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Journal of Musculoskeletal & Neuronal... Jun 2015We performed a meta-analysis to evaluate the effects of whole-body vibration on physiologic and functional measurements in children with cerebral palsy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We performed a meta-analysis to evaluate the effects of whole-body vibration on physiologic and functional measurements in children with cerebral palsy.
DESIGN AND METHODS
We searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, Scielo, CINAHL (from the earliest date available to November 2014) for randomized controlled trials, that aimed to investigate the effects of whole-body vibration versus exercise and/or versus control on physiologic and functional measurements in children with cerebral palsy. Two reviewers independently selected the studies. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated.
RESULTS
Six studies with 176 patients comparing whole-body vibration to exercise and/or control were included. Whole-body vibration resulted in improvement in: gait speed WMDs (0.13 95% CI: 0.05 to 0.20); gross motor function dimension E WMDs (2.97 95% CI: 0.07 to 5.86) and femur bone density (1.32 95% CI: 0.28 to 2.36). The meta-analysis also showed a nonsignificant difference in muscle strength and gross motor function dimension D for participants in the whole-body vibration compared with control group. No serious adverse events were reported.
CONCLUSIONS
Whole-body vibration may improve gait speed and standing function in children with cerebral palsy and could be considered for inclusion in rehabilitation programs.
Topics: Adolescent; Cerebral Palsy; Child; Exercise Therapy; Female; Humans; Male; Mobility Limitation; Physical Therapy Modalities; Postural Balance; Vibration
PubMed: 26032205
DOI: No ID Found -
Archives of Physical Medicine and... Sep 2013To conduct a systematic review of evidence surrounding the effects of exercise training on physical fitness, mobility, fatigue, and health-related quality of life in... (Meta-Analysis)
Meta-Analysis Review
Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development.
OBJECTIVE
To conduct a systematic review of evidence surrounding the effects of exercise training on physical fitness, mobility, fatigue, and health-related quality of life in adults with multiple sclerosis (MS).
DATA SOURCES
The databases included EMBASE, 1980 to 2011 (wk 12); Ovid MEDLINE and Ovid OLDMEDLINE, 1947 to March (wk 3) 2011; PsycINFO, 1967 to March (wk 4) 2011; CINAHL all-inclusive; SPORTDiscus all-inclusive; Cochrane Library all-inclusive; and Physiotherapy Evidence Database all-inclusive.
STUDY SELECTION
The review was limited to English-language studies (published before December 2011) of people with MS that evaluated the effects of exercise training on outcomes of physical fitness, mobility, fatigue, and/or health-related quality of life.
DATA EXTRACTION
One research assistant extracted data and rated study quality. A second research assistant verified the extraction and quality assessment.
DATA SYNTHESIS
From the 4362 studies identified, 54 studies were included in the review. The extracted data were analyzed using a descriptive approach. There was strong evidence that exercise performed 2 times per week at a moderate intensity increases aerobic capacity and muscular strength. The evidence was not consistent regarding the effects of exercise training on other outcomes.
CONCLUSIONS
Among those with mild to moderate disability from MS, there is sufficient evidence that exercise training is effective for improving both aerobic capacity and muscular strength. Exercise may improve mobility, fatigue, and health-related quality of life.
Topics: Exercise Therapy; Fatigue; Humans; Mobility Limitation; Multiple Sclerosis; Physical Fitness; Practice Guidelines as Topic; Quality of Life; Walking
PubMed: 23669008
DOI: 10.1016/j.apmr.2013.04.020 -
The Cochrane Database of Systematic... May 2020Stroke is caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels within the brain (hemorrhagic stroke) and may lead to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Stroke is caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels within the brain (hemorrhagic stroke) and may lead to changes in perception, cognition, mood, speech, health-related quality of life, and function, such as difficulty walking and using the arm. Activity limitations (decreased function) of the upper extremity are a common finding for individuals living with stroke. Mental practice (MP) is a training method that uses cognitive rehearsal of activities to improve performance of those activities.
OBJECTIVES
To determine whether MP improves outcomes of upper extremity rehabilitation for individuals living with the effects of stroke. In particular, we sought to (1) determine the effects of MP on upper extremity activity, upper extremity impairment, activities of daily living, health-related quality of life, economic costs, and adverse effects; and (2) explore whether effects differed according to (a) the time post stroke at which MP was delivered, (b) the dose of MP provided, or (c) the type of comparison performed.
SEARCH METHODS
We last searched the Cochrane Stroke Group Trials Register on September 17, 2019. On September 3, 2019, we searched the Cochrane Central Register of Controlled Trials (the Cochrane Library), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Web of Science, the Physiotherapy Evidence Database (PEDro), and REHABDATA. On October 2, 2019, we searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. We reviewed the reference lists of included studies.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) of adult participants with stroke who had deficits in upper extremity function (called upper extremity activity).
DATA COLLECTION AND ANALYSIS
Two review authors screened titles and abstracts of the citations produced by the literature search and excluded obviously irrelevant studies. We obtained the full text of all remaining studies, and both review authors then independently selected trials for inclusion. We combined studies when the review produced a minimum of two trials employing a particular intervention strategy and a common outcome. We considered the primary outcome to be the ability of the arm to be used for appropriate tasks, called upper extremity activity. Secondary outcomes included upper extremity impairment (such as quality of movement, range of motion, tone, presence of synergistic movement), activities of daily living (ADLs), health-related quality of life (HRQL), economic costs, and adverse events. We assessed risk of bias in the included studies and applied GRADE to assess the certainty of the evidence. We completed subgroup analyses for time since stroke, dosage of MP, type of comparison, and type of arm activity outcome measure.
MAIN RESULTS
We included 25 studies involving 676 participants from nine countries. For the comparison of MP in addition to other treatment versus the other treatment, MP in combination with other treatment appears more effective in improving upper extremity activity than the other treatment without MP (standardized mean difference [SMD] 0.66, 95% confidence interval [CI] 0.39 to 0.94; I² = 39%; 15 studies; 397 participants); the GRADE certainty of evidence score was moderate based on risk of bias for the upper extremity activity outcome. For upper extremity impairment, results were as follows: SMD 0.59, 95% CI 0.30 to 0.87; I² = 43%; 15 studies; 397 participants, with a GRADE score of moderate, based on risk of bias. For ADLs, results were as follows: SMD 0.08, 95% CI -0.24 to 0.39; I² = 0%; 4 studies; 157 participants; the GRADE score was low due to risk of bias and small sample size. For the comparison of MP versus conventional treatment, the only outcome with available data to combine (3 studies; 50 participants) was upper extremity impairment (SMD 0.34, 95% CI -0.33 to 1.00; I² = 21%); GRADE for the impairment outcome in this comparison was low due to risk of bias and small sample size. Subgroup analyses of time post stroke, dosage of MP, or comparison type for the MP in combination with other rehabilitation treatment versus the other treatment comparison showed no differences. The secondary outcome of health-related quality of life was reported in only one study, and no study noted the outcomes of economic costs and adverse events.
AUTHORS' CONCLUSIONS
Moderate-certainty evidence shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity activity. Moderate-certainty evidence also shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity impairment after stroke. Low-certainty evidence suggests that ADLs may not be improved with MP in addition to other treatment versus the other treatment. Low-certainty evidence also suggests that MP versus conventional treatment may not improve upper extremity impairment. Further study is required to evaluate effects of MP on time post stroke, the volume of MP required to affect outcomes, and whether improvement is maintained over the long term.
Topics: Arm; Combined Modality Therapy; Female; Humans; Imagination; Male; Paresis; Practice, Psychological; Randomized Controlled Trials as Topic; Recovery of Function; Stroke; Stroke Rehabilitation
PubMed: 32449959
DOI: 10.1002/14651858.CD005950.pub5 -
Clinical Rehabilitation May 2018The technique called Lee Silverman Voice Treatment (LSVT)-LOUD has previously been used to improve voice quality in people with Parkinson's disease. The objective of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The technique called Lee Silverman Voice Treatment (LSVT)-LOUD has previously been used to improve voice quality in people with Parkinson's disease. The objective of this study was to assess the effectiveness of an alternate intervention, LSVT-BIG (signifying big movements), to improve functional mobility.
DESIGN
Systematic review with meta-analysis of randomized trials.
DATA SOURCES
Medline, Embase, CINAHL, AgeLine, Scopus and Cochrane Library were searched from inception to September 2017 using multiple search terms related to Parkinson's disease and LSVT-BIG.
REVIEW METHOD
Two researchers searched the literature for studies of the LSVT-BIG intervention of 16 sessions, delivered by a certified instructor over four weeks, to any other intervention. Outcomes related to functional ability were included. Study quality was appraised using the Cochrane Risk of Bias tool.
RESULTS
Four studies were included, reporting on three randomized trials of 84 participants with mild Parkinson's disease. Compared to physiotherapy exercises, or a shorter training protocol, there was a significant improvement in motor function assessed with the Unified Parkinson's Disease Rating Scale part III (mean difference = -3.20, 95% confidence interval = -5.18 to -1.23) and a trend towards faster Timed Up and Go performance (mean difference = -0.47, 95% confidence interval = -0.99 to 0.06) and 10-metre walk test (mean difference = -0.53, 95% confidence interval = -1.07 to 0.01).
CONCLUSION
Compared to shorter format LSVT-BIG or general exercise, LSVT-BIG was more effective at improving motor function. This provides preliminary, moderate quality evidence that amplitude-oriented training is effective in reducing motor impairments for people with mild Parkinson's disease.
Topics: Disability Evaluation; Exercise Therapy; Gait Disorders, Neurologic; Humans; Mobility Limitation; Parkinson Disease
PubMed: 28980476
DOI: 10.1177/0269215517734385 -
Archives of Physical Medicine and... Jul 2013To determine the effectiveness of an ankle-foot orthosis (AFO) on mobility, walking, and balance in people with stroke. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the effectiveness of an ankle-foot orthosis (AFO) on mobility, walking, and balance in people with stroke.
DATA SOURCES
The following databases were searched from inception to November 2011: Cochrane Stroke, Movement Disorders and Injuries Groups, MEDLINE, Embase, CINAHL, AMED, PsycINFO, and the Physiotherapy Evidence Database. Previous reviews, reference lists, and citation tracking of the selected articles were screened, and the authors of selected trials were contacted for any further unpublished data.
STUDY SELECTION
Randomized controlled trials of AFOs in people with stroke, which measured balance, walking impairments, or mobility and were reported in English, were selected. Then we independently identified trials, extracted data, and assessed trial quality.
DATA EXTRACTION
Trials with a low risk of selection, performance, and attrition bias were selected for analysis. Information on the trial design, population recruited, intervention delivered, outcomes measured, and the mean ± SD values for the treatment and control groups were extracted.
DATA SYNTHESIS
Continuous outcomes were combined using weighted or standardized mean differences with 95% confidence intervals and a fixed-effect model. Thirteen trials with 334 participants were selected. The effect of an AFO on walking activity (P=.000-.001), walking impairment (P=.02), and balance (weight distribution) (P=.003) was significant and beneficial. The effect on postural sway (P=.10) and timed mobility tests (P=.07-.09) was nonsignificant, and the effect on functional balance was mixed. The selected trials were all crossover trials of the immediate effects; long-term effects are unexplored.
CONCLUSIONS
An AFO can improve walking and balance after stroke, but only the immediate effects have been examined. The effects and acceptability of long-term usage need to be evaluated.
Topics: Ankle; Foot; Humans; Mobility Limitation; Orthotic Devices; Postural Balance; Randomized Controlled Trials as Topic; Stroke Rehabilitation; Walking
PubMed: 23416220
DOI: 10.1016/j.apmr.2012.12.025 -
Clinical Rehabilitation Nov 2009To identify psychometrically robust and clinically feasible measures of walking and mobility in people with neurological conditions. (Review)
Review
OBJECTIVE
To identify psychometrically robust and clinically feasible measures of walking and mobility in people with neurological conditions.
DATA SOURCES
MEDLINE, CINAHL, EMBASE, PEDro and AMED.
REVIEW METHODS
Independent reviewers selected and extracted data from articles that assessed the reliability, validity, sensitivity to change or clinical utility of measures of walking and mobility in adult neurological conditions. Measures with 'good' psychometrics and 9/10 clinical utility scores were recommended.
RESULTS
Seventeen measures were selected. Of these, the 5-m and 10-m walk tests, six-minute walk test, High Level Mobility Assessment Tool (HiMAT) and the Rivermead Mobility Index (RMI) reached the required standards and are usable in clinical practice. None of the recommended measures assessed wheelchair mobility. The least frequently assessed property was sensitivity to change. Further measures could be recommended if the minimal detectable change were demonstrated.
CONCLUSION
The 5-m, 10-m and six-minute walk test, High Level Mobility Assessment Tool and the Rivermead Mobility Index are psychometrically robust measures of walking and mobility and are feasible for use in clinical practice.
Topics: Disability Evaluation; Humans; Mobility Limitation; Nervous System Diseases; Observer Variation; Psychometrics; Reproducibility of Results; Walking
PubMed: 19786420
DOI: 10.1177/0269215509339004 -
Systematic Reviews Sep 2023We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies...
We investigated whether an impediment to progress in understanding the environmental factors that cause falls may be the difficulty in comparing results across studies because walking surfaces are poorly defined and underspecified. We conducted a systematic review of 384 studies from 370 articles that tested how different surfaces influenced human walking and falling. For each study, we report which categories of surfaces were used (indoor, outdoor, treadmill, virtual reality and qualitative), the nature of each surface (stairs, slopes, slippery, compliant, rough or default) and how information about each surface was measured. We found that minimal information was provided for many surfaces, making it impossible to meaningfully compare results for different types of surfaces across studies. We conclude that most published studies of walking and falling provide insufficient data to describe the surfaces that they used and we provide recommendations about how to improve the reporting of walking surfaces.
Topics: Humans; Accidental Falls; Virtual Reality; Walking
PubMed: 37660050
DOI: 10.1186/s13643-023-02315-0 -
Clinical Interventions in Aging 2017A new term, dysmobility syndrome, has recently been described as a new approach to identify older people at risk of poor health outcomes. The aim was to undertake a... (Review)
Review
BACKGROUND
A new term, dysmobility syndrome, has recently been described as a new approach to identify older people at risk of poor health outcomes. The aim was to undertake a systematic review of the existing research literature on dysmobility syndrome.
METHOD
All articles reporting dysmobility syndrome were identified in a systematic review of Medline (Proquest), CINAHL, PubMed, PsycInfo, EMBASE, and Scopus databases. Key characteristics of identified studies were extracted and summarized.
RESULTS
The systematic review identified five papers (three cross-sectional, one case control, and one longitudinal study). No intervention studies were identified. Prevalence of dysmobility syndrome varied between studies (22%-34% in three of the studies). Dysmobility syndrome was shown to be associated with reduced function, increased falls and fractures, and a longitudinal study showed its significant association with mortality.
CONCLUSION
Early research on dysmobility syndrome indicates that it may be a useful classification approach to identify older people at risk of adverse health outcomes and to target for early interventions. Future research needs to standardize the optimal mix of measures and cut points, and investigate whether balance performance may be a more useful factor than history of falls for dysmobility syndrome.
Topics: Accidental Falls; Aged; Aging; Body Composition; Bone Diseases, Metabolic; Case-Control Studies; Cross-Sectional Studies; Fractures, Bone; Frail Elderly; Humans; Longitudinal Studies; Mobility Limitation; Muscle Strength; Prevalence; Syndrome
PubMed: 28144132
DOI: 10.2147/CIA.S102961 -
Zeitschrift Fur Naturforschung. C,... Jan 2023The COVID-19 mainly causes respiratory disorders with high infection and severe morbidity and mortality. Neurologists have concerns about potential neurological side... (Review)
Review
The COVID-19 mainly causes respiratory disorders with high infection and severe morbidity and mortality. Neurologists have concerns about potential neurological side effects, profits, and timing of COVID-19 vaccines. This study aimed to review systematically research for the COVID-19 vaccine and neurological complications. Data was searched in Scopus, ISI web of knowledge, Medline, PubMed, Wiley, Embase, International Clinical Trials Registry Platform and Clinical Trials, Cochrane Library, and Google Scholar. Two reviewer authors individually searched and assessed the titles and abstracts of all articles. The third reviewer resolved disagreement between them. Data were documented regarding study location, study design, type of complications, number of patients, various types of COVID-19 vaccine, and type of neurological complications. Six studies in COVID-19 vaccine and neurological complications include two studies about neurological manifestations after the mRNA vaccines, four records about side effects of vector-based vaccine were included in the study. The main neurological complication associated mRNA vaccines were body aches, paresthesia, and difficulty walking, erythema migrans lesion, fatigue, myalgia, and pain in the left lateral deltoid region. The major neurological complication related to vector-based vaccines were urinary retention difficulty, feeding and ambulating, arm soreness, mild fatigue, chills, left-sided facial droop, headaches, a generalized epileptic seizure, hemianopia, and mild aphasia, acute somnolence and right-hand hemiparesis, acute transverse myelitis, deep vein thrombosis in her left leg, a vigilance disorder and a twitching, a severe immobilizing opsoclonus myoclonus syndrome, and encephalitis. A large spectrum of severe neurological unfavorable has been reported. These complications could occur as a result of molecular stimulation and later neuronal damage. Generally, the advantages of COVID-19 vaccination are dominant on the risks of a neurological complication at both individual and population levels. Future investigations will be required to find any relationship between neurological complications and COVID-19 vaccines principally as new strains of the virus and new vaccines are technologically advanced against them.
Topics: Humans; Female; COVID-19 Vaccines; COVID-19
PubMed: 36087300
DOI: 10.1515/znc-2022-0092 -
Disability and Rehabilitation Sep 2022To identify the short-term effects of robotic-assisted gait training (RAGT) on walking distance, gait speed and functionality of cerebral palsy (CP) patients, and to... (Meta-Analysis)
Meta-Analysis
Clinical effects of assisted robotic gait training in walking distance, speed, and functionality are maintained over the long term in individuals with cerebral palsy: a systematic review and meta-analysis.
PURPOSE
To identify the short-term effects of robotic-assisted gait training (RAGT) on walking distance, gait speed and functionality of cerebral palsy (CP) patients, and to verify if the effects of RAGT are maintained in the long term.
METHODS
A systematic literature review was performed in PubMed, PEDro, CINAHL, and LILACS databases. Studies were included considering: (1) population (CP individuals); (2) study design (experimental studies); (3) type of intervention (RAGT); (4) outcome (gait parameters and function); and (5) period (short and long term).
RESULTS
This systematic review included seven articles in meta-analysis. Only walking distance, thru six minutes walking test, increased statistically after RAGT. However, RAGT demonstrated large clinical effects differences (minimal clinically important difference - MCID) in gait speed and Gross Motor Function Measure score (dimensions D and E), for CP population. After RAGT intervention, differences in short term (comparison 1) were maintained in long term (comparison 2) for all outcomes. Gait speed results were not significant.
CONCLUSIONS
Evidence from the present study demonstrated that RAGT can be an important intervention to improve gait parameters and functionality, in children with CP, that are maintained over long-term.Implications for RehabilitationRobotic-assisted gait training (RAGT) is a beneficial treatment for children with cerebral palsy (CP).RAGT improvements in walking distance are maintained over the long-term in children with CP.RAGT demonstrated large clinical effect differences in gait speed and functionality in CP population.
Topics: Cerebral Palsy; Child; Exercise Therapy; Gait; Humans; Robotic Surgical Procedures; Robotics; Walking
PubMed: 34232847
DOI: 10.1080/09638288.2021.1942242