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BioMed Research International 2017This study synthesized literature concerning casual evidence of effects of various physical activity programs on motor skills and cognitive development in typically... (Review)
Review
OBJECTIVE
This study synthesized literature concerning casual evidence of effects of various physical activity programs on motor skills and cognitive development in typically developed preschool children.
METHODS
Electronic databases were searched through July 2017. Peer-reviewed randomized controlled trials (RCTs) examining the effectiveness of physical activity on motor skills and cognitive development in healthy young children (4-6 years) were screened.
RESULTS
A total of 15 RCTs were included. Of the 10 studies assessing the effects of physical activity on motor skills, eight (80%) reported significant improvements in motor performance and one observed mixed findings, but one failed to promote any beneficial outcomes. Of the five studies investigating the influence of physical activity on cognitive development, four (80%) showed significant and positive changes in language learning, academic achievement, attention, and working memory. Notably, one indicated no significant improvements were observed after the intervention.
CONCLUSIONS
Findings support causal evidence of effects of physical activity on both motor skills and cognitive development in preschool children. Given the shortage of available studies, future research with large representative samples is warranted to explore the relationships between physical activity and cognitive domains as well as strengthen and confirm the dose-response evidence in early childhood.
Topics: Child; Child Development; Child, Preschool; Cognition; Exercise; Female; Humans; Male; Motor Skills; Randomized Controlled Trials as Topic
PubMed: 29387718
DOI: 10.1155/2017/2760716 -
BMJ Open May 2019To assess and compare the performance of triage systems for identifying high and low-urgency patients in the emergency department (ED). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess and compare the performance of triage systems for identifying high and low-urgency patients in the emergency department (ED).
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
EMBASE, Medline OvidSP, Cochrane central, Web of science and CINAHL databases from 1980 to 2016 with the final update in December 2018.
ELIGIBILITY CRITERIA
Studies that evaluated an emergency medical triage system, assessed validity using any reference standard as proxy for true patient urgency and were written in English. Studies conducted in low(er) income countries, based on case scenarios or involving less than 100 patients were excluded.
REVIEW METHODS
Reviewers identified studies, extracted data and assessed the quality of the evidence independently and in duplicate. The Quality Assessment of studies of Diagnostic Accuracy included in Systematic Reviews -2 checklist was used to assess risk of bias. Raw data were extracted to create 2×2 tables and calculate sensitivity and specificity. ED patient volume and casemix severity of illness were investigated as determinants of triage systems' performance.
RESULTS
Sixty-six eligible studies evaluated 33 different triage systems. Comparisons were restricted to the three triage systems that had at least multiple evaluations using the same reference standard (Canadian Triage and Acuity Scale, Emergency Severity Index and Manchester Triage System). Overall, validity of each triage system to identify high and low-urgency patients was moderate to good, but performance was highly variable. In a subgroup analysis, no clear association was found between ED patient volume or casemix severity of illness and triage systems' performance.
CONCLUSIONS
Established triage systems show a reasonable validity for the triage of patients at the ED, but performance varies considerably. Important research questions that remain are what determinants influence triage systems' performance and how the performance of existing triage systems can be improved.
Topics: Canada; Emergency Medical Services; Emergency Service, Hospital; Humans; Sensitivity and Specificity; Task Performance and Analysis; Triage
PubMed: 31142524
DOI: 10.1136/bmjopen-2018-026471 -
The Cochrane Database of Systematic... Nov 2017Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015.
OBJECTIVES
Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity.Secondary objectives: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance, global motor function, cognitive function, activity limitation, participation restriction, quality of life, and adverse events.
SEARCH METHODS
We searched the Cochrane Stroke Group Trials Register (April 2017), CENTRAL, MEDLINE, Embase, and seven additional databases. We also searched trials registries and reference lists.
SELECTION CRITERIA
Randomised and quasi-randomised trials of virtual reality ("an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance and global motor function.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data, and assessed risk of bias. A third review author moderated disagreements when required. The review authors contacted investigators to obtain missing information.
MAIN RESULTS
We included 72 trials that involved 2470 participants. This review includes 35 new studies in addition to the studies included in the previous version of this review. Study sample sizes were generally small and interventions varied in terms of both the goals of treatment and the virtual reality devices used. The risk of bias present in many studies was unclear due to poor reporting. Thus, while there are a large number of randomised controlled trials, the evidence remains mostly low quality when rated using the GRADE system. Control groups usually received no intervention or therapy based on a standard-care approach.
PRIMARY OUTCOME
results were not statistically significant for upper limb function (standardised mean difference (SMD) 0.07, 95% confidence intervals (CI) -0.05 to 0.20, 22 studies, 1038 participants, low-quality evidence) when comparing virtual reality to conventional therapy. However, when virtual reality was used in addition to usual care (providing a higher dose of therapy for those in the intervention group) there was a statistically significant difference between groups (SMD 0.49, 0.21 to 0.77, 10 studies, 210 participants, low-quality evidence).
SECONDARY OUTCOMES
when compared to conventional therapy approaches there were no statistically significant effects for gait speed or balance. Results were statistically significant for the activities of daily living (ADL) outcome (SMD 0.25, 95% CI 0.06 to 0.43, 10 studies, 466 participants, moderate-quality evidence); however, we were unable to pool results for cognitive function, participation restriction, or quality of life. Twenty-three studies reported that they monitored for adverse events; across these studies there were few adverse events and those reported were relatively mild.
AUTHORS' CONCLUSIONS
We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the type of device (commercial or customised) were not strong influencers of outcome. There was a trend suggesting that higher dose (more than 15 hours of total intervention) was preferable as were customised virtual reality programs; however, these findings were not statistically significant.
Topics: Activities of Daily Living; Gait; Humans; Postural Balance; Psychomotor Performance; Quality of Life; Randomized Controlled Trials as Topic; Stroke; Stroke Rehabilitation; Therapy, Computer-Assisted; Upper Extremity; User-Computer Interface; Video Games
PubMed: 29156493
DOI: 10.1002/14651858.CD008349.pub4 -
The American Journal of Occupational... 2018This systematic review addresses the question "What is the efficacy of occupational therapy using Ayres Sensory Integration (ASI) to support functioning and... (Review)
Review
This systematic review addresses the question "What is the efficacy of occupational therapy using Ayres Sensory Integration (ASI) to support functioning and participation as defined by the International Classification of Functioning, Disability and Health for persons with challenges in processing and integrating sensory information that interfere with everyday life participation?" Three randomized controlled trials, 1 retroactive analysis, and 1 single-subject ABA design published from 2007 to 2015, all of which happened to study children with autism, met inclusion criteria. The evidence is strong that ASI intervention demonstrates positive outcomes for improving individually generated goals of functioning and participation as measured by Goal Attainment Scaling for children with autism. Moderate evidence supported improvements in impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities. Child outcomes in play, sensory-motor, and language skills and reduced caregiver assistance with social skills had emerging but insufficient evidence.
Topics: Autism Spectrum Disorder; Child; Child Health Services; Humans; Occupational Therapy; Psychomotor Performance; Randomized Controlled Trials as Topic
PubMed: 29280711
DOI: 10.5014/ajot.2018.028431 -
Journal of Neurology Jun 2023Motor-cognitive training in Parkinson's disease (PD) can positively affect gait and balance, but whether motor-cognitive (dual-task) performance improves is unknown.... (Meta-Analysis)
Meta-Analysis Review
Motor-cognitive training in Parkinson's disease (PD) can positively affect gait and balance, but whether motor-cognitive (dual-task) performance improves is unknown. This meta-analysis, therefore, aimed to establish the current evidence on the effects of motor-cognitive training on dual-task performance in PD. Systematic searches were conducted in five databases and 11 studies with a total of 597 people (mean age: 68.9 years; mean PD duration: 6.8 years) were included. We found a mean difference in dual-task gait speed (0.12 m/s (95% CI 0.08, 0.17)), dual-task cadence (2.91 steps/min (95% CI 0.08, 5.73)), dual-task stride length (10.12 cm (95% CI 4.86, 15.38)) and dual-task cost on gait speed (- 8.75% (95% CI - 14.57, - 2.92)) in favor of motor-cognitive training compared to controls. The GRADE analysis revealed that the findings were based on high certainty evidence. Thus, we can for the first time systematically show that people with PD can improve their dual-task ability through motor-cognitive training.
Topics: Humans; Aged; Task Performance and Analysis; Parkinson Disease; Cognitive Training; Gait; Walking Speed
PubMed: 36820916
DOI: 10.1007/s00415-023-11610-8 -
International Journal of Environmental... Oct 2022The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD.
METHODS
On 28 June 2021, a systematic review with meta-analysis was performed using the following databases: MEDLINE, SciELO, LILACS, PEDro, SPORTDiscus, CINAHL, SCOPUS, Web of Science, Cochrane, and Science Direct. We analyzed the methodological quality and risk of bias using the Jadad scale and Cochrane tool, respectively. Motor coordination results were meta-analyzed using the RevMan program. Two independent researchers used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool to assess the level of evidence from the meta-analysis.
RESULTS
We found four studies in the listed databases and five randomized clinical trials were included in the meta-analysis that included 109 children with ASD. Children with ASD who performed physical activity did not present significantly better motor coordination than control children ( = 0.12).
CONCLUSIONS
Considering the clinical importance of physical activity for children with ASD, this systematic review with meta-analysis showed that physical activity had no statistically significant effects on coordination in individuals with ASD.
Topics: Child; Humans; Autism Spectrum Disorder; Motor Skills; Exercise
PubMed: 36360956
DOI: 10.3390/ijerph192114081 -
Biological Psychiatry Apr 2016Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has... (Review)
Review
Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistence or recovery across all cognitive domains remains underresearched. Associations between poorer performance and a range of cannabis use parameters, including a younger age of onset, are frequently reported. Little further evidence has emerged for the development of tolerance to the acutely impairing effects of cannabis. Evidence for potential protection from harmful effects by cannabidiol continues to increase but is not definitive. In light of increasing trends toward legalization of cannabis, the knowledge gained from this body of research needs to be incorporated into strategies to minimize harm.
Topics: Attention; Cannabinoids; Cannabis; Cognition; Cognition Disorders; Executive Function; Humans; Marijuana Abuse; Marijuana Smoking; Memory; Neuropsychological Tests; Psychomotor Performance; Verbal Learning
PubMed: 26858214
DOI: 10.1016/j.biopsych.2015.12.002 -
The Cochrane Database of Systematic... Nov 2016Repetitive task training (RTT) involves the active practice of task-specific motor activities and is a component of current therapy approaches in stroke rehabilitation. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Repetitive task training (RTT) involves the active practice of task-specific motor activities and is a component of current therapy approaches in stroke rehabilitation.
OBJECTIVES
Primary objective: To determine if RTT improves upper limb function/reach and lower limb function/balance in adults after stroke. Secondary objectives: 1) To determine the effect of RTT on secondary outcome measures including activities of daily living, global motor function, quality of life/health status and adverse events. 2) To determine the factors that could influence primary and secondary outcome measures, including the effect of 'dose' of task practice; type of task (whole therapy, mixed or single task); timing of the intervention and type of intervention.
SEARCH METHODS
We searched the Cochrane Stroke Group Trials Register (4 March 2016); the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 5: 1 October 2006 to 24 June 2016); MEDLINE (1 October 2006 to 8 March 2016); Embase (1 October 2006 to 8 March 2016); CINAHL (2006 to 23 June 2016); AMED (2006 to 21 June 2016) and SPORTSDiscus (2006 to 21 June 2016).
SELECTION CRITERIA
Randomised/quasi-randomised trials in adults after stroke, where the intervention was an active motor sequence performed repetitively within a single training session, aimed towards a clear functional goal.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened abstracts, extracted data and appraised trials. We determined the quality of evidence within each study and outcome group using the Cochrane 'Risk of bias' tool and GRADE (Grades of Recommendation, Assessment, Development and Evaluation) criteria. We did not assess follow-up outcome data using GRADE. We contacted trial authors for additional information.
MAIN RESULTS
We included 33 trials with 36 intervention-control pairs and 1853 participants. The risk of bias present in many studies was unclear due to poor reporting; the evidence has therefore been rated 'moderate' or 'low' when using the GRADE system. There is low-quality evidence that RTT improves arm function (standardised mean difference (SMD) 0.25, 95% confidence interval (CI) 0.01 to 0.49; 11 studies, number of participants analysed = 749), hand function (SMD 0.25, 95% CI 0.00 to 0.51; eight studies, number of participants analysed = 619), and lower limb functional measures (SMD 0.29, 95% CI 0.10 to 0.48; five trials, number of participants analysed = 419). There is moderate-quality evidence that RTT improves walking distance (mean difference (MD) 34.80, 95% CI 18.19 to 51.41; nine studies, number of participants analysed = 610) and functional ambulation (SMD 0.35, 95% CI 0.04 to 0.66; eight studies, number of participants analysed = 525). We found significant differences between groups for both upper-limb (SMD 0.92, 95% CI 0.58 to 1.26; three studies, number of participants analysed = 153) and lower-limb (SMD 0.34, 95% CI 0.16 to 0.52; eight studies, number of participants analysed = 471) outcomes up to six months post treatment but not after six months. Effects were not modified by intervention type, dosage of task practice or time since stroke for upper or lower limb. There was insufficient evidence to be certain about the risk of adverse events.
AUTHORS' CONCLUSIONS
There is low- to moderate-quality evidence that RTT improves upper and lower limb function; improvements were sustained up to six months post treatment. Further research should focus on the type and amount of training, including ways of measuring the number of repetitions actually performed by participants. The definition of RTT will need revisiting prior to further updates of this review in order to ensure it remains clinically meaningful and distinguishable from other interventions.
Topics: Activities of Daily Living; Adult; Extremities; Humans; Motor Activity; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Recovery of Function; Stroke Rehabilitation; Task Performance and Analysis; Walking
PubMed: 27841442
DOI: 10.1002/14651858.CD006073.pub3 -
Sports Medicine (Auckland, N.Z.) Mar 2016Agility is an important characteristic of team sports athletes. There is a growing interest in the factors that influence agility performance as well as appropriate... (Review)
Review
BACKGROUND
Agility is an important characteristic of team sports athletes. There is a growing interest in the factors that influence agility performance as well as appropriate testing protocols and training strategies to assess and improve this quality.
OBJECTIVE
The objective of this systematic review was to (1) evaluate the reliability and validity of agility tests in team sports, (2) detail factors that may influence agility performance, and (3) identify the effects of different interventions on agility performance.
METHODS
The review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of PubMed, Google Scholar, Science Direct, and SPORTDiscus databases. We assessed the methodological quality of intervention studies using a customized checklist of assessment criteria.
RESULTS
Intraclass correlation coefficient values were 0.80-0.91, 0.10-0.81, and 0.81-0.99 for test time using light, video, and human stimuli. A low-level reliability was reported for youth athletes using the video stimulus (0.10-0.30). Higher-level participants were shown to be, on average, 7.5% faster than their lower level counterparts. Reaction time and accuracy, foot placement, and in-line lunge movement have been shown to be related to agility performance. The contribution of strength remains unclear. Efficacy of interventions on agility performance ranged from 1% (vibration training) to 7.5% (small-sided games training).
CONCLUSIONS
Agility tests generally offer good reliability, although this may be compromised in younger participants responding to various scenarios. A human and/or video stimulus seems the most appropriate method to discriminate between standard of playing ability. Decision-making and perceptual factors are often propositioned as discriminant factors; however, the underlying mechanisms are relatively unknown. Research has focused predominantly on the physical element of agility. Small-sided games and video training may offer effective methods of improving agility, although practical issues may hinder the latter.
Topics: Athletic Performance; Exercise Test; Humans; Motor Skills; Movement; Physical Conditioning, Human; Reaction Time; Reproducibility of Results; Sports
PubMed: 26670456
DOI: 10.1007/s40279-015-0428-2 -
Physical & Occupational Therapy in... May 2018To describe the clinical properties and psychometric soundness of pediatric oral motor feeding assessments. (Review)
Review
AIM
To describe the clinical properties and psychometric soundness of pediatric oral motor feeding assessments.
METHODS
A systematic search was conducted using Medline, CINAHL, EMBASE, PsycInfo, and HAPI databases. Assessments were analyzed for their clinical and psychometric characteristics.
RESULTS
12 assessment tools were identified to meet the inclusion/exclusion criteria. Clinical properties varied from assessments evaluating oral-motor deficits, screening to identify feeding problems, and monitoring feeding progress. Most assessments were designed for children with developmental disabilities or cerebral palsy. Eleven assessments had psychometric evidence, of these nine had reliability and validity testing (Ability for Basic Feeding and Swallowing Scale for Children, Behavioral Assessment Scale of Oral Functions in Feeding, Dysphagia Disorder Survey, Functional Feeding Assessment-modified, Gisel Video Assessment, Montreal Children's Hospital Feeding Scale, Oral Motor Assessment Scale, Schedule for Oral Motor Assessment, and Screening Tool of Feeding Problems Applied to Children). The Brief Assessment of Motor Function-Oral Motor Deglutition and the Pediatric Assessment Scale for Severe Feeding Problems had reliability testing only. The Slurp Test was not tested for any psychometric properties. Overall, psychometric evidence was inconsistent and inadequate for the evaluative tools.
Topics: Adolescent; Child; Child, Preschool; Deglutition; Feeding and Eating Disorders; Humans; Infant; Motor Skills; Mouth; Psychometrics; Reproducibility of Results; Young Adult
PubMed: 28430014
DOI: 10.1080/01942638.2017.1290734