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Arquivos de Neuro-psiquiatria Jun 2021Multiple sclerosis (MS) is a major cause of chronic neurological disability in young adults. An increasing number of controlled studies have assessed the potential...
BACKGROUND
Multiple sclerosis (MS) is a major cause of chronic neurological disability in young adults. An increasing number of controlled studies have assessed the potential rehabilitative effects of new drug-free treatments, complementary to the standard care, including music-based therapy (MBT).
OBJECTIVE
To analyze the evidence for the effectiveness of MBT within the therapeutic approaches to individuals diagnosed with MS.
METHODS
A systematic review of clinical trials was performed with searches in the following databases: BIOSIS, CINAHL, Cochrane, EBSCO, ERIC, Google Scholar, IBECS, LILACS, LISA (ProQuest), Medline, PEDro, PsycINFO (APA), Psychological & Behavioral, PubMed, SciELO, Scopus, SPORTDiscus and Web of Science. Clinical trials comparing MBT versus conventional therapy/no intervention were included.
RESULTS
From the 282 studies identified, 10 trials were selected. Among these, the total sample consisted of 429 individuals: 253 were allocated to the experimental group (MBT) and 176 to the control group (conventional therapies or no intervention). All the studies presented high methodological quality. Modalities of MBT were clustered into four groups: (1) Rhythmic auditory; (2) Playing musical instruments; (3) Dance strategy; and (4) Neurological music therapy. Overall, the studies consistently showed that MBT was better than conventional therapy or no intervention, with regard to gait parameters (double support time and walking speed), fatigue level, fatigability, coordination, dexterity, balance, walking endurance, lower extremity functional strength, emotional status and pain. Regarding mental fatigability and memory, the data were conflicting and the evidence was unclear.
CONCLUSION
MBT is a safe and effective approach for clinical rehabilitation of MS patients that leads to positive results regarding both motor and non-motor functions.
Topics: Clinical Trials as Topic; Emotions; Gait; Humans; Multiple Sclerosis; Music; Music Therapy
PubMed: 34320057
DOI: 10.1590/0004-282X-ANP-2020-0374 -
Frontiers in Psychology 2021Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However,...
Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However, the brain of a child is not simply a small adult brain, and therefore adult theories are not directly translatable to the pediatric population. The present study aims to synthesize brain imaging data about the neural processing of music in children aged 0-18 years, to form a theoretical basis for music interventions with children presenting with a disorder of consciousness following acquired brain injury. We conducted a systematic review with narrative synthesis utilizing an adaptation of the methodology developed by Popay and colleagues. Following the development of the narrative that answered the central question "what does brain imaging data reveal about the receptive processing of music in children?", discussion was centered around the clinical implications of music therapy with children following acquired brain injury. The narrative synthesis included 46 studies that utilized EEG, MEG, fMRI, and fNIRS scanning techniques in children aged 0-18 years. From birth, musical stimuli elicit distinct but immature electrical responses, with components of the auditory evoked response having longer latencies and variable amplitudes compared to their adult counterparts. Hemodynamic responses are observed throughout cortical and subcortical structures however cortical immaturity impacts musical processing and the localization of function in infants and young children. The processing of complex musical stimuli continues to mature into late adolescence. While the ability to process fundamental musical elements is present from birth, infants and children process music more slowly and utilize different cortical areas compared to adults. Brain injury in childhood occurs in a period of rapid development and the ability to process music following brain injury will likely depend on pre-morbid musical processing. Further, a significant brain injury may disrupt the developmental trajectory of complex music processing. However, complex music processing may emerge earlier than comparative language processing, and occur throughout a more global circuitry.
PubMed: 33935868
DOI: 10.3389/fpsyg.2021.615209 -
Frontiers in Psychology 2021People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both...
People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
PubMed: 33868071
DOI: 10.3389/fpsyg.2021.581578 -
PloS One 2020We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of...
OBJECTIVE
We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions.
METHODS
A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers.
RESULTS
Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers.
CONCLUSIONS
The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.
Topics: Art Therapy; Caregivers; Humans; Mental Health; Music Therapy; Nervous System Diseases; Quality of Life; Sensory Art Therapies
PubMed: 33284840
DOI: 10.1371/journal.pone.0243461 -
BMC Neurology Oct 2020Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the...
A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease.
BACKGROUND
Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status.
METHODS
Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists.
RESULTS
Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains.
CONCLUSIONS
This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.
Topics: Cognition; Humans; Parkinson Disease; Quality of Life; Recovery of Function; Sensory Art Therapies
PubMed: 33038925
DOI: 10.1186/s12883-020-01938-3 -
JAMA Network Open Sep 2020Falls increase morbidity and mortality in adults 65 years and older. The role of dance-based mind-motor activities in preventing falls among healthy older adults is not... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Falls increase morbidity and mortality in adults 65 years and older. The role of dance-based mind-motor activities in preventing falls among healthy older adults is not well established.
OBJECTIVE
To assess the effectiveness of dance-based mind-motor activities in preventing falls.
DATA SOURCES
Systematic search included the PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsychINFO, Abstracts in Social Gerontology, AgeLine, AMED, and Scopus databases from database inception to February 18, 2018, using the Medical Subject Headings aged 65 and older, accidental falls, and dancing.
STUDY SELECTION
This systematic review and meta-analysis included 29 randomized clinical trials that evaluated a dance-based mind-motor activity in healthy older adults with regard to fall risk, fall rate, or well-established measures of physical function in the domains of balance, mobility, and strength. The included studies targeted participants without comorbidities associated with higher fall risk. Dance-based mind-motor activities were defined as coordinated upright mind-motor movements that emphasize dynamic balance, structured through music or an inner rhythm (eg, breathing) and distinctive instructions or choreography, and that involve social interaction.
DATA EXTRACTION AND SYNTHESIS
Standardized independent screening, data extraction, and bias assessment were performed. Data were pooled using random-effects models. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline.
MAIN OUTCOMES AND MEASURES
Primary outcomes were risk of falling and rate of falls. For the secondary end points of physical function (balance, mobility, and strength), standardized mean differences (SMDs) were estimated and pooled (Hedges g).
RESULTS
In this systematic review and meta-analysis of 29 randomized clinical trials, dance-based mind-motor activities were significantly associated with reduced (37%) risk of falling (risk ratio, 0.63; 95% CI, 0.49-0.80; 8 trials, 1579 participants) and a significantly reduced (31%) rate of falls (incidence rate ratio, 0.69; 95% CI, 0.53-0.89; 7 trials, 2012 participants). In addition, dance-based mind-motor activities were significantly associated with improved physical function in the domains of balance (standardized mean difference [SMD], 0.62; 95% CI, 0.33-0.90; 15 trials, 1476 participants), mobility (SMD, -0.56; 95% CI, -0.81 to -0.31; 13 trials, 1379 participants), and lower body strength (SMD, 0.57; 95% CI, 0.23-0.91; 13 trials, 1613 participants) but not upper body strength (SMD, 0.18; 95% CI, -0.03 to 0.38; 4 trials, 414 participants).
CONCLUSION AND RELEVANCE
Among healthy older adults, dance-based mind-motor activities were associated with decreased risk of falling and rate of falls and improved balance, mobility, and lower body strength. This type of activity may be useful in preventing falls in this population.
Topics: Accidental Falls; Aged; Aged, 80 and over; Dance Therapy; Dancing; Female; Healthy Volunteers; Humans; Independent Living; Male; Muscle Strength; Physical Functional Performance; Postural Balance; Psychomotor Performance; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 32975570
DOI: 10.1001/jamanetworkopen.2020.17688 -
Journal of Clinical Medicine Apr 2020Parkinson's disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical... (Review)
Review
Parkinson's disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson's disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = -1.16; 95% Confidence Interval (CI):(-2.30 to -0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson's disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject.
PubMed: 32272665
DOI: 10.3390/jcm9041038 -
BMJ Open Feb 2020Compared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Compared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness.
DESIGN
A systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure.
SETTING
Most interventions were conducted in a group setting, with some including an at-home, self-directed component.
PARTICIPANTS
Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment.
PRIMARY AND SECONDARY OUTCOME MEASURES
Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait.
RESULTS
Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale.
CONCLUSIONS
Physical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed.
PROSPERO REGISTRATION NUMBER
CRD42018103638.
Topics: Exercise; Exercise Movement Techniques; Exercise Therapy; Humans; Vision Disorders; Visually Impaired Persons
PubMed: 32051316
DOI: 10.1136/bmjopen-2019-034036 -
International Journal of Environmental... Oct 2019With the emergence of electronic products, smartphones have become an indispensable tool in our daily life. On the other hand, smartphone addiction has become a public... (Meta-Analysis)
Meta-Analysis
BACKGROUND
With the emergence of electronic products, smartphones have become an indispensable tool in our daily life. On the other hand, smartphone addiction has become a public health issue. To help reduce smartphone addiction, cost-effective interventions such as exercise are encouraged.
PURPOSE
We therefore performed a systematic review and meta-analysis evaluating existing literature on the rehabilitative effects of exercise interventions for individuals with a smartphone addiction.
METHODS
We searched PubMed, Web of Science, Scopus, CNKI, and Wanfang from inception to September 2019. Nine eligible randomized controlled trials (RCT) were finally included for meta-analysis (SMD represents the magnitude of effect of exercise) and their methodological quality were assessed using the PEDro scale.
RESULTS
We found significant positive effects of exercise interventions (Taichi, basketball, badminton, dance, run, and bicycle) on reducing the total score (SMD = -1.30, 95% CI -1.53 to -1.07, < 0.005, = 62%) of smartphone addiction level and its four subscales (withdrawal symptom: = -1.40, 95% CI -1.73 to -1.07, < 0.001, = 81%; highlight behavior: SMD = -1.95, 95% CI -2.99 to -1.66, < 0.001, = 79%; social comfort: SMD = -0.99, 95% CI -1.18 to -0.81, = 0.27, = 21%; mood change: SMD = -0.50, 95% CI 0.31 to 0.69, = 0.25, = 25%). Furthermore, we found that individuals with severe addiction level (SMD = -1.19, = 0%, 95%CI:-1.19 to -0.98) benefited more from exercise engagement, as compared to those with mild to moderate addiction levels (SMD = - 0.98, = 50%, 95%CI:-1.31 to -0.66); individuals with smartphone addiction who participated in exercise programs of 12 weeks and above showed significantly greater reduction on the total score (SMD = -1.70, = 31.2%, 95% CI -2.04 to -1.36, = 0.03), as compared to those who participated in less than 12 weeks of exercise intervention (SMD = -1.18, = 0%, 95% CI-1.35 to -1.02, < 0.00001). In addition, individuals with smartphone addiction who participated in exercise of closed motor skills showed significantly greater reduction on the total score (SMD = -1.22, = 0 %, 95% CI -1.41 to -1.02, = 0.56), as compared to those who participated in exercise of open motor skills (SMD = -1.17, = 44%, 95% CI-1.47 to -0.0.87, = 0.03).
CONCLUSIONS
Exercise interventions may have positive effects on treating smartphone addiction and longer intervention durations may produce greater intervention effects.
Topics: Behavior, Addictive; Exercise Therapy; Humans; Randomized Controlled Trials as Topic; Smartphone
PubMed: 31618879
DOI: 10.3390/ijerph16203912 -
Tremor and Other Hyperkinetic Movements... 2019There is a lack of published guidelines related to the use of complementary and alternative medicine (CAM) for Huntington's disease (HD). We conducted a review of the...
BACKGROUND
There is a lack of published guidelines related to the use of complementary and alternative medicine (CAM) for Huntington's disease (HD). We conducted a review of the literature to summarize the available evidence for various mind-body practices and nutraceuticals.
METHODS
PubMed and Cochrane Library electronic databases were searched independently from inception to February 2019 by two independent raters. Studies were classified for the level of evidence (Class I, II, III, or IV) according to the American Academy of Neurology (AAN) classification scale.
RESULTS
Randomized controlled trials in HD were reviewed for mind-body interventions (dance therapy, music therapy, and exercise), alternative systems (traditional Chinese medicine [TCM]), and nutraceuticals/diet (aminooxyacetic acid [AOAA], coenzyme q10, creatine, cannabinoids, alpha-tocopherol, eicosapentaenoic acid, idebenone, levocarnitine, and triheptanoin). Few studies met AAN Class I or II level of evidence for benefits, and these are highlighted.
DISCUSSION
There is a relative paucity of clinical trials examining CAM modalities in HD when compared to other neurodegenerative disorders. Currently, there is no evidence supporting disease modification or symptom improvement with any specific dietary or nutraceutical supplement for HD. Supervised exercise and contemporary dance are safe for people with HD, but more robust studies are warranted to guide specific recommendations for these and other mind-body interventions.
Topics: Dance Therapy; Diet Therapy; Dietary Supplements; Exercise Therapy; Humans; Huntington Disease; Mind-Body Therapies; Outcome Assessment, Health Care
PubMed: 31523487
DOI: 10.7916/tohm.v0.678