scholarly journals Action observation training for rehabilitation in brain injuries: a systematic review and meta-analysis

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bianca Buchignani ◽  
Elena Beani ◽  
Valerie Pomeroy ◽  
Oriana Iacono ◽  
Elisa Sicola ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Damage ◽  
Upper Limb ◽  
Effect Size ◽  
Lower Limb ◽  
Action Observation ◽  
Meta Analysis ◽  
Body Function ◽  
Observation Training ◽  
Activity Domain

Abstract Background To systematically review and analyse the effects of Action Observation Training on adults and children with brain damage. Methods Seven electronic databases (Cochrane, EBSCO, Embase, Eric, PubMed, Scopus and Web of Science) were searched up to 16 September 2018 to select Randomized Controlled Trials focused on adults and children with brain damage that included AOT training on upper and/or lower limb carried out for at least 1 week. Identification of studies and data extraction was conducted with two reviewers working independently. Oxford Centre for Evidence-based Medicine (March2009) – Levels of Evidence and Physiotherapy Evidence Database scale were used to grade studies. The data collected from the articles were analysed using software R, version 3.4.3. Hedge’s g values were calculated and effect size estimates were pooled across studies. Separate meta-analyses were carried out for each ICF domain (i.e. body function and activity) for upper and lower limb. Results Out of the 210 records identified after removing duplicates, 22 were selected for systematic review and 19 were included in the meta-analysis. Thirteen studies included in the meta-analysis focused on upper limb rehabilitation (4 in children and 9 in adults) and 6 on lower limb rehabilitation (only studies in adults). A total of 626 patients were included in the meta-analysis. An overall statistically significant effect size was found for upper limb body function (0.44, 95% CI: [0.24, 0.64], p < 0.001) and upper limb activity domain (0.47, 95% CI: [0.30, 0.64], p < 0.001). For lower limb, only the activity domain was analysed, revealing a statistically significant overall effect size (0.56, 95% CI: [0.28, 0.84], p < 0.001). Conclusions Action Observation Training (AOT) is an innovative rehabilitation tool for individuals with brain damage, which shows promising results in improving the activity domain for upper and lower limbs, and also the body function domain for the upper limb. However, the examined studies lack uniformity and further well-designed, larger controlled trials are necessary to determine the most suitable type of AOT particularly in children. Systematic review registration CRD42019119600.

scholarly journals The effects of action observation training on improving upper limb motor functions in people with stroke: A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0221166 ◽  
Author(s):  
Bingbing Zhang ◽  
Laidi Kan ◽  
Anqin Dong ◽  
Jiaqi Zhang ◽  
Zhongfei Bai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Upper Limb ◽  
Action Observation ◽  
Meta Analysis ◽  
Motor Functions ◽  
Observation Training

scholarly journals The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4424
Author(s):  
Rosa Cabanas-Valdés ◽  
Jordi Calvo-Sanz ◽  
Pol Serra-Llobet ◽  
Joana Alcoba-Kait ◽  
Vanessa González-Rueda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Meta Analysis ◽  
Stroke Survivors ◽  
Randomized Controlled Clinical Trials ◽  
Therapeutic Massage ◽  
Limb Spasticity ◽  
Conventional Physiotherapy

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I2 = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

scholarly journals The Effect of Priming on Outcomes of Task-Oriented Training for the Upper Extremity in Chronic Stroke: A Systematic Review and Meta-analysis

2020 ◽  
Vol 34 (6) ◽  
pp. 479-504
Author(s):  
Erika Shirley Moreira da Silva ◽  
Gabriela Nagai Ocamoto ◽  
Gabriela Lopes dos Santos-Maia ◽  
Roberta de Fátima Carreira Moreira Padovez ◽  
Claudia Trevisan ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Effect Size ◽  
Action Observation ◽  
Chronic Stroke ◽  
Upper Extremities ◽  
Body Function ◽  
Task Oriented ◽  
Activity Domain ◽  
Quality Evidence

Background. Priming results in a type of implicit memory that prepares the brain for a more plastic response, thereby changing behavior. New evidence in neurorehabilitation points to the use of priming interventions to optimize functional gains of the upper extremity in poststroke individuals. Objective. To determine the effects of priming on task-oriented training on upper extremity outcomes (body function and activity) in chronic stroke. Methods. The PubMed, CINAHL, Web of Science, EMBASE, and PEDro databases were searched in October 2019. Outcome data were pooled into categories of measures considering the International Classification Functional (ICF) classifications of body function and activity. Means and standard deviations for each group were used to determine group effect sizes by calculating mean differences (MDs) and 95% confidence intervals via a fixed effects model. Heterogeneity among the included studies for each factor evaluated was measured using the I2 statistic. Results. Thirty-six studies with 814 patients undergoing various types of task-oriented training were included in the analysis. Of these studies, 17 were associated with stimulation priming, 12 with sensory priming, 4 with movement priming, and 3 with action observation priming. Stimulation priming showed moderate-quality evidence of body function. Only the Wolf Motor Function Test (time) in the activity domain showed low-quality evidence. However, gains in motor function and in use of extremity members were measured by the Fugl-Meyer Assessment (UE-FMA). Regarding sensory priming, we found moderate-quality evidence and effect size for UE-FMA, corresponding to the body function domain (MD 4.77, 95% CI 3.25-6.29, Z = 6.15, P < .0001), and for the Action Research Arm Test, corresponding to the activity domain (MD 7.47, 95% CI 4.52-10.42, Z = 4.96, P < .0001). Despite the low-quality evidence, we found an effect size (MD 8.64, 95% CI 10.85-16.43, Z = 2.17, P = .003) in movement priming. Evidence for action observation priming was inconclusive. Conclusion. Combining priming and task-oriented training for the upper extremities of chronic stroke patients can be a promising intervention strategy. Studies that identify which priming techniques combined with task-oriented training for upper extremity function in chronic stroke yield effective outcomes in each ICF domain are needed and may be beneficial for the recovery of upper extremities poststroke.

scholarly journals Neurostructural and Neurophysiological Correlates of Multiple Sclerosis Physical Fatigue: Systematic Review and Meta-Analysis of Cross-Sectional Studies

2021 ◽  
Author(s):  
Paula M. Ellison ◽  
Stuart Goodall ◽  
Niamh Kennedy ◽  
Helen Dawes ◽  
Allan Clark ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Upper Limb ◽  
Lower Limb ◽  
Grey Matter ◽  
Meta Analysis ◽  
Grey Literature ◽  
Voluntary Activation ◽  
Cross Sectional ◽  
Neurophysiological Data

Abstract Fatigue is one of the most debilitating symptoms for people with multiple sclerosis (PwMS). By consolidating a diverse and conflicting evidence-base, this systematic review and meta-analysis aimed to gain new insights into the neurobiology of MS fatigue. MEDLINE, ProQuest, CINAHL, Web of Science databases and grey literature were searched using Medical Subject Headings. Eligible studies compared neuroimaging and neurophysiological data between people experiencing high (MS-HF) versus low (MS-LF) levels of perceived MS fatigue, as defined by validated fatigue questionnaire cut-points. Data were available from 66 studies, with 46 used for meta-analyses. Neuroimaging studies revealed lower volumetric measures in MS-HF versus MS-LF for whole brain (­22.74 ml; 95% CI: -37.72 to -7.76 ml; p = 0.003), grey matter (­18.81 ml; 95% CI: ­29.60 to ­8.03 ml; p < 0.001), putamen (­0.40 ml; 95% CI: ­0.69 to ­0.10 ml; p = 0.008) and acumbens (­0.09 ml; 95% CI: ­0.15 to ­0.03 ml; p = 0.003) and a higher volume of T1-weighted hypointense lesions (1.10 ml; 95% CI: 0.47 to 1.73 ml; p < 0.001). Neurophysiological data showed reduced lower-limb maximum voluntary force production (­19.23 N; 95% CI: ­35.93 to ­2.53 N; p = 0.02) and an attenuation of upper-limb (­5.77%; 95% CI:­8.61 to ­2.93%; p < 0.0001) and lower-limb (­2.16%; 95% CI:­4.24 to ­0.07%; p = 0.04) skeletal muscle voluntary activation, accompanied by more pronounced upper-limb fatigability (­5.61%; 95% CI: -9.57 to -1.65%; p = 0.006) in MS-HF versus MS-LF. Results suggest that MS fatigue is characterised by greater cortico-subcortical grey matter atrophy and neural lesions, accompanied by neurophysiological decrements, which include reduced strength and voluntary activation. Prospero registration Prospero registration number: CRD42016017934

Effectiveness of motor imagery and action observation training on musculoskeletal pain intensity: A systematic review and meta‐analysis

2020 ◽  
Vol 24 (5) ◽  
pp. 886-901 ◽  
Author(s):  
Luis Suso‐Martí ◽  
Roy La Touche ◽  
Santiago Angulo‐Díaz‐Parreño ◽  
Ferran Cuenca‐Martínez
Keyword(s):  
Systematic Review ◽  
Pain Intensity ◽  
Musculoskeletal Pain ◽  
Motor Imagery ◽  
Action Observation ◽  
Meta Analysis ◽  
Observation Training

scholarly journals Different Therapeutic Effects of Transcranial Direct Current Stimulation on Upper and Lower Limb Recovery of Stroke Patients with Motor Dysfunction: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Xi Bai ◽  
Zhiwei Guo ◽  
Lin He ◽  
Long Ren ◽  
Morgan A. McClure ◽  
...  
Keyword(s):  
Upper Limb ◽  
Direct Current ◽  
Effect Size ◽  
Transcranial Direct Current Stimulation ◽  
Lower Limb ◽  
Meta Analysis ◽  
Motor Dysfunction ◽  
Stroke Patients ◽  
Direct Current Stimulation ◽  
Subacute Stroke

Objective. To explore the effects of transcranial direct current stimulation (tDCS) on the motor recovery of stroke patients and the effect differences between the upper limb and lower limb. Methods. Randomized control trials published until January 2019 were searched from PubMed, Embase, ScienceDirect, and Cochrane Library databases. The standardized mean difference (SMD) with 95% confidence interval (CI) was estimated separately for upper and lower limb motor outcomes to understand the mean effect size. Results. Twenty-nine studies with 664 subjects were included in this meta-analysis. The overall analyses of tDCS demonstrated significant effect size both for the upper limb (SMD=0.26, P=0.002) and the lower limb (SMD=0.47, P=0.002). Compared with acute and subacute stroke patients, chronic stroke patients obtained significant effects after tDCS (SMD=0.25, P=0.03) in upper limb function. Furthermore, both anode and cathode stimulations produced significant effect size for stroke patients after ≤10 sessions of tDCS (anode: SMD=0.40, P=0.001; cathode: SMD=0.79, P<0.0001) with >0.029 mA/cm2 of density (anode: SMD=0.46, P=0.002; cathode: SMD=0.79, P<0.0001). But for lower limb function, more prominent effects were found in subacute stroke patients (SMD=0.56, P=0.001) with bilateral tDCS (SMD=0.59, p=0.009). Conclusion. tDCS is effective for the recovery of stroke patients with motor dysfunction. In addition, upper limb and lower limb functions obtain distinct effects from different therapeutic parameters of tDCS at different stages, respectively.

scholarly journals The Effects of Virtual Reality Training on Function in Chronic Stroke Patients: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Han Suk Lee ◽  
Yoo Junk Park ◽  
Sun Wook Park
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Effect Size ◽  
Lower Limb ◽  
Meta Analysis ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Limb Function ◽  
Vr Training ◽  
Lower Limb Function

Objective. The aim of this study was to perform a meta-analysis to examine whether virtual reality (VR) training is effective for lower limb function as well as upper limb and overall function in chronic stroke patients. Methods. Three databases, OVID, PubMed, and EMBASE, were used to collect articles. The search terms used were “cerebrovascular accident (CVA),” “stroke”, and “virtual reality”. Consequently, twenty-one studies were selected in the second screening of meta-analyses. The PEDro scale was used to assess the quality of the selected studies. Results. The total effect size for VR rehabilitation programs was 0.440. The effect size for upper limb function was 0.431, for lower limb function it was 0.424, and for overall function it was 0.545. The effects of VR programs on specific outcomes were most effective for improving muscle tension, followed by muscle strength, activities of daily living (ADL), joint range of motion, gait, balance, and kinematics. Conclusion. The VR training was effective in improving the function in chronic stroke patients, corresponding to a moderate effect size. Moreover, VR training showed a similar effect for improving lower limb function as it did for upper limb function.

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