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- Characteristics of respiratory rehabilitation programs for people with Parkinson’s disease: a scoping reviewPublication . Loureiro, Ricardo Filipe de Moura; Santana, Elaine dos Santos; Duque, Filipa Margarida Gonçalves; Bernardes, Rafael Alves; Ventura, Filipa Isabel Quaresma; Silva, Rosa Carla Gomes da; Oliveira, Albertina Lima de; Lima, Margarida Pedroso de; Almeida, Maria de Lurdes Ferreira de; Cardoso, Daniela Filipa Batista; Cardoso, Ana Filipa dos Reis Marques; Aromataris, EdoardoObjective: The objective of this review was to map the characteristics of respiratory rehabilitation programs for people with Parkinson's disease. Introduction: Parkinson's disease is a progressive and heterogeneous neurodegenerative disease. Respiratory dysfunction is highly prevalent in people with Parkinson's disease and is a major contributor to morbidity and mortality. People with Parkinson's disease may experience respiratory dysfunction such as ineffective coughing and dyspnea. Complications, such as atelectasis and respiratory infections, significantly impact their self-care and quality of life. To mitigate its impact on people's lives, various respiratory rehabilitation programs have been developed and implemented. Many studies have examined this topic, yet respiratory rehabilitation programs vary significantly in structure and evaluated outcomes. Eligibility criteria: We considered studies focused on respiratory rehabilitation programs implemented to prevent or target one or more symptoms for adults (18 years and older) with Parkinson's disease, regardless of the disease stage. The programs could be provided by any health professional in any health care setting. Methods: We followed JBI methodology for conducting the scoping review, and the results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A literature search was conducted across PubMed, CINAHL Complete (EBSCOhost), Cochrane Central Register of Controlled Trials (EBSCOhost), the Cochrane Database of Systematic Reviews (EBSCOhost), Scielo, Scopus, PEDro, and ClinicalTrials.gov. Unpublished studies were identified via Google Scholar, DART-Europe, and MedNar. All search strategies were conducted on April 24, 2023. Sources published in English, Spanish, and Portuguese were included and no date restrictions were applied. Study selection and data extraction were conducted independently by 2 reviewers using a standardized extraction tool. Results: Thirty-three studies published between 2001 and 2023 were included. Studies were conducted in the USA, Brazil, Turkey, Chile, Australia, Taiwan, Czechia, Italy, Republic of Korea, Germany, India, and Israel. The sample sizes ranged from 1 participant to 75 participants. The combined sample size of all studies was 1007 participants. Most programs integrated respiratory muscle strength training using devices, targeting people with Parkinson´s disease in Hoehn and Yahr scale stages 1-3. Speech-language pathologists, physiotherapists, and medical doctors were the health professionals responsible for delivering these programs in home-based or clinical settings. A broad spectrum of outcomes related to respiratory function was reported. Additionally, the studies assessed other outcomes such as quality of life, functional capacity, motor symptoms, and fatigue. Conclusions: Respiratory rehabilitation programs for people with Parkinson's disease have predominantly targeted respiratory muscle strength training, without a multidisciplinary approach. More research is needed emphasizing inclusive studies in terms of exercises/interventions in respiratory rehabilitation programs, stages of disease progression, and with the adoption of a multidisciplinary approach. Review registration: OSF https://osf.io/hgajt. Supplemental digital content: A translation of the abstract of this review is available in Portuguese at http://links.lww.com/SRX/A107 .
- Nursing Interventions in the Prevention of Musculoskeletal Injuries in Adolescent Athletes: Integrative ReviewPublication . Bernardo, Joana; Martins, Rosa; Morgado, Camila; Carmo, Henrique; Aguiar, Luís; Santos, Teresa; Carvalho, Nélia; Loureiro, RicardoMusculoskeletal injuries are a growing concern among adolescent athletes, with significant physical and psychological consequences. This integrative literature review aimed to analyze the risk factors associated with musculoskeletal injuries in adolescents engaged in sports and to explore the role of nursing interventions in their prevention. A systematic search was conducted across four databases and one gray literature source, including studies published between 2014 and 2024. Three descriptive studies were included, with evidence levels ranging from 3 to 4, according to the Joanna Briggs Institute classification. The main findings highlight that risk factors for musculoskeletal injuries include excessive training loads, inadequate sports technique, lack of professional supervision, improper use of equipment, and failure to recognize early signs of discomfort. Preventive nursing interventions were shown to be effective, particularly those focused on health education, proprioceptive training, and continuous monitoring. Multidisciplinary collaboration between nurses, coaches, and other health professionals emerged as a key strategy in creating safe sporting environments. Despite limitations such as the scarcity of studies on nursing-specific interventions in diverse sports contexts, this review supports the potential of structured, evidence-based nursing actions to reduce musculoskeletal injuries incidence, promote safer sports practices, and enhance adolescent athletes’ health outcomes.
- Evidence synthesis methodology for questions relating to barriers and enablers in health care: a scoping reviewPublication . Stern, Cindy; Valenzuela, Chelsea; Whitehorn, Ashley; Pollock, Danielle; Minooee, Sonia; Gohil, Dilan; Zhu, Zheng; Kirkpatrick, Pamela; Loureiro, Ricardo; Davies, Ellen; Cardoso, Daniela; Munn, Zachary; Carrier, Judith; Pieper, Dawid; Cooper, Kay; Jia, Romy; Loveday, Heather; Martin, Priya; Salmond, Susan; dos Santos, Kelli; Habibi, Nahal; Lizarondo, Lucylynn; Aromataris, EdoardoObjective: The objective of this scoping review was to map the range of methodologies and methods used to undertake evidence synthesis aimed at determining barriers and/or enablers in health care, and to inform further research relevant to synthesis methodology in this area. Introduction: Questions related to identifying and exploring barriers and/or enablers within health care are becoming increasingly popular. Currently, there are multiple approaches to synthesizing this evidence, and it is unclear whether a more consistent approach is warranted. Eligibility criteria: Evidence synthesis on barriers and/or enablers (facilitators) that included interest-holders at different levels of the health system were considered. Evidence synthesis projects had to include primary research studies and were published from 2010 to 2021. Literature reviews, narrative reviews, and umbrella reviews were excluded, as were reviews published in languages other than English. Methods: This scoping review followed JBI methodology and was based on a published a priori protocol and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A 3-step search strategy using a combination of key terms and index headings was undertaken in October 2021 via the following databases/resources: PubMed, Embase, CINAHL (EBSCOhost), PsycINFO (Ovid), Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and EPPI-Centre Systematic Reviews. An extensive piloting process for screening and selection, and data extraction was undertaken due to the large number of reviewers involved. All records were screened independently by 2 reviewers, and any disagreements were resolved through either a third reviewer or discussion with a panel of reviewers. Extraction was undertaken using a customized form, and data were analyzed using descriptive statistics. Data are presented via tables, figures, a word cloud, and an infographic, supplemented with a narrative synthesis. Results: Following completion of the search, 24,823 records were screened and 774 reviews were included in the scoping review. Systematic reviews were the most commonly used methodology (68%) to synthesize barrier and/or enabler questions. Reviews often included diverse types of evidence and involved an assessment of methodological quality (70%). Findings related to barriers and/or enablers were usually grouped and organized into categories, often by thematic methods (33%) or a narrative approach (20%). Incongruencies related to nomenclature, missing information, and methods used were evident across the large dataset. Conclusions: A variety of methodological approaches are being followed to undertake reviews focused on barriers and/or enablers in health care. The current state of the literature indicates that most authors answer these questions via the conduct of a systematic review and include diverse types of evidence. Further work is needed to determine whether authors are unclear when deciding on methodology and whether guidance is required.