The use of eHealth to promote physical activity in people living with Parkinson’s disease: A systematic review

2021 ◽  
pp. 1-14
Author(s):  
Adam McDermott ◽  
Ciaran Haberlin ◽  
Jonathan Moran

BACKGROUND: People living with Parkinson’s disease (PD) are less active than healthy individuals. Ehealth is an emerging concept in healthcare which presents opportunities to promote physical activity (PA) in people with PD. The aim of this systematic review was to explore the effectiveness of ehealth in the promotion of PA in people living with PD. METHODS: Suitable articles were searched for using EMBASE, PsychInfo, Web of Science and OVID Medline databases using a combination of keywords and medical subject headings. Articles were included if they described an ehealth intervention designed to promote PA in people living with PD. Two reviewers screened studies for suitability and extracted data. Risk of bias was assessed using the Cochrane risk of bias 2 tool and the Downs and Black risk of bias checklist. Due to the heterogeneity of studies, a narrative synthesis of study interventions and results was completed rather than a quantitative analysis. RESULTS: 1449 articles were screened. Four studies met the eligibility criteria which included 652 participants. Web and mobile applications were used to design the PA interventions. PA levels were measured using self-reported questionnaires, Fitbits, activity monitors and accelerometers. Three of the studies reported improvements in aspects of PA. However, this was not consistently reported in all study participants. No adverse effects, a high level of enjoyment and a relatively low attrition rate (∼12.5%) were reported. CONCLUSION: Ehealth is a safe and feasible intervention to promote PA in this population. It is unclear whether ehealth is effective at promoting PA in people with PD. Keywords:

CoDAS ◽  
2018 ◽  
Vol 30 (5) ◽  
Author(s):  
Patrícia Pinho ◽  
Larissa Monteiro ◽  
Maria Francisca de Paula Soares ◽  
Lorena Tourinho ◽  
Ailton Melo ◽  
...  

Abstract Purpose Investigate the association between levodopa therapy and vocal characteristics in Parkinson’s disease patients. Search strategy Studies published at MEDLINE, LILACS, and SciELO, from 1960 to December 2016. A systematic review and meta-analysis was performed using the following keywords: Parkinson’s disease; levodopa; L-dopa; voice; speech disorders; dysphonia; dysarthria. After analyzing titles and abstracts, two independent reviewers selected all clinical trials that met the eligibility criteria and selected the articles and the data recorded in a previously standardized table. Selection criteria Trials published in English between 1960 and December 2016 individuals with clinical diagnosis of Parkinson’s disease; use of levodopa therapy in stable doses; acoustic analysis combined or not with auditory-perceptual analysis to evaluate the vocal parameters under investigation. Data analysis The following vocal parameters were analyzed: fundamental frequency (F 0), jitter, and vocal intensity. Standardized mean differences (SMD) were calculated using the Comprehensive Meta-analysis V2 software. Results Nine articles met the eligibility criteria and were selected, with a total of 119 individuals. From these, six articles with 83 individuals were included in the meta-analysis. During the levodopa therapy “on” state, modifications in F 0 (SMD=0.39; 95% CI - 0.21-0.57) and jitter (SMD=0.23; 95% CI - 0.02-0.45) were observed. Vocal intensity was not affected (SMD=0.09; 95% CI - 0.22-0.39) by levodopa ingestion. Data of the included studies were controversial in the auditory-perceptual analysis of voice. Conclusion Levodopa therapy modifies F0 and jitter. No changes in vocal intensity were observed in either the “on” or “off” states of levodopa therapy.


2018 ◽  
Vol 4 (1) ◽  
pp. e000341 ◽  
Author(s):  
Andy J Daly-Smith ◽  
Stephen Zwolinsky ◽  
Jim McKenna ◽  
Phillip D Tomporowski ◽  
Margaret Anne Defeyter ◽  
...  

ObjectiveTo examine the impact of acute classroom movement break (CMB) and physically active learning (PAL) interventions on physical activity (PA), cognition, academic performance and classroom behaviour.DesignSystematic review.Data sourcesPubMed, EBSCO, Academic Search Complete, Education Resources Information Center, PsycINFO, SPORTDiscus, SCOPUS and Web of Science.Eligibility criteria for selecting studiesStudies investigating school-based acute bouts of CMB or PAL on (PA), cognition, academic performance and classroom behaviour. The Downs and Black checklist assessed risk of bias.ResultsTen PAL and eight CMB studies were identified from 2929 potentially relevant articles. Risk of bias scores ranged from 33% to 64.3%. Variation in study designs drove specific, but differing, outcomes. Three studies assessed PA using objective measures. Interventions replaced sedentary time with either light PA or moderate-to-vigorous PA dependent on design characteristics (mode, duration and intensity). Only one study factored individual PA outcomes into analyses. Classroom behaviour improved after longer moderate-to-vigorous (>10 min), or shorter more intense (5 min), CMB/PAL bouts (9 out of 11 interventions). There was no support for enhanced cognition or academic performance due to limited repeated studies.ConclusionLow-to-medium quality designs predominate in investigations of the acute impacts of CMB and PAL on PA, cognition, academic performance and classroom behaviour. Variable quality in experimental designs, outcome measures and intervention characteristics impact outcomes making conclusions problematic. CMB and PAL increased PA and enhanced time on task. To improve confidence in study outcomes, future investigations should combine examples of good practice observed in current studies.PROSPERO registration numberCRD42017070981.


2021 ◽  
Vol 13 ◽  
Author(s):  
Xiaopeng Wen ◽  
Kunbin Li ◽  
Hao Wen ◽  
Qian Wang ◽  
Zhiyuan Wu ◽  
...  

Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD).Methods: A literature search within eight databases [including Medline, Embase, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database] was performed covering a time frame from their inception to August 2020. Randomized controlled trials (RCTs) comparing acupuncture-related therapies combined with conventional medication vs. conventional medication in patients with PD were eligible. Two authors independently assessed the risk of bias. Assessments were performed with the total and subscales scores of the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), the dosage of Madopar, Mini-Mental State Examination (MMSE), and 17-item Hamilton Depression Scale (HAMD). Data were analyzed by adopting the Cochrane Collaboration's RevMan 5.4 (Review Man, Copenhagen, Denmark); and mean effect sizes and 95% confidence intervals were estimated. Tests for heterogeneity were used to assess differences in treatment effects across different types of acupuncture used.Results: Sixty-six trials met the inclusion criteria, of which 61 trials provided data for the meta-analysis. We defined high-quality articles as those with a low risk of bias in four or more domains; and only 10 (15.15%) articles were of high quality. Compared with the controls, acupuncture-related therapies with conventional medication achieved a benefit in the primary outcomes of UPDRS (motor subscore: −3.90, −4.33 to −3.49, P < 0.01; total score: −7.37 points, −8.91 to −5.82, P < 0.001; activities of daily living subscore: −3.96, −4.96 to −2.95, P < 0.01). For the subgroup difference test among the effects of different acupuncture methods, significant differences existed in outcomes with the UPDRS-III, UPDRS-I, UPDRS-IV, and PDQ-39 scores and Madopar dosage, while non-significant differences existed with the UPDRS-total, UPDRS-II, HAMD, and MMSE scores.Conclusions: Acupuncture-related therapies combined with conventional medication may benefit individuals with PD. Our review findings should be considered with caution because of the methodological weaknesses in the included trials. Future, large randomized trials of acupuncture-related therapies for PD with high methodological quality are warranted.Systematic Review Registration: Identifier CRD42021228110.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23158-e23158
Author(s):  
Gilberto Castro ◽  
Alberto Codima ◽  
Willian das Neves ◽  
Ana Paula Souza Borges

e23158 Background: The symptoms which burden lung cancer patients contribute to a vicious cycle of physical inactivity as the disease progresses. Some studies have shown that exercise is feasible and safe for this population, and it improves their symptoms and quality of life. However, the current recommendations are non-specific, and little is known about the optimal amount and type of exercise in this scenario. Here we aimed to identify a specific recommendation of physical activity that could work more efficiently, benefiting lung cancer patients, in terms of diminishing their symptom burden and improving quality of life. Methods: A systematic review was undertaken through structured searches on PubMed, Medline, Embase, Scopus, Web of Science and SciELO. The search protocol was registered on the Prospero platform. Rayyan QCRI was used for data extraction and determining eligible studies after a blind screening of titles and abstracts by the three authors. The Physiotherapy Evidence Database (PEDro) scale was used for quality assessment of each eligible trial in regards of risk of bias. Trials which had clear eligibility criteria and a summary score equal or superior than 6 were considered to have low risk of bias, and accepted for full text review. Results: From September/1998 to January/2019, a total amount of 1998 studies were returned from the aforementioned databases, and 17 studies were established to be eligible for quality assessment. All the 17 quality-assessed studies were randomized clinical trials. However, two of them did not clearly report the eligibility criteria and were immediately excluded. Five other studies were considered to have high risk of bias. Therefore, we considered only 10 trials to be fully reviewed, including 843 patients. Only 3 trials found significant improvement in the quality of life after their interventions, and included 243 patients. Two studies associated aerobic exercise and resistance training from 10 to 20 weeks post surgery, while the other studied intervention was Tai Chi for 10 days after each chemotherapy cycle. Conclusions: Evidence from this review suggests that exercise may improve quality of life of lung cancer patients. However, we could not identify an ideal amount nor type of physical activity given the limited available data and the heterogeneity of methods. Further studies are warranted.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040656
Author(s):  
Hanna Malmberg Gavelin ◽  
Magdalena Domellöf ◽  
Isabella Leung ◽  
Anna Stigsdotter Neely ◽  
Carsten Finke ◽  
...  

IntroductionCognitive impairment is recognised as an important non-motor symptom in Parkinson’s disease (PD) and there is a need for evidence-based non-pharmacological interventions that may prevent or slow cognitive decline in this patient group. One such intervention is computerised cognitive training (CCT), which has shown efficacious for cognition across older adult populations. This systematic review aims to investigate the efficacy of CCT across cognitive, psychosocial and functional domains for people with PD and examine study and intervention design factors that could moderate CCT effects on cognition.Methods and analysisRandomised controlled trials investigating the effects of CCT in patients with PD without dementia, on cognitive, psychosocial or functional outcomes, will be included. The primary outcome is overall cognitive function. Secondary outcomes are domain-specific cognitive function, psychosocial functioning and functional abilities. We systematically searched MEDLINE, Embase and PsycINFO through 14 May 2020 to identify relevant literature. Risk of bias will be assessed using the revised Cochrane Risk of Bias tool. Effect sizes will be calculated as standardised mean difference of baseline to postintervention change (Hedges’ g) with 95% CI for each eligible outcome measure. Pooling of outcomes across studies will be conducted using random-effects models, accounting for dependency structure of effect sizes within studies. Heterogeneity will be assessed using τ2 and I2 statistic. Potential moderators, based on key study and intervention design factors, will be investigated using mixed-effects meta-regression models.Ethics and disseminationNo ethical approval is required. The findings will be disseminated in a peer-reviewed scientific journal.PROSPERO registration numberCRD42020185386.


2021 ◽  
Author(s):  
Janet Rodríguez-Torres ◽  
Andrés Calvache-Mateo ◽  
Araceli Ortíz-Rubio ◽  
Natalia Muñoz-Vigueras ◽  
Laura López-López ◽  
...  

Abstract PurposeSurvival rates for many forms of thoracic malignancies have improved over the past few decades, however, many survivors are coping with the side effects of cancer treatment for longer. Physical activity has been proposed as a therapeutic strategy to act across multiple organ systems and improve clinical outcomes and eHealth could be a good way to encourage patients. The aim of this systematic review was to explore the effects of eHealth in the promotion of PA among thoracic malignancies.MethodsSuitable articles were searched using PubMed, Web of Science and Scopus databases using a combination of medical subject headings. Articles were screened by two independent reviewers and were included if they presented an eHealth intervention to improve PA in thoracic malignancies.ResultsIn total, 4781 articles were identified, of which ten met eligibility criteria. Different eHealth interventions were described in these studies: mobile application (app) (n=3), website (n=2), email (n=2), web and mobile application (n=1), telephone counseling (n=1) and online sheet (n=1). All studies reported improvements in PA, with 8/10 studies reporting statistically significant changes. ConclusionMeta-analysis revealed eHealth is a good way to improve PA in thoracic malignancies survivors, compared to no intervention, conventional treatment or a diet approach. Future studies are needed to clarify the specific intervention to improve these patients’ recovery.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Cai ◽  
Fei Feng ◽  
Qianqian Wei ◽  
Zheng Jiang ◽  
Ruwei Ou ◽  
...  

Background: Parkinson's disease (PD) and sarcopenia are two common diseases in aging people. To date, the prevalence of sarcopenia in PD patients and the relationship between clinical features and sarcopenia in PD patients are not clear. The aim of the study was to (1) assess the prevalence of sarcopenia in PD patients and (2) reveal the clinical features between PD patients with and without sarcopenia.Method: A systematic review was carried out through screening PubMed, EMBASE, and Cochrane database in May 2020. All study designs (case–control, cohort, and cross-sectional studies) were eligible for meta-analysis. Data of patients' characteristics, sarcopenia criteria, sarcopenia prevalence, and sarcopenia measures were retrieved. The primary outcome was estimated prevalence of sarcopenia by a pooled prevalence (%) and its 95% confidence interval (CI), using a random-effects model. The secondary outcome was the differences in clinical features between PD patients with and without sarcopenia by meta-analysis. Included articles were assessed for risk of bias. Potential sources of variation were investigated by using subgroup analyses and meta-regression.Result: Ten studies were included in the review. Among them, nine were cross-sectional studies, and one was a prospective cohort study. Age of participants with PD in the studies ranged from 51.1 to 80.7 years. The estimated prevalence of sarcopenia ranged from 6 to 55.5%. The random-effects pooled prevalence was 29% (95% CIs: 0.18–0.40). When only studies at low risk of bias were considered, pooled prevalence decreased to 17% (95% CIs: 0.02–0.33), with still high heterogeneity. The incidence of falls in PD patients with sarcopenia was higher than that in PD patients without sarcopenia. There was no difference in sex ratio between PD patients with and without sarcopenia.Conclusion: Sarcopenia seems to be common in patients with PD. Early assessment of sarcopenia should be implemented in PD to avoid fall and disability.


2018 ◽  
Vol 49 (14) ◽  
pp. 2342-2353 ◽  
Author(s):  
Charlotte Louise Eversfield ◽  
Llwyd David Orton

AbstractBackgroundNon-motor features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), such as auditory hallucinations (AH), contribute to disease burden but are not well understood.MethodsSystematic review and random-effects meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods.ResultsSearches identified 4542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% [95% confidence interval (CI) 5.3–14.5], while in DLB was estimated to be 30.8% (±23.4 to 39.3). Verbal hallucinations, perceived as originating outside the head, were the most common form of AH. Non-verbal AH were also common while musical AH were rare. VH were more prevalent, with an estimated pooled prevalence in PD of 28.2% (±19.1 to 39.5), while in DLB they were estimated to be 61.8% (±49.1 to 73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates.ConclusionsAH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.


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