scholarly journals The Efficacy of the proprioceptive neuromuscular facilitation (PNF) approach in stroke rehabilitation to improve basic activities of daily living and quality of life: a systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e016739 ◽  
Author(s):  
Francesc Xavier Guiu-Tula ◽  
Rosa Cabanas-Valdés ◽  
Mercè Sitjà-Rabert ◽  
Gerard Urrútia ◽  
Natàlia Gómara-Toldrà

IntroductionProprioceptive neuromuscular facilitation (PNF) is a widely used rehabilitation concept, although its efficacy has not yet been demonstrated in stroke survivors. The aim of this systematic review is to identify, assess and synthesise the potential benefits of using PNF to improve the activities of daily living (ADL) and quality of life (QoL) of individuals with stroke.Methods and analysisA systematic electronic search will be conducted in MEDLINE, Embase, CENTRAL and PEDro. We will include randomised or quasi-randomised controlled trials of PNF interventions conducted in stroke survivors up to April 2017. Two review authors will independently select relevant studies and will extract data using the Cochrane handbook for systematic reviews of interventions approach and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The methodological quality will be assessed by using the PEDro scale. Finally, with the permitted numeric data, we will carry out a meta-analysis.Ethics and disseminationEthical considerations will not be required. Results will be disseminated in a peer-review journal. This systematic review aims to examine the effects of PNF (neurophysiological approach) in order to clarify its efficacy in improving ADL and QoL in the rehabilitation process of stroke survivors.PROSPERO registration numberCRD42016039135.

2019 ◽  
Vol 41 (3) ◽  
pp. 529-536 ◽  
Author(s):  
Joseph Triegaardt ◽  
Thang S. Han ◽  
Charif Sada ◽  
Sapna Sharma ◽  
Pankaj Sharma

Abstract Introduction Parkinson’s disease (PD) is managed primarily by dopamine agonists and physiotherapy while virtual reality (VR) has emerged recently as a complementary method. The present study reviewed the effectiveness of VR in rehabilitation of patients with PD. Methods Literature search up to June 2019 identified ten studies (n = 343 participants) suitable for meta-analysis and 27 studies (n = 688 participants) for systematic review. Standard mean difference (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Results In meta-analysis, compared with active rehabilitation intervention, VR training led to greater improvement of stride length, SMD = 0.70 (95%CI = 0.32–1.08, p = 0.0003), and was as effective for gait speed, balance and co-ordination, cognitive function and mental health, quality of life and activities of daily living. Compared with passive rehabilitation intervention, VR had greater effects on balance: SMD = 1.02 (95%CI = 0.38–1.65, p = 0.002). Results from single randomised controlled trials showed that VR training was better than passive rehabilitation intervention for improving gait speed SMD = 1.43 (95%CI = 0.51–2.34, p = 0.002), stride length SMD = 1.27 (95%CI = 0.38–2.16, p = 0.005) and activities of daily living SMD = 0.96 (95%CI = 0.02–1.89). Systematic review showed that VR training significantly (p < 0.05) improved motor function, balance and co-ordination, cognitive function and mental health, and quality of life and activities of daily living. Conclusion VR used in rehabilitation for patients with PD improves a number of outcomes and may be considered for routine use in rehabilitation.


2021 ◽  
pp. 026921552199517
Author(s):  
Runze Li ◽  
Yanran Zhang ◽  
Yunxia Jiang ◽  
Mengyao Wang ◽  
Wei How Darryl Ang ◽  
...  

Objective: To examine the effectiveness of rehabilitation training based on virtual reality in improving balance, quality of life, activities of daily living, and depressive symptoms of patients with Parkinson’s disease. Data sources: PubMed, EMBASE, CINAHL, Scopus, Cochrane Library, PsycINFO, ProQuest, Physiotherapy Evidence Database, IEEE Xplore, China National Knowledge Infrastructure, Wanfang, and VIP Information databases were searched from their inception to October 15, 2020. Trial registries, gray literature, and target journals were also searched. Methods: Eligible randomized controlled trials included studies with patients with Parkinson’s disease in rehabilitation training based on virtual reality. Comprehensive Meta-Analysis 3.0 software was used. Physiotherapy Evidence Database Scale and the Grading of Recommendation, Assessment, Development, and Evaluation system were used to assess the methodological quality of individual trials and the overall quality of the evidence, respectively. Results: A total of 22 randomized controlled trials with 836 patients were included. Meta-analysis revealed that training significantly improved balance ( g = 0.66, P < 0.001), quality of life ( g = 0.28, P = 0.015), activities of daily living ( g = 0.62, P < 0.001), and depressive symptoms ( g = 0.67, P = 0.021) compared to the control group. Subgroup analysis indicated that training should utilize video game consoles. Meta-regression analyses showed that age, sessions, and frequency of training had statistically significant impacts on balance scores. Quality of individual trials was high and overall evidence ranged from very low to low. Conclusion: Virtual rehabilitation training could be adopted in healthcare institutions as supplementary training for patients with Parkinson’s disease.


2018 ◽  
Author(s):  
Huidi Tchero ◽  
Maturin Tabue-Teguo ◽  
Annie Lannuzel ◽  
Emmanuel Rusch

BACKGROUND Telerehabilitation is an emerging technology through which medical rehabilitation care can be provided from a distance. OBJECTIVE This systematic review and meta-analysis aims to investigate the efficacy of telerehabilitation in poststroke patients. METHODS Eligible randomized controlled trials (RCTs) were identified by searching MEDLINE, Cochrane Central, and Web of Science databases. Continuous data were extracted for relevant outcomes and analyzed using the RevMan software as the standardized mean difference (SMD) and 95% CI in a fixed-effect meta-analysis model. RESULTS We included 15 studies (1339 patients) in our systematic review, while only 12 were included in the pooled analysis. The combined effect estimate showed no significant differences between the telerehabilitation and control groups in terms of the Barthel Index (SMD –0.05, 95% CI –0.18 to 0.08), Berg Balance Scale (SMD –0.04, 95% CI –0.34 to 0.26), Fugl-Meyer Upper Extremity (SMD 0.50, 95% CI –0.09 to 1.09), and Stroke Impact Scale (mobility subscale; SMD 0.18, 95% CI –0.13 to 0.48]) scores. Moreover, the majority of included studies showed that both groups were comparable in terms of health-related quality of life (of stroke survivors), Caregiver Strain Index, and patients’ satisfaction with care. One study showed that the cost of telerehabilitation was lower than usual care by US $867. CONCLUSIONS Telerehabilitation can be a suitable alternative to usual rehabilitation care in poststroke patients, especially in remote or underserved areas. Larger studies are needed to evaluate the health-related quality of life and cost-effectiveness with the ongoing improvements in telerehabilitation networks.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017571 ◽  
Author(s):  
Irmela Gnass ◽  
Michaela Ritschel ◽  
Silke Andrich ◽  
Silke Kuske ◽  
Kai Moschinski ◽  
...  

IntroductionSurvivors of polytrauma experience long-term and short-term burden that influences their lives. The patients’ view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments’ application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function).Methods and analysisThe systematic review protocol is developed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials and the trials registers ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched. Keywords, for example, ‘polytrauma’, ‘multiple trauma’, ‘quality of life’, ‘activities of daily living’ or ‘pain’ will be used. Publications published between January 2005 and the most recent date (currently: August 2016) will be included. In order to present the latest possible results, an update of the search is conducted before publication. The data extraction and a content analysis will be carried out systematically. A critical appraisal will be performed.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be published in a peer-reviewed publication.PROSPERO registration numberCRD42017060825.


2018 ◽  
Vol 31 (2) ◽  
pp. 97-105
Author(s):  
Akira Sagari ◽  
Yuta Ikio ◽  
Nobuko Imamura ◽  
Kayoko Deguchi ◽  
Toko Sakai ◽  
...  

Background/objective Chemotherapy for cancer negatively affects activities of daily living and quality of life. This study aimed to validate and compare the efficacy of two different interventions in patients with haematopoietic malignancies undergoing chemotherapy: (1) occupation-based interventions, designed using the Aid for Decision-making in Occupation Choice (ADOC) (an iPAD application) and (2) impairment-based interventions. ADOC helps promote decision-making during activities and participation in occupation-based goal setting. The impairment-based intervention group served as the comparison group and underwent impairment-based interventions focusing on dysfunction. Methods In this single-blinded pilot randomised controlled trial, 19 participants received an occupation-based intervention (n = 9) or an impairment-based intervention (n = 10). The treatment period comprised two sessions. Recruitment, compliance and outcome completion rates were calculated for the study. Effect sizes were examined for outcomes regarding physical performance, instrumental activities of daily living and quality of life as evaluated by a blinded assessor. Results In this study, 24.8% (28/113) of the eligible patients with haematopoietic malignancies were enrolled, and 67.9% (19/28) of these were retained up to the post-assessment stage. Recruitment (25%) and compliance (68%) rates were satisfactory. The Functional Assessment of Cancer Therapy-General emotional well-being and total scores were significantly higher for the occupation-based intervention group than for the impairment-based intervention group (both p < 0.05; d = 0.54, d = 0.51, respectively). Other outcomes showed no significant differences. Conclusion Occupation-based interventions designed using the ADOC application were useful for patients with haematopoietic malignancies.


2019 ◽  
Vol 60 (8) ◽  
pp. e600-e608 ◽  
Author(s):  
Sara Isabel Lebre de Almeida ◽  
Madalena Gomes da Silva ◽  
Alda Sofia Pires de Dias Marques

Abstract Background and Objectives Physical activity has the potential to improve health outcomes in people with dementia, namely when living at home. However, the knowledge about home-based physical activity for this population is scarce. Thus, we aim to identify and synthesize the effects of home-based physical activity for people with dementia. Research Design and Methods A systematic review was conducted. Quality of studies was assessed using the Delphi List. Effect sizes (ES) were calculated with MetaXL 2.0. A meta-analysis was conducted for the Mini-Mental Status Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia, Alzheimer’s Disease Cooperative Study Group Activities of Daily Living Scale (ADCS-ADL), Functional Reach test, Timed Up and Go (TUG) test, Short Physical Performance Battery, Dementia Quality of Life, NPI Caregivers subscale and Zarit Burden Interview (ZBI). Results Sixteen randomized controlled trials were included. Most were of high quality and published after 2015. A large heterogeneity of interventions was found. Meta-analysis showed significant results in MMSE (ES = 0.71, 95% CI 0.43, 0.99), NPI (ES = −0.37, 95% CI −0.57, −0.17), ADCS-ADL (ES = 0.80, 95% CI 0.53, 1.07), Functional Reach test (ES = 2.24, 95% CI 1.80, 2.68), TUG test (ES = −2.40, 95% CI −2.84, −1.96), NPI Caregivers subscale (ES = −0.63, 95% CI −0.94, −0.32), and ZBI (ES = −0.45, 95% CI −0.77, −0.13). Few minor adverse events and high adherence to intervention were found. Discussion and Implications Home-based physical activity seems safe and effective in delaying cognitive function decline and improving changes in behavioral and psychological symptoms of dementia, activities of daily living, health-related physical fitness, and carer’s burden in people with dementia living at home.


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