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American Journal of Physical Medicine &... Oct 2017Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor,... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life.
DESIGN
In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool.
RESULTS
Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs.
CONCLUSION
Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.
Topics: Animals; Disabled Persons; Equine-Assisted Therapy; Gait; Horses; Humans; Postural Balance; Quality of Life
PubMed: 28252520
DOI: 10.1097/PHM.0000000000000726 -
Journal of Bodywork and Movement... Jul 2022To investigate the effect of disk training and tape application on diminished proprioception after Lateral Ankle Sprain (LAS) in active populations. (Review)
Review
OBJECTIVE
To investigate the effect of disk training and tape application on diminished proprioception after Lateral Ankle Sprain (LAS) in active populations.
ELIGIBILITY CRITERIA
Only clinical trials investigating the effectiveness of disk training and ankle tape on proprioception deficits following LAS by assessing JPS or kinaesthesia were included.
INFORMATION SOURCES
Electronic databases of PubMed, MEDLINE, SPORTDiscus, CINAHL, Web of Science, Cochrane and PEDro were searched. The main search was conducted in February 2022.
RISK OF BIAS
The physiotherapy Evidence Database (PEDro) scale was utilised to assess the methodological quality of each article.
RESULT
The search yielded six studies investigating the effects of disk training and four studies investigating the effects of inelastic tape. Five articles showed a significant improvement on JPS after disk training. However, no difference across different intervention groups was observed in one study. Only one trial presented an immediate significant improvement when taped, while another study showed that external ankle supports significantly improved JPS after 2 weeks and after 2 months. Three of four studies found no immediate improvement on proprioceptive deficits by the use of tape.
CONCLUSIONS
This review found that disk training may improve impaired proprioception after LAS, whilst the efficacy of inelastic tape was not evident due to methodological quality of the few available studies. Further studies are needed to establish whether these interventions can be used clinically with sufficient evidence.
Topics: Ankle; Ankle Injuries; Ankle Joint; Humans; Physical Therapy Modalities; Proprioception
PubMed: 35710223
DOI: 10.1016/j.jbmt.2022.04.001 -
Topics in Stroke Rehabilitation May 2018Purpose It is hypothesized that peripheral somatosensory stimulation (PSS) can promote postural recovery after stroke by increasing afferent input and postural... (Review)
Review
Purpose It is hypothesized that peripheral somatosensory stimulation (PSS) can promote postural recovery after stroke by increasing afferent input and postural contribution of the paretic leg. Therefore, this systematic review aims to investigate which PSS approaches are documented and investigated on effectiveness. Methods Five databases (PubMed, Web of Science, PEDro, Cochrane Library Trials, RehabData) have been searched on clinical studies in stroke rehabilitation, investigating PSS, which is defined as a non-motor and focal stimulation to the paretic leg aiming an increase in somatosensory input. Results Twenty studies present different PSS approaches (mainly electrical and vibration stimulation) and following results: (I) There is an immediate effect after a single session of PSS on postural stability. In contrast, (II) repetitive sessions of isolated PSS led to highly inconsistent results. Finally, (III) PSS as an adjuvant to exercises did promote long-term postural recovery. Conclusion PSS is found to be effective immediately and on a long-term as an adjuvant therapy only in improving postural stability in a chronic stroke population. However, if PSS enhances paretic leg postural contribution remains unclear. Future research is warranted considering promising results and high prevalence of postural instability impacting daily life of stroke survivors.
Topics: Databases, Factual; Exercise Therapy; Humans; Postural Balance; Proprioception; Recovery of Function; Stroke; Stroke Rehabilitation
PubMed: 29473456
DOI: 10.1080/10749357.2018.1440694 -
NeuroRehabilitation 2020Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and...
BACKGROUND
Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI.
OBJECTIVE
To examine the effects of physical therapy interventions on balance impairments in individuals with TBI.
METHODS
We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale.
RESULTS
Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions.
CONCLUSIONS
The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.
Topics: Brain Injuries, Traumatic; Humans; Neurological Rehabilitation; Physical Therapy Modalities; Postural Balance; Randomized Controlled Trials as Topic
PubMed: 32508337
DOI: 10.3233/NRE-203047 -
Aging Clinical and Experimental Research Feb 2024The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease.... (Meta-Analysis)
Meta-Analysis Review
Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials.
The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease. Age-related declines in muscle mass and cognitive abilities significantly contribute to frailty and dependency. Thus, this study focuses on a meticulous analysis of the protective effects of multidomain interventions, an emerging resource combating age-related declines. It seeks to underscore their profound impact on cognitive flexibility and sarcopenia, highlighting their pivotal role in mitigating the adverse effects of aging. To identify relevant randomized controlled trials up to November 2023, we reviewed eight online academic databases, following PERSiST guidelines, PRISMA reporting system, and PICOs criteria. Meta-analyses on selected functional outcomes utilized a random-effects model, including the Timed Up and Go Test, Sit to Stand Test, Victoria Stroop Test, and Trail Making Test. Out of 2082 scrutinized articles, 17 were included in the systematic review, and 8 in the meta-analysis. Positive effects (p = 0.05, I = 57%; 95% CI - 0.63 to - 0.05) were observed in cognitive flexibility for certain interventions. Similarly, interventions addressing muscle strength demonstrated improvements in the Sit to Stand Test for the exercise group compared to the control group (p = 0.02, I = 0%; 95% CI - 0.63 to - 0.05). These findings underscore the importance of incorporating physical activity as a primary component of public health interventions for promoting healthy aging and reducing the burden of age-related diseases. Future interventions may explore more homogeneous approaches and evaluate the impact of thrice multidomain weekly sessions.
Topics: Humans; Aged; Sarcopenia; Healthy Aging; Postural Balance; Time and Motion Studies; Randomized Controlled Trials as Topic; Cognition
PubMed: 38386173
DOI: 10.1007/s40520-024-02700-2 -
Headache Mar 2022To summarize the evidence regarding static and dynamic balance alterations among patients with headache. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To summarize the evidence regarding static and dynamic balance alterations among patients with headache.
METHODS
Electronic databases (PubMed, CINAHL, and Web of Science) were searched by two researchers independently up to September 2021. Two reviewers selected eligible studies, extracted the data, and assessed the quality of evidence using the Downs and Black checklist. Case-control studies were included if they involved balance assessment of any kind of headache, including objective outcome measures of dynamic and static tests such as body sway displacement, limits of stability (LOS), gait, and tandem walk tests. A meta-analysis and post hoc sensitivity analyses were performed when possible.
RESULTS
Twenty-two studies (1202 patients with headache and 597 controls) were included in this review and 16 of them in the meta-analysis. Risk of bias ranged from low to moderate among all studies. Greater sway area in static posturography was shown by patients with migraine in comparison to controls, with more consistent differences in more challenging test conditions, such as over a foam surface with eyes closed (difference of 4.8 cm , 95% CI: 3.8-5.9). Lower performance of patients with migraine during the tandem walk test (difference of -7.8 cm/s, 95% CI: -9.0 to -6.5) and slower reaction time in the LOS test (difference of 0.3 s, 95% CI: 0.2-0.4) were also verified. There is no evidence of altered sway velocity and length in static posturography among patients with migraine (p > 0.05). The level of evidence is very low for balance alteration of any kind among patients with tension-type and cervicogenic headache owing to the limited number of studies and high heterogeneity.
CONCLUSION
This review confirmed the presence of static and dynamic balance alterations among patients with migraine. Future studies with low risk of bias are needed to decrease heterogeneity in methodology and explore the role of subdiagnosis on the balance of patients with headache.
Topics: Case-Control Studies; Headache; Humans; Migraine Disorders; Post-Traumatic Headache; Postural Balance
PubMed: 35315066
DOI: 10.1111/head.14281 -
Ageing Research Reviews Mar 2021To systematically examine stepping performance as a risk factor for falls. More specifically, we examined (i) if step tests can distinguish fallers from non-fallers and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically examine stepping performance as a risk factor for falls. More specifically, we examined (i) if step tests can distinguish fallers from non-fallers and (ii) the type of step test (e.g. volitional vs reactive stepping) that is required to distinguish fallers from non-fallers.
DATA SOURCE
PubMed, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and reference lists of included articles.
STUDY SELECTION
Cross-sectional and cohort studies that assessed the association between at least one step test and falls in older people (age ≥ 60 and/or mean age of 65).
RESULTS
A meta-analysis of 61 studies (n = 9536) showed stepping performance was significantly worse in fallers compared to non-fallers (Cohen'sd 0.56, 95 % CI 0.48 to 0.64, p < 0.001, I 66 %). This was the case for both volitional and reactive step tests. Twenty-three studies (n = 3615) were included in a diagnostic meta-analysis that showed that step tests have moderate sensitivity (0.70, 95 % CI 0.62 to 0.77), specificity (0.68, 95 % CI 0.58 to 0.77) and area under the receiver operating characteristics curve (AUC) (0.75, 95 % CI 0.59 to 0.86) in discriminating fallers from non-fallers.
CONCLUSIONS
This large systematic review demonstrated that both volitional and reactive stepping impairments are significant fall risk factors among older adults. Step tests can identify fallers from non-fallers with moderate accuracy.
Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Exercise Test; Humans; Postural Balance; Risk Factors
PubMed: 33352293
DOI: 10.1016/j.arr.2020.101238 -
PM & R : the Journal of Injury,... Jun 2023Patients with chronic ankle instability (CAI) may experience ankle force sense deficits due to mechanoreceptor injury and proprioceptive deafferentation in the affected... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Patients with chronic ankle instability (CAI) may experience ankle force sense deficits due to mechanoreceptor injury and proprioceptive deafferentation in the affected ankles. This study aimed to systematically review the literature and investigate (1) whether patients with CAI have impaired force sense when compared with uninjured contralateral sides or healthy controls, and (2) which characteristics of CAI (e.g., any measurement of CAI symptoms, clinical questionnaires, or functional tests on the injured ankles) are correlated with force sense deficits. TYPE: Systematic review and meta-analysis.
LITERATURE SURVEY
PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus were searched for ankle-related, injury-related, and force sense-related terms from inception to February 2, 2022.
METHODOLOGY
The following information was extracted from included articles: demographic data, sample size, selection criteria, methodology, force reproduction test outcomes, and correlations between force sense and other characteristics of CAI. Meta-analyses were conducted for the force sense outcomes, and a narrative review was undertaken for the correlation between force sense deficits and other characteristics of CAI.
SYNTHESIS
Eight studies were included. The meta-analyses revealed eversion force sense deficits of the injured ankles in absolute error (magnitude of force reproduction error) at 20% maximal voluntary isometric contractions (MVIC) (standardized mean difference [SMD] = 0.67, 95% confidence interval [CI] 0.23-1.11) and variable error (consistency of force reproduction) at 30% MVIC (SMD = 0.46, 95% CI 0.07-0.85), as compared with healthy controls. None of the included studies reported a significant correlation between these two deficits and other characteristics of CAI.
CONCLUSIONS
Patients with CAI have eversion force sense deficits in the magnitude of force reproduction error at 20% MVIC and the consistency of force reproduction at 30% MVIC.
Topics: Humans; Ankle; Ankle Joint; Proprioception; Isometric Contraction; Joint Instability; Ankle Injuries; Chronic Disease
PubMed: 35532066
DOI: 10.1002/pmrj.12833 -
Explore (New York, N.Y.) 2022The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease.
MATERIALS AND METHODS
A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study.
RESULTS
According to our meta-analysis; there was a significant effect of Tai Chi on balance (SMD, -0.777 95% CI -0.921 to -0.633; p = 0.000), functional mobility (SMD, -0.719 95% CI -0.944 to -0.494; p = 0.000), and falls (SMD, -0.456 95% CI -0.668 to -0.245; p = 0.000) in PD.
CONCLUSION
Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.
Topics: Humans; Parkinson Disease; Postural Balance; Tai Ji
PubMed: 34952799
DOI: 10.1016/j.explore.2021.12.002 -
Sensors (Basel, Switzerland) Jul 2021Compared to laboratory equipment inertial sensors are inexpensive and portable, permitting the measurement of postural sway and balance to be conducted in any setting.... (Meta-Analysis)
Meta-Analysis Review
Compared to laboratory equipment inertial sensors are inexpensive and portable, permitting the measurement of postural sway and balance to be conducted in any setting. This systematic review investigated the inter-sensor and test-retest reliability, and concurrent and discriminant validity to measure static and dynamic balance in healthy adults. Medline, PubMed, Embase, Scopus, CINAHL, and Web of Science were searched to January 2021. Nineteen studies met the inclusion criteria. Meta-analysis was possible for reliability studies only and it was found that inertial sensors are reliable to measure static standing eyes open. A synthesis of the included studies shows moderate to good reliability for dynamic balance. Concurrent validity is moderate for both static and dynamic balance. Sensors discriminate old from young adults by amplitude of mediolateral sway, gait velocity, step length, and turn speed. Fallers are discriminated from non-fallers by sensor measures during walking, stepping, and sit to stand. The accuracy of discrimination is unable to be determined conclusively. Using inertial sensors to measure postural sway in healthy adults provides real-time data collected in the natural environment and enables discrimination between fallers and non-fallers. The ability of inertial sensors to identify differences in postural sway components related to altered performance in clinical tests can inform targeted interventions for the prevention of falls and near falls.
Topics: Accidental Falls; Gait; Humans; Postural Balance; Reproducibility of Results; Walking; Young Adult
PubMed: 34372404
DOI: 10.3390/s21155167