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Spinal Cord Jun 2023Systematic review and meta-analysis. Spinal cord injury (SCI) is a pathological condition that provokes the loss of one or more body functions due to an injury to the... (Meta-Analysis)
Meta-Analysis Review
STUDY DESIGN
Systematic review and meta-analysis. Spinal cord injury (SCI) is a pathological condition that provokes the loss of one or more body functions due to an injury to the spinal cord as a result of trauma or disease. Hydrotherapy plays a key role in the rehabilitation of neurological patients due to the properties of water environments.
OBJECTIVES
The goal of this study was to evaluate the efficacy of hydrotherapy in patients who suffer from SCIs.
METHODS
We searched 5 different databases: CINAHL, PubMed, Scopus, Web of Science, and PEDro for studies to include. Only randomized controlled trials (RCTs) published in English were considered. To evaluate the risk of bias, Jadad and PEDro scales were used.
RESULTS
Eleven Randomized Controlled Trials were included, and 3 articles remained to be analyzed. According to the evaluation through Cochrane Risk of Bias tool, one study had a high level of quality. The remaining 2 studies achieved a score indicative of a low level of quality. A total of 71 individuals with SCI were included in the studies; age and level of injury varied in each study. The outcome measures used in the studies were: Functional Independence Measure (FIM), Ashworth scale, CardioTouch 3000 s in sitting position and Quark CPET.
CONCLUSION
The aquatic environment provides a rehabilitation tool able to facilitate movement, physical and cardiovascular exercise, resistance training, and body relaxation.
Topics: Humans; Spinal Cord Injuries; Aquatic Therapy; Physical Therapy Modalities; Outcome Assessment, Health Care
PubMed: 36966260
DOI: 10.1038/s41393-023-00892-4 -
Supportive Care in Cancer : Official... Apr 2023The axillary web syndrome (AWS) is a surgical breast cancer sequel that limits the functionality of the patient and delays the protocol times of application of cancer... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The axillary web syndrome (AWS) is a surgical breast cancer sequel that limits the functionality of the patient and delays the protocol times of application of cancer treatments. This implies a long period of discomfort and limitations for the user.
OBJECTIVE
To investigate the different physiotherapy treatments for the AWS and how effective they are.
METHODS
A systematic review based on PRISMA protocol and registered in PROSPERO (CRD42021281354) was conducted. The research was performed using PubMed, Scopus, CINAHL, PEDro, and Web of Science databases during January 2022 and March 2022. All randomized controlled trials and controlled clinical trials were included in this review.
RESULTS
A total of 188 articles were identified, with 9 studies selected for the systematic review. These studies basically propose treatments based on exercises and stretching, manual therapy, and the combination of manual therapy and exercises.
CONCLUSIONS
Exercise and stretching are the most effective therapies within the field of physiotherapy for the rehabilitation of axillary web syndrome. They restore range of motion faster, reduce pain, improve quality of life, and reduce disabilities. Manual therapy, scar massage, and myofascial release could help improve outcomes but with worse results. The meta-analysis conclusion is that pain is the only outcome with a significant reduction after the application of physiotherapy treatments - 0.82 [- 1.67; 0.03]. This conclusion is drawn from the only three studies with small sample sizes.
Topics: Humans; Female; Breast Neoplasms; Quality of Life; Physical Therapy Modalities; Exercise Therapy; Musculoskeletal Manipulations; Pain
PubMed: 37043039
DOI: 10.1007/s00520-023-07666-x -
Pediatric Physical Therapy : the... Jul 2022To conduct a systematic review and meta-analysis on the effect of motor intervention on motor function of infants and toddlers with cerebral palsy (CP). (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis on the effect of motor intervention on motor function of infants and toddlers with cerebral palsy (CP).
METHODS
Four databases were searched for randomized controlled trials (RCTs) of motor interventions for children with or at high risk of CP younger than 36 months. Studies were excluded if less than 50% of children developed CP.
RESULTS
Eleven RCTs included 363 children; 85% diagnosed with CP. Very low-quality evidence supports that: (1) task-specific motor training was more effective than standard care for improving motor function (small effect), (2) constraint-induced movement therapy (CIMT) may be more effective than bimanual play or massage for improving function of the more affected hand (moderate effect), and high-intensity treadmill training is no more effective than low-intensity for improving walking.
CONCLUSIONS
Very low-quality evidence supports that task-specific motor training and CIMT may improve motor function of infants and toddlers with CP.The Supplemental Digital Content Video Abstract is available at: http://links.lww.com/PPT/A382 .
Topics: Cerebral Palsy; Child, Preschool; Hand; Humans; Infant; Massage; Physical Therapy Modalities; Walking
PubMed: 35671383
DOI: 10.1097/PEP.0000000000000914 -
Physical Therapy May 2023Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programs in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of pulmonary rehabilitation using minimal equipment for aerobic and/or resistance training in people with COPD.
METHODS
Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs for exercise capacity, health-related quality of life (HRQoL), and strength.
RESULTS
Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132 m). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = -27 to 56 m). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99, 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N, 95% CI = -2 to 13 N) or lower limb strength (20 N, 95% CI = -30 to 71 N).
CONCLUSION
In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength.
IMPACT
Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Quality of Life; Resistance Training; Exercise Therapy; Exercise Tolerance
PubMed: 37140475
DOI: 10.1093/ptj/pzad013 -
Disability and Rehabilitation Jun 2020To evaluate the effectiveness of the Bobath concept in sensorimotor rehabilitation after stroke. A systematic literature review was conducted on the Bobath concept from...
To evaluate the effectiveness of the Bobath concept in sensorimotor rehabilitation after stroke. A systematic literature review was conducted on the Bobath concept from the first publication available to January 2018, consulting PUBMED, CENTRAL, CINAHL and PEDro databases. Fifteen clinical trials were selected in two consecutive screenings. Two independent researchers rated the studies according to the PEDro scale from which a best evidence synthesis was derived to determine the strength of the evidence. The Bobath concept is not more effective than other approaches used in post-stroke rehabilitation. There is moderate evidence for the superiority of other therapeutic approaches such as forced use of the affected upper limb and constraint-induced movement therapy for motor control of the upper limb. The Bobath concept is not superior to other approaches for regaining mobility, motor control of the lower limb and gait, balance and activities of daily living of patients after stroke. There is moderate evidence regarding the superior results of other approaches in terms of the motor control and dexterity of the upper limb. Due to the limitations concerning the methodological quality of the studies, further well-designed studies are needed.Implications for rehabilitationThe Bobath concept is not superior to other approaches for patients after stroke.The treatments that incorporate overuse of the affected upper limb via intensive treatments with high-repetitions with or without robotic aids present greater effectiveness in the motor control of the upper limb and dexterity.
Topics: Gait Disorders, Neurologic; Humans; Neurological Rehabilitation; Stroke; Stroke Rehabilitation
PubMed: 31017023
DOI: 10.1080/09638288.2019.1590865 -
Physical Therapy May 2021Telerehabilitation is an option that should be adapted as soon as possible to face the crisis caused by coronavirus disease 2019. An umbrella and mapping review with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Telerehabilitation is an option that should be adapted as soon as possible to face the crisis caused by coronavirus disease 2019. An umbrella and mapping review with meta-meta-analysis (MMA) of the available scientific evidence was performed to determine whether telerehabilitation could be an effective alternative to conventional rehabilitation in physical therapist practice.
METHODS
A systematic review of reviews and a synthesis of the findings of all systematic evidence published to date with a visual map and a meta-meta-analysis (MMA) were performed. A systematic search was realized in Cochrane Database of Systematic Reviews, MEDLINE (PubMed), and Google Scholar. Two independent reviewers performed a data analysis and assessed the quality of the included reviews, assessing the risk of bias using ROBIS.
RESULTS
Twenty-nine articles that met the inclusion criteria were selected and divided according to the type of patient targeted for rehabilitation (patients with cardiorespiratory, musculoskeletal, and neurological conditions). The MMA regarding physical function between telerehabilitation and usual care rehabilitation did not reveal a statistically significant difference for patients with cardiorespiratory and musculoskeletal conditions. For patients with neurological conditions, the MMA revealed a statistically significant but negligible effect size in 6 reviews in favor of telerehabilitation (standardized mean difference = 0.18; 95% CI = 0.03-0.34).
CONCLUSION
The results of the present review showed that telerehabilitation offers positive clinical results, even comparable to conventional face-to-face rehabilitation approaches.
IMPACT
The advantages of lower cost and less interference by the rehabilitation processes in patients' daily life could justify implementing telerehabilitation in clinical settings in the coronavirus disease 2019 era.
Topics: COVID-19; Cardiac Rehabilitation; Humans; Musculoskeletal Diseases; Nervous System Diseases; Pandemics; Physical Therapy Modalities; Review Literature as Topic; SARS-CoV-2; Telerehabilitation
PubMed: 33611598
DOI: 10.1093/ptj/pzab075 -
Australian Occupational Therapy Journal Dec 2019Occupational therapists commonly provide intervention that promotes quality of life in people with Parkinson's disease. Existing research supports the effects of... (Review)
Review
INTRODUCTION
Occupational therapists commonly provide intervention that promotes quality of life in people with Parkinson's disease. Existing research supports the effects of multidisciplinary and motor intervention for people with Parkinson's disease. However, few studies have identified the effectiveness of occupational therapy intervention alone. The aim of this review was to examine the efficacy of interventions provided by occupational therapists for people with Parkinson's disease.
METHODS
A comprehensive database search of the literature was performed using Medline, EMBASE, PsycInfo and CINAHL between 2003 and January 2018. There were no restrictions on study design and studies with or without a control group were selected for review. Studies were included if intervention consisted of at least 50% of occupational therapy intervention for Parkinson's disease. Two independent reviewers extracted and synthesised data from relevant articles.
RESULTS
In all, 10 studies representing data from 1343 people with Parkinson's disease and 180 caregivers were included in this review. Occupational therapy interventions focussing on meaningful activities were shown to improve perceived occupational performance. Upper limb therapy programmes were shown to improve upper limb function in the short term though longer-term effects are unclear.
CONCLUSION
Current research supports interventions which are intermittent, short term and intensive, and involve tailored therapy plans working towards an individual's goals. Occupational therapists should implement goal-oriented intervention programmes in conjunction with following the guidance of existing best practice guidelines.
Topics: Activities of Daily Living; Aged; Australia; Databases, Factual; Female; Humans; Male; Occupational Therapy; Parkinson Disease; Quality of Life; Retrospective Studies; Treatment Outcome
PubMed: 31599467
DOI: 10.1111/1440-1630.12615 -
Journal of Bodywork and Movement... Jul 2023Complex Regional Pain Syndrome (CRPS) is an umbrella term for a variety of clinical presentations characterized by persistent pain usually in the hands or feet that is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Complex Regional Pain Syndrome (CRPS) is an umbrella term for a variety of clinical presentations characterized by persistent pain usually in the hands or feet that is disproportionate to any preceding injury and characterized by many autonomic, sensory, and motor symptoms. CRPS is among the most common causes of post stroke shoulder pain in approximately 80% of stroke survivors. This study reviewed the available literature of physiotherapy treatment for CRPS following a stroke.
METHODS
Two electronic databases; PubMed and Google Scholar were searched to screen the articles from 2008 to March 2021 to be included in the study. Meta-analysis was done using the RevMan version 5.4 software. Higgins I and Chi-square (Tau) statistical tests were used to assess heterogeneity.
RESULTS
Out of all 389 studies, only 4 RCT's were included for systematic review and meta-analysis. Mirror therapy, Laser therapy and Fluidotherapy was found to be effective than control in improving pain intensity (SMD 4.13, 95% CI 3.51 to 4.74, I2 = 99%) and functional independence (SMD 2.07, 95% CI 1.45 to 2.70, I = 100%) in patients with CRPS following stroke.
CONCLUSION
This review concluded that physiotherapy interventions in the form of exercise therapy and electrotherapy has proven to be effective in treating the symptoms of CRPS following stroke. This commonest and devastating condition has not been studied to an extent in clinical settings, there is an utmost need for further studies using the available literature.
Topics: Humans; Complex Regional Pain Syndromes; Physical Therapy Modalities; Electric Stimulation Therapy; Stroke; Exercise Therapy
PubMed: 37330766
DOI: 10.1016/j.jbmt.2023.04.040 -
Journal of Oral Rehabilitation Apr 2022Within physical therapy, manual therapy is known to be effective for managing temporomandibular disorders (TMDs). However, manual therapy is a broad term including... (Review)
Review
BACKGROUND
Within physical therapy, manual therapy is known to be effective for managing temporomandibular disorders (TMDs). However, manual therapy is a broad term including different approaches applied to different body regions.
AIMS
This is the first systematic review that aims to evaluate the effectiveness of manual therapy applied specifically to the craniomandibular structures (Cranio-Mandibular Manual Therapy [CMMT]) on pain and maximum mouth opening in people with TMD.
MATERIAL AND METHODS
This systematic review was developed based on a pre-determined published protocol which was prospectively registered with PROSPERO (CRD42019160213). A search of MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews-Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar databases was conducted from inception until October 2020. Randomised controlled trials comparing the effect of CMMT on pain and maximum mouth opening versus other types of treatment in TMDs were included. Two reviewers independently screened articles for inclusion, extracted data, assessed risk of bias with the revised Cochrane risk of bias tool for randomised trials and evaluated the overall quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluations.
RESULTS
A total of 2720 records were screened, of which only 6 (293 participants) satisfied the inclusion criteria. All studies showed some concerns in risk of bias, except for one, which was high risk of bias. The overall quality of evidence was very low for all outcomes because of high heterogeneity and small sample sizes. All studies showed a significant improvement in pain and maximum mouth opening for CMMT from baseline in the mid-term, but only two showed superiority compared to other interventions. Given the high heterogeneity and small sample sizes of the included studies, a quantitative synthesis was not performed.
DISCUSSION AND CONCLUSION
There is the need for future high methodology research investigating different manual therapy techniques applied to different regions and different populations (e.g., chronic versus acute TMD) to determine what is most effective for pain and maximum mouth opening in patients with TMDs.
Topics: Humans; Mandible; Musculoskeletal Manipulations; Physical Therapy Modalities; Temporomandibular Joint Disorders
PubMed: 34931336
DOI: 10.1111/joor.13299 -
Developmental Neurorehabilitation 2023The aim of the review was to evaluate the evidence regarding the effectiveness of aquatic rehabilitation based on the Halliwick concept (HC) in psychomotor development,... (Review)
Review
The aim of the review was to evaluate the evidence regarding the effectiveness of aquatic rehabilitation based on the Halliwick concept (HC) in psychomotor development, gross motor function and aquatic skills of children with cerebral palsy. We followed PRISMA recommendations, performing a systematic search in PubMed, Science Direct, LILACS, SciELO, and PEDro database. We identified 474 studies; five met the eligibility criteria and were included in the review. Four studies demonstrated a significant improvement in gross motor function and aquatic skills. Social interaction skills were also improved. However, the methodological quality of these studies was limited, and then, research that adopt controlled experimental designs are necessary.
Topics: Child; Humans; Cerebral Palsy; Aquatic Therapy
PubMed: 37728374
DOI: 10.1080/17518423.2023.2259986