PMID- 37355261
OWN - NLM
STAT- MEDLINE
DCOM- 20230626
LR  - 20231122
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 6
DP  - 2023 Jun 23
TI  - What is the landscape of evidence about the safety of physical agents used in 
      physical medicine and rehabilitation? A scoping review.
PG  - e068134
LID - 10.1136/bmjopen-2022-068134 [doi]
LID - e068134
AB  - BACKGROUND: Several systematic reviews (SRs) assessing the effectiveness of 
      superficial physical agents have been published, but the evidence about their 
      safety remains controversial. OBJECTIVE: To identify areas where there is 
      evidence of the safety of physical agents by a scoping review. DESIGN: Four 
      databases were systematically searched for including English SRs that explored 
      and reported safety in terms of adverse events (AEs) related to the application 
      of physical agents in outpatient and inpatient physical medicine and 
      rehabilitation settings managed by healthcare professionals, published in January 
      2011-29 September 2021. The severity of AEs was classified according to the 
      Common Terminology Criteria. Then, AE findings were summarised according to the 
      SR syntheses. Finally, the reporting of the certainty of the evidence was mapped. 
      RESULTS: Overall, 117 SRs were retrieved. Most of the SRs included randomised 
      controlled trials (77%) and patients with musculoskeletal disorders (67%). The 
      most investigated physical agents were extracorporeal shock wave therapy (ESWT) 
      (15%), transcutaneous electrical nerve stimulation (13%) and electrical 
      stimulation (12%). No AE (35%) was reported in one-third of the included primary 
      studies in SRs, whereas few severe AEs occurred in less than 1% of the sample. 
      Among physical agents, ESWT showed an increased risk of experiencing mild AEs 
      compared with the control. Most SRs reported a qualitative AE synthesis (65.8%), 
      and few reported the certainty of the evidence (17.9%), which was mainly low. 
      CONCLUSION: We found evidence of safety on several physical agents coming mostly 
      from qualitative synthesis. No significant harms of these interventions were 
      found except for ESWT reporting mild AEs. More attention to the AEs reporting and 
      their classification should be pursued to analyse them and assess the certainty 
      of evidence quantitatively. REVIEW REGISTRATION: https://osf.io/6vx5a/.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Bargeri, Silvia
AU  - Bargeri S
AUID- ORCID: 0000-0002-3489-6429
AD  - Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
FAU - Pellicciari, Leonardo
AU  - Pellicciari L
AUID- ORCID: 0000-0002-9521-3759
AD  - IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy 
      leonardo.pellicciari@gmail.com.
FAU - Gallo, Chiara
AU  - Gallo C
AUID- ORCID: 0000-0003-2898-2133
AD  - Fisiopoint Physical Therapy Department, Rome, Italy.
FAU - Rossettini, Giacomo
AU  - Rossettini G
AUID- ORCID: 0000-0002-1623-7681
AD  - School of Physiotherapy, University of Verona, Verona, Italy.
FAU - Castellini, Greta
AU  - Castellini G
AUID- ORCID: 0000-0002-3345-8187
AD  - Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
FAU - Gianola, Silvia
AU  - Gianola S
AUID- ORCID: 0000-0003-3770-0011
AD  - Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
CN  - AIFI Consortium
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230623
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Humans
MH  - *Physical and Rehabilitation Medicine
PMC - PMC10314460
OTO - NOTNLM
OT  - adverse events
OT  - health & safety
OT  - rehabilitation medicine
COIS- Competing interests: None declared.
FIR - Fulvio, Anna
IR  - Fulvio A
FIR - Barsaglini, Serena
IR  - Barsaglini S
FIR - Genovese, Vincenzo
IR  - Genovese V
FIR - Benedini, Matteo
IR  - Benedini M
FIR - Proverbio, Emanuele
IR  - Proverbio E
FIR - Cecchetto, Simone
IR  - Cecchetto S
EDAT- 2023/06/25 01:08
MHDA- 2023/06/26 06:41
PMCR- 2023/06/23
CRDT- 2023/06/24 20:43
PHST- 2023/06/26 06:41 [medline]
PHST- 2023/06/25 01:08 [pubmed]
PHST- 2023/06/24 20:43 [entrez]
PHST- 2023/06/23 00:00 [pmc-release]
AID - bmjopen-2022-068134 [pii]
AID - 10.1136/bmjopen-2022-068134 [doi]
PST - epublish
SO  - BMJ Open. 2023 Jun 23;13(6):e068134. doi: 10.1136/bmjopen-2022-068134.