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Backgrounds: Despite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male‐directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that >50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception. Aim: The present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence‐based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA). Methods: An expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Results: Sixty evidence‐based and graded recommendations were produced on couple‐centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non‐hormonal methods, vaccines, and social and ethical considerations. Conclusion: As gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male‐directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non‐hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception. [ABSTRACT FROM AUTHOR]

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The interior space of a cabinet of this type is composed of the air in the rooms, the contact surfaces (walls, ceiling, lighting fixtures, floor, doors, windows, furniture, equipment), instruments and dental materials being exposed to various pathogens that must be kept under strict control through various accredited decontamination methods. Most dental treatments are aerosol-generating procedures that produce a mixture of sprays, droplets, and aerosols containing saliva, blood, water, and viable microorganisms (including bacteria, fungi, and viruses). Chemical agents – antiseptic biocidal products and chemical disinfectants used in sanitary facilities must have a bactericidal, fungicidal, mycobactericidal, virucidal and sporicidal effect, depending on the purpose of use. The interaction between the chemical compounds of disinfectants and microbial cells can cause a serious reaction to public health and sanitary security. The risk factor intensifies the probability of selection and dissemination of multidrug resistance among pathogenic bacteria. The use of a UVC air decontamination device that is safe for human exposure could provide the desired antimicrobial benefits without accompanying human health concerns raised by conventional UVGI germicidal lamps.

BACKGROUND: Occupational noise exposure is a significant health problem. In addition to hearing impairments, noise as a stressor may cause cardiovascular problems. OBJECTIVE: This study aimed to investigate the effect of exposure to workplace noise on cardiovascular disease risk factors. METHODS: This case-control study was conducted in 2021 in a power plant in Iran. In this study, the health status of 406 employees in both exposed (n = 203) and non-exposed (n = 203) to noise groups was examined for cardiovascular disease risk factors. Also, the trend of changes in the studied variables from 2012 to 2020 in exposed employees was examined. Data were collected from participants' annual physical examinations and occupational noise exposure measurements. To measure the noise in the present study, the KIMO-DB300 noise level meter was used. Data were analyzed in SPSS-26 software. RESULTS: The results revealed that mean fasting blood sugar (FBS), triglyceride, liver enzyme (SGOT), blood pressure, and body mass index were significantly different in the two groups (p-value<0.05). There was no significant difference in the mean of creatinine, cholesterol, and liver enzyme (SGPT) between the two groups (p-value>0.05). In the exposed group, the mean of all studied variables except diastolic blood pressure was statistically different during the study years (p-value<0.05). CONCLUSION: This study demonstrates that exposure to noise above the permissible level can affect the cardiovascular disease risk factors, so it is recommended to apply engineering and management measures like using Hearing Conservation Programme (HCP) to reduce the risk of these diseases with periodically assessing the health status of employees and timely diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: The most common domestic injury among housewives is falling from stairs and ramps or on the floor. The present study aimed to find and associate the prevalence of falls with various agents, risk factors causing falls and the impact of falls among rural housewives. Methods: A cross-sectional survey was carried out among 500 randomly selected housewives from rural areas of Raipur district, Chhattisgarh in the month of March to June 2019. Demographic data and information regarding the occurrence of falls, various agents & factors associated with falls were collected by questionnaires, lux meter, anemometer and sound level meter through interviews, and observation techniques. The Nordic questionnaire was used to assess the impact of falls. Collected data were analyzed by using SPSS 20 statistical package. Results: 295 out of 500 housewives had domestic injuries which included 12.8 % of fall injuries. Fall had a significant association with various physical agents like illumination in the living room (χ2=11.004, df=1), relative humidity of the kitchen (χ2=18.03, df=2) and presence of adequate natural light (χ2=11.232, df=1). Even various personal risk factors were significant causes of falls like wearing slippers on a wet floor (χ2=11.845, df=1), presence of open electric wires (χ2=4.84, df=1), self-cleaning of toilet & floor (χ2=11.371, df=1) and self-cooking (χ2=10.959, df=1). Heavy works like carrying water in a big container (χ2=6.025, df=1), working under direct sunlight (χ2=4.195, df=1), prolonged standing while cooking or on an agricultural field (χ2=32.073, df=1) and using of hand pump per day to draw water (χ2=42.329, df=1) were highly significant causes of domestic fall. Conclusion: Findings of the study concluded that fall was very much prevalent among housewives, and being at home still housewives are exposed to various agents and personal risk factors causing fall.

Background: A decrease in semen quality is an increasingly widespread pathological condition worldwide. Jobs and lifestyles have changed a lot with the advancement of technology in the last few decades, and a new series of risk factors for male infertility have spread. Objective: This review aims to summarize the current literature on this relationship, evaluating alterations in semen parameters and hormonal profile. Methods: A deep research was performed through MEDLINE via PubMed, Scopus, and Web of Science on articles regarding the relationship between physical agents and male fertility over the last twenty years. Some physical agents already associated with male infertility, such as heat and radiation, while emerging ones, such as physical exertion, psychological stress and sedentary activities, were newly considered. Results: Most studies described sperm quality after exposure. Overall sperm impairment was shown after radiation and alteration of specific parameters, such as sperm concentration, were observed after psychological stress and sedentary work. In addition, an association was also reported between physical exertion and hormonal profile, especially pituitary hormones and testosterone. Conclusions: Although the associations between physical agents and male infertility are suggestive, the level of evidence of the studies is not adequate to define their influence, except for physical exertion. Therefore, new prospective studies are necessary for the validation of the correlation and the possible safeguarding of the exposed working classes. [ABSTRACT FROM AUTHOR]

Wood harvesting operations involve mechanized and semi-mechanized machines that expose operators to occupational noise. It was verified that the emission of occupational noise levels in the harvest of mechanized and semi-mechanized wood in Brazilian forests planted with eucalyptus were in compliance with Directive 2003/10/EC. Noise data were collected using two personal-use integrative meters. The lower action level of 80 dB(A), the upper action level of 85 dB(A) and the exposure limit of 87 dB(A) were evaluated. The results showed that 16.6% of the operators were exposed to thresholds above the lower action level, but remained below the upper level of 85 dB(A), 8.3% of the operators were exposed to occupational noise levels above the upper action level, without exceeding the exposure limit of 87 dB(A) and 25% of operators were exposed to levels above the exposure limit. Therefore, the occupational noise levels achieved when harvesting mechanized and semi-mechanized wood in forests planted with eucalyptus do not comply with Directive 2003/10/EC. [ABSTRACT FROM AUTHOR]

Physiotherapy must be considered and reprioritized as an adjunctive medical service for long term health and rehabilitation. Comprehensive physiotherapy has the potential to be administered in out-patient rehabilitation facilities, hospitals, and Thermal Health Centers. A review of select adjunctive physiotherapy methods will be presented along with a case report of the successful treatment, with rationally selected physiotherapeutic agents, of a Diabetic Neuropathic Foot Ulcer scheduled for surgical amputation. By highlighting this case, the author is attempting to bring attention to familiar and time-tested therapies that have fallen out of use in a primary intervention context. This case report aims to exemplify that the role for rational physiotherapeutic methods stretches beyond current mainstream applications. Historical Context. Will supply the historical and foundational work in the field of physiotherapy that contextualizes the rational basis for the applications described in the case. Therapies. Lists the physiotherapy methods highlighted in this case, reviews the mechanism of action, discusses the therapeutic application, and provides modern citation for the rationalization of the therapy. Case Report. Reviews a detailed narrative of the case in review. Covers intake, case history, progression of case, as well as clinical applications for physiotherapy as they arise in the course of case management. Conclusion. Reviews the emphasis for reconsidering the role of Physiotherapy in the primary management of acute and chronic illness.

Background: There are extensive studies focusing on non-invasive modalities to recover physiological systems after exercise-induced muscle damage (EIMD). Whole-body cryotherapy (WBC) and Partial-body cryotherapy (PBC) have been recommended for recovery after EIMD. However, to date, no systematic reviews have been performed to compare their effects on muscle performance and muscle recovery markers. Methods: This systematic review with metanalysis compared the effects of WBC and PBC on muscle performance, muscle soreness (DOMS), and markers of muscular damage following EIMD. We used Pubmed, Embase, PEDro, and Cochrane Central Register of Controlled Trials as data sources. Two independent reviewers verified the methodological quality of the studies. The studies were selected if they used WBC and PBC modalities as treatment and included muscle performance and muscle soreness (DOMS) as the primary outcomes. Secondary outcomes were creatine kinase and heart rate variability. Results: Six studies with a pooled sample of 120 patients were included. The methodological quality of the studies was moderate, with an average of 4.3 on a 0–10 scale (PEDro). Results: Both cryotherapy modalities induce similar effects without difference between them. Conclusion: WBC and PBC modalities have similar global responses on muscle performance, soreness, and markers of muscle damage. [ABSTRACT FROM AUTHOR]

There is growing concern regarding the health and safety issues of endocrine-disrupting chemicals (EDCs). Long-term exposure to EDCs has alarming adverse health effects through both hormone-direct and hormone-indirect pathways. Non-chemical agents, including physical agents such as artificial light, radiation, temperature, and stress exposure, are currently poorly investigated, even though they can seriously affect the endocrine system, by modulation of hormonal action. Several mechanisms have been suggested to explain the interference of EDCs with hormonal activity. However, difficulty in quantifying the exposure, low standardization of studies, and the presence of confounding factors do not allow the establishment of a causal relationship between endocrine disorders and exposure to specific toxic agents. In this review, we focus on recent findings on the effects of EDCs and hormone system modulators on the endocrine system, including the thyroid, parathyroid glands, adrenal steroidogenesis, beta-cell function, and male and female reproductive function. [ABSTRACT FROM AUTHOR]

Information is physical (Landauer 1961 IBM J. Res. Dev. 5 183–91), and for a physical theory to be universal, it should model observers as physical systems, with concrete memories where they store the information acquired through experiments and reasoning. Here we address these issues in Spekkens’ toy theory (Spekkens 2005 Phys. Rev. A 71 052108), a non-contextual epistemically restricted model that partially mimics the behaviour of quantum mechanics. We propose a way to model physical implementations of agents, memories, measurements, conditional actions and information processing. We find that the actions of toy agents are severely limited: although there are non-orthogonal states in the theory, there is no way for physical agents to consciously prepare them. Their memories are also constrained: agents cannot forget in which of two arbitrary states a system is. Finally, we formalize the process of making inferences about other agents’ experiments and model multi-agent experiments like Wigner’s friend. Unlike quantum theory (Nurgalieva and del Rio Lidia 2019 Electron. Proc. Theor. Comput. Sci. 287 267–97; Fraser et al 2020 Fitch’s knowability axioms are incompatible with quantum theory arXiv: 2009.00321 ; Frauchiger and Renner 2018 Nat. Commun. 9 3711; Nurgalieva and Renner 2021 Contemp. Phys. 61 1–24; Brukner 2018 Entropy 20 350) or box world (Vilasini et al 2019 New J. Phys. 21 113028), in toy theory there are no inconsistencies when physical agents reason about each other’s knowledge.

Early osteoarthritis (EOA) still represents a challenge for clinicians. Although there is no consensus on its definition and diagnosis, a prompt therapeutic intervention in the early stages can have a significant impact on function and quality of life. Exercise remains a core treatment for EOA; however, several physical modalities are commonly used in this population. The purpose of this paper is to investigate the role of physical agents in the treatment of EOA. A technical expert panel (TEP) of 8 medical specialists with expertise in physical agent modalities and musculoskeletal conditions performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP searched for evidence of the following physical modalities in the management of EOA: “Electric Stimulation Therapy”, “Pulsed Electromagnetic field”, “Low-Level Light Therapy”, “Laser Therapy”, “Magnetic Field Therapy”, “Extracorporeal Shockwave Therapy”, “Hyperthermia, Induced”, “Cryotherapy”, “Vibration therapy”, “Whole Body Vibration”, “Physical Therapy Modalities”. We found preclinical and clinical data on transcutaneous electrical nerve stimulation (TENS), extracorporeal shockwave therapy (ESWT), low-intensity pulsed ultrasound (LIPUS), pulsed electromagnetic fields stimulation (PEMF), and whole-body vibration (WBV) for the treatment of knee EOA. We found two clinical studies about TENS and PEMF and six preclinical studies—three about ESWT, one about WBV, one about PEMF, and one about LIPUS. The preclinical studies demonstrated several biological effects on EOA of physical modalities, suggesting potential disease-modifying effects. However, this role should be better investigated in further clinical studies, considering the limited data on the use of these interventions for EOA patients. [ABSTRACT FROM AUTHOR]

The stomatologist profession induces, over long run, modifications of the backbone, caused by the position on the chair. The degenerative diseases of the vertebral column represent a current issue, manifested extensively in all social domains. The present study identified, applied and adapted the most correct, safe and efficient strategy of treating musculoskeletal disorders, on considering the conditions related to patients. Comparatively with other professions, stomatologists register a higher incidence of musculoskeletal pain caused by their work (MSK). Such pain, induced by musculoskeletal disorders, has an enormous impact, altering and restricting a large range of activities. Our study evidences the importance of the utilization of physical agents and of comparative procedures for both therapeutical and prophylactic purposes. [ABSTRACT FROM AUTHOR]

Introduction: Housewives perform various household works both inside and outside the home, which may cause domestic injuries and ill health. Domestic injuries are usually sustained due to exposure to various physical agents. The objectives of the current study were to find out the various physical agents, the prevalence of various types of domestic injuries & to find out the association between domestic injuries and selected physical agents. Methods: In this study 500 housewives aged more than 18 years from villages of Raipur, Chhattisgarh were selected by multistage stratified random sampling. Demographic information, the occurrence of domestic injuries, and the factors associated with injuries were collected by questionnaires, interviews, and observation technique. Collected data were analyzed by using SPSS 16 statistical package. Results: Results showed that the mean age of housewives was 39.27 (±12.07) years and the majority of them were between 22-35 years of age group. Data revealed that 59% of housewives had suffered from domestic injuries. Out of them, the majority were suffering from vision problems (45.1%) and headache (36%), 21% suffered from heat, 15% got cut and 14.8% had fire burn from home environment. Around 14% got eye irritation and 12.8% of housewives had experienced falls on the floor. A significant association was found between injuries and physical agents. Conclusion: The study concluded that housewives are exposed to various physical agents in their own homes, which contributes to the prevalence of various types of domestic injuries among them. Housewives themselves and family members have to be aware of those physical agents present in their home which silently affecting their health.

Antibiotic resistance to most antibiotics currently used is constantly on the rise, thus posing a serious threat to human health. Control of microorganisms is essential to prevent the transmission of diseases and infections and to prevent unwanted microbial contamination. Therefore, it is necessary to develop new strategies by which pathogenic bacteria could be eliminated. The spread of microorganisms can controlled by using physical and chemical agents. Physical agents include control methods such as high or low temperature, desiccation, radiation, osmotic pressure, filtration. The result of the action of these factors is related to their intensity, the duration of time the bacterial cell was exposed, the environment in which it activates, the cell structure, but also its sensitivity to one or more factors. That is why it is necessary to develop new strategies through which pathogenic bacteria can be easily annihilated, as alternatives to, or associated with, antibiotic treatment. [ABSTRACT FROM AUTHOR]

Early osteoarthritis (EOA) still represents a challenge for clinicians. Although there is no consensus on its definition and diagnosis, a prompt therapeutic intervention in the early stages can have a significant impact on function and quality of life. Exercise remains a core treatment for EOA; however, several physical modalities are commonly used in this population. The purpose of this paper is to investigate the role of physical agents in the treatment of EOA. A technical expert panel (TEP) of 8 medical specialists with expertise in physical agent modalities and musculoskeletal conditions performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP searched for evidence of the following physical modalities in the management of EOA: “Electric Stimulation Therapy”, “Pulsed Electromagnetic field”, “Low-Level Light Therapy”, “Laser Therapy”, “Magnetic Field Therapy”, “Extracorporeal Shockwave Therapy”, “Hyperthermia, Induced”, “Cryotherapy”, “Vibration therapy”, “Whole Body Vibration”, “Physical Therapy Modalities”. We found preclinical and clinical data on transcutaneous electrical nerve stimulation (TENS), extracorporeal shockwave therapy (ESWT), low-intensity pulsed ultrasound (LIPUS), pulsed electromagnetic fields stimulation (PEMF), and whole-body vibration (WBV) for the treatment of knee EOA. We found two clinical studies about TENS and PEMF and six preclinical studies—three about ESWT, one about WBV, one about PEMF, and one about LIPUS. The preclinical studies demonstrated several biological effects on EOA of physical modalities, suggesting potential disease-modifying effects. However, this role should be better investigated in further clinical studies, considering the limited data on the use of these interventions for EOA patients.

Objective: To evaluate whether combining fluidotherapy to conventional rehabilitation program provides additional improvements on pain severity, upper extremity functions, and edema volume in patients with poststroke complex regional pain syndrome (CRPS).Design: Randomized controlled trial.Setting: Training and research hospital.Participants: Thirty hemiplegic patients with subacute stage CRPS type-1 of the upper extremity.Interventions: The patients randomly divided into 2 groups. Both groups received a 3 week conventional rehabilitation program (5 days/week, 2-4 hours/day). Experimental group received 15 sessions additional fluidotherapy application to the affected upper extremity (40 °C, 20 minutes in continuous mode, 5 sessions/week).Main Outcome Measures: We evaluated the distal upper arm edema with a volumeter. Other used clinical assessment scales were Brunnstrom recovery stages of the arm and hand for motor recovery, motor items of the functional independence measure for functional status, visual analog scale for pain severity, and the painDETECT questionnaire for presence and the severity of neuropathic pain.Results: The mean age of the participants was 64.3 ± 11.66 (28-84). At the post-treatment evaluation, significant improvements were revealed regarding to the edema volume, pain visual analog scale, painDETECT and functional independence measure scores, and the Brunnstrom stages of upper extremity and hand in both groups (P < .05). But among the parameters mentioned above, only the decrease in edema volume and the painDETECT scores were greater in fluidotherapy group than the control group (P < .05).Conclusions: Addition of the fluidotherapy to the conventional rehabilitation program provides better improvements on neuropathic pain and edema volume in subacute stage poststroke CRPS. [ABSTRACT FROM AUTHOR]

Background: Numerous systematic reviews have been published on tendinopathies that deals with specific therapies on a specific location. Clinical therapists find it difficult to synthesize these results into their practice as evidence is conflicting between the sites of tendinopathy. The objective of this systematic review is to see the effectiveness of physiotherapy interventions (both active- exercise and passive- physical agents) in the management of tendinopathies. Methods: Articles were selected from Web of Science (WoS) by entering keywords in mid-December 2017. Articles published in the English language, between 2000 and 2017 were selected. The author selected 14 reviews from 31 possible reviews for this article and all, but one was indexed in PubMed too. Seven, 1, 3 and 3 were the number of articles that were carried treatment, physiotherapy, exercise and physical agents in their titles. Shoulder, hip or knee, ankle locations were dealt in 6, 4 and four articles respectively. Results: Current evidence-based literature shows that exercise especially eccentric one is the definite physiotherapy treatment option for treating lower limb and some upper limb tendinopathies. However, reviews show that other forms of exercises particularly stabilization as a promising option in upper limb conditions. Physical agents (Ultra Sound [US], Transcutaneous electrical nerve stimulation [TENS] are showing conflicting results hence not recommended at this point. The LASER can be used in Shoulder tendinopathies. Conclusion: The traditional concept of eccentric training in tendinopathies is challenged by recent reviews which show stabilization and other types of exercises also improving pain and function in tendinopathies. Well-designed large RCT trials are required to see the effectiveness of physical agents, different types of exercise training on tendinopathies.

Background: Biophysical agents (BPA) are adjuncts to care plans prescribed by physical therapists to patients in clinic. Recent statements by the American Physical Therapy Association caution usage of certain BPAs. Currently, information is lacking as to which BPAs are available and utilized in physical therapy settings in the United States, rationale for inclusion of BPAs in patient care plans and perceptions of importance of inclusion in a DPT curriculum. Objectives: A survey was sent out to 520 physical therapists in the United States (response rate 25%) Major Findings: Over 80% of respondents reported access to BPAs and of those, 92% used BPAs with patients. The most commonly used BPAs were cold packs, hot packs, and varied applications of electrical stimulation, while mechanical compression and diathermy were least frequently used. The most common rationale for BPA use was prior positive experience. Respondents’ perceptions of importance of inclusion of specific BPAs in a DPT curriculum mirrored some of the clinical usage patterns found in this study. Conclusions: BPAs are widely available and utilized in physical therapy practice in the United States. Rationale for clinician use of BPAs includes both prior positive experience- and evidence-based practice. Results from this study suggest the importance of BPAs in DPT curriculum to ensure safe and appropriate use. [ABSTRACT FROM AUTHOR]

Background and aimsIn the industrial world, almost everyone is unavoidably exposed to ambient magnetic field (ELF) generated by various technical and household appliances. According to the studies carried out in a power station in Shiraz, psychological disorders causedby jobs are among the most important problems of the workers.MethodsThis study is performed to determine the presence or absence of psychological disorders. The General Health Questionnaire (GHQ) is used in this study to recognize psychosomatic disorders.ResultsMeasurements indicate that range of magnetic field varies from 0.087) micro Tesla(in the phone homes to 30)micro Tesla( in power stations. The results of this study has shown that a significant number of staff which were exposed to magnetic fields and noise )78.2%) were suspected to have a kind of mental disorders.ConclusionThe results obtained from this study which shows the prevalence of mental disorders among the suspected case is higher than the results of Noorbala and colleagues study in 2006. Therefore, there are necessities to do more research in order to find the relationship between electric and magnetic fields and psychological disorders.

U radu je prikazana metoda za procenu rizika nastalog usled izloženosti čoveka vibracijama. Merenja vibracija koje se prenose na celo telo i na sistem šaka-ruka izvršena su za posadu helikoptera, rečnog broda i terenskog vozila. Izmerene vibracije ocenjene su prema kriterijumima 'štetnosti po zdravlje' i 'kvaliteta komfora'. / This paper presents test methods for assessing risks arising from human exposure to vibrations. The measuring of vibrations transmitted to the 'whole-body' and human 'hand-arm' system is carried out for helicopter, river boat and off-road vehicle crews. The measured vibrations are assessed according to the criteria of the 'health quality' level and the 'comfort quality' level.

Objective: To verify the efficacy of high voltage pulsed current in collagen realignment and synthesis and in angiogenesis after the partial rupturing of the Achilles tendon in rats. Method: Forty male Wistar rats were randomized into four groups of 10 animals each: sham, cathodic stimulation, anodic stimulation, and alternating stimulation. Their Achilles tendons were submitted to direct trauma by a free-falling metal bar. Then, the treatment was administered for six consecutive days after the injury. In the simulation group, the electrodes were positioned on the animal, but the device remained off for 30 minutes. The other groups used a frequency of 120 pps, sensory threshold, and the corresponding polarity. On the seventh day, the tendons were removed and sent for histological slide preparation for birefringence and Picrosirius Red analysis and for blood vessel quantification. Results: No significant difference was observed among the groups regarding collagen realignment (types I or III collagen) or quantity of blood vessels. Conclusion: High voltage pulsed current for six consecutive days was not effective in collagen realignment, synthesis, or angiogenesis after the partial rupturing of the Achilles tendon in rats. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: Systematic review. BACKGROUND: Soft tissue injuries to the lower limb bring a substantial health and economic burden to society. Physical agents are commonly used to treat these injuries. However, the effectiveness of many such physical agents is not clearly established in the literature. OBJECTIVE: To evaluate the effectiveness and safety of physical agents for soft tissue injuries of the lower limb. METHODS: We searched 5 databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort studies, and case-control studies. Paired reviewers independently screened the retrieved literature and appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a high risk of bias were excluded. We synthesized low-risk-of-bias studies according to principles of best-evidence synthesis. RESULTS: We screened 10261 articles. Of 43 RCTs identified, 20 had a high risk of bias and were excluded from the analysis, and 23 RCTs had a low risk of bias and were included in the analysis. The available higher-quality evidence suggests that patients with persistent plantar fasciitis may benefit from ultrasound or foot orthoses, while those with persistent midportion Achilles tendinopathy may benefit from Shockwave therapy. However, the current evidence does not support the use of Shockwave therapy for recent plantar fasciitis, low-Dye taping for persistent plantar fasciitis, low-level laser therapy for recent ankle sprains, or splints for persistent midportion Achilles tendinopathy. Finally, evidence on the effectiveness of the following interventions is not established in the current literature: (1) Shockwave therapy for persistent plantar fasciitis, (2) cryotherapy or as-sistive devices for recent ankle sprains, (3) braces for persistent midportion Achilles tendinopathy, and (4) taping or electric muscle stimulation for patellofemoral pain syndrome. CONCLUSION: Almost half the identified RCTs that evaluated the effectiveness of physical agents for the management of lower-limb soft tissue injuries had a high risk of bias. High-quality RCTs are still needed to assess the effectiveness of physical agents for managing the broad range of lower-limb soft tissue injuries. The effectiveness of most interventions remains unclear. [ABSTRACT FROM AUTHOR]