuncture for overactive bladder. When compared with no treatment or with sham acupuncture, the effects of acupuncture on improving overactive bladder symptoms were uncertain. When compared with medication, acupuncture may have the same effect on urinary frequency and may slightly reduce the number of times people wake at night to urinate (nocturia), but differences for urinary urgency and incontinence were uncertain. Most studies were small and many had methodological problems. Larger and better studies are needed.
Probiotics for Preventing Acute Upper Respiratory Tract Infections
Research suggests that probiotics may improve local and systemic immunity, and reviewers sought to clarify this for acute upper respiratory infections (URIs). Based on 24 randomized controlled trials (6950 participants) testing probiotics for preventing URIs in healthy children or adults, reviewers concluded that probiotics may reduce the risk of an URI by 24%, reduce the mean length of an URI episode by 1.22 days, and reduce the number of people using antibiotics for an URI by 42%. There may be no difference in the number of people with adverse events with probiotics versus placebo or no treatment. More research on the effects of probiotics for reducing absences from school or work is needed.
Replacing Salt with Low-Sodium Salt Substitutes for Cardiovascular Health in Adults, Children, and Pregnant Women
Diets high in sodium contribute to high blood pressure, which is a risk factor for cardiovascular morbidity and mortality. Reviewers examined whether replacing dietary sodium with low sodium salt substitutes could improve cardiovascular health. They found 26 randomized trials (34,961 adults and 92 children) and concluded that in adults, salt substitutes probably slightly reduce systolic and diastolic blood pressure and slightly reduce the risk of stroke, acute coronary syndrome, and death from heart disease. Salt substitutes probably slightly increase blood potassium but may make little or no difference in abnormal potassium levels. There is less or no information on adults without high blood pressure, children, and pregnant women.
Marine-Derived n-3 Fatty Acids Therapy for Stroke
Animal studies have shown that omega-3 fatty acids may help brain cells immediately after stroke, but the effects in humans are unclear. This review found 30 randomized controlled trials testing marine-derived n-3 fatty acids in participants after stroke or transient ischemic attack (TIA), and relevant data were available from nine of the studies (3339 participants). Few studies reported on the primary outcome of stroke recovery, and the evidence was uncertain. The review authors state there is an overall lack of studies focused on stroke recovery, particularly during the acute phase, and call for more studies evaluating vascular-related death, recurrence, adverse events, quality of life, and mood in populations with stroke or TIA.
Interventions for Preventing Falls in Parkinson's Disease
People with Parkinson's disease (PD) are at high risk of falls. Reviewers found 32 randomized controlled trials (3370 participants) testing interventions to prevent falls in people with PD. Twelve studies compared exercise with usual care. The exercise in these studies was primarily gait, balance, and functional training, although resistance training and Tai Chi were also tested. Exercise probably reduces the rate of falls by 26% and reduces the number of people experiencing one or more falls by 10%. Reviewers did not find a difference in effects between exercise types, but they found that fully supervised exercise may be more effective than partially supervised evidence. More research is needed into people with more severe PD and a higher risk of falls.
Physical Activity for Treatment of Irritable Bowel Syndrome
Guidelines recommend physical activity as part of managing irritable bowel syndrome (IBS), but the underlying evidence base is limited. Reviewers found 11 randomized controlled trials (622 participants) comparing physical activity interventions with usual care or another intervention in people with IBS. Compared with usual care, physical activity may improve IBS symptoms, but the evidence is uncertain (six studies). There may be no difference for IBS symptoms between yoga and a walking intervention (two studies) or between yoga and medication (two studies), but all evidence was uncertain. Based on one study, there may be no difference in effects between yoga and a dietary intervention (low certainty evidence). Further research is needed.
Nonpharmacologic Interventions for Sleep Promotion in Hospitalized Children
Sleep is important for the health and development of children but may be impaired during hospitalization. Reviewers examined whether nonpharmacologic treatments could improve sleep in hospitalized children. They found 10 randomized controlled studies (528 children and young people) testing several interventions, including relaxation, massage, and exercise. Reviewers found that multicomponent relaxation therapies and exercise may make little or no difference on the amount or quality of sleep, but touch therapy may improve total sleep time and sleep quality in children with burns. Massage and bedtime stories may also improve sleep. However, all findings are uncertain and better trials with standardized outcomes are needed.