scholarly journals Vibrotactile-Based Rehabilitation on Balance and Gait in Patients with Neurological Diseases: A Systematic Review and Metanalysis

2021 ◽  
Vol 11 (4) ◽  
pp. 518
Author(s):  
Sara De Angelis ◽  
Alessandro Antonio Princi ◽  
Fulvio Dal Farra ◽  
Giovanni Morone ◽  
Carlo Caltagirone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fear Of Falling ◽  
Neurological Diseases ◽  
Cerebrovascular Diseases ◽  
Gait Rehabilitation ◽  
Proprioceptive Information ◽  
High Quality ◽  
Active Involvement ◽  
Task Oriented ◽  
Multisensory Information

Postural instability and fear of falling represent two major causes of decreased mobility and quality of life in cerebrovascular and neurologic diseases. In recent years, rehabilitation strategies were carried out considering a combined sensorimotor intervention and an active involvement of the patients during the rehabilitation sessions. Accordingly, new technological devices and paradigms have been developed to increase the effectiveness of rehabilitation by integrating multisensory information and augmented feedback promoting the involvement of the cognitive paradigm in neurorehabilitation. In this context, the vibrotactile feedback (VF) could represent a peripheral therapeutic input, in order to provide spatial proprioceptive information to guide the patient during task-oriented exercises. The present systematic review and metanalysis aimed to explore the effectiveness of the VF on balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. A total of 18 studies met the inclusion criteria and were included. Due to the lack of high-quality studies and heterogeneity of treatments protocols, clinical practice recommendations on the efficacy of VF cannot be made. Results show that VF-based intervention could be a safe complementary sensory-motor approach for balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. More high-quality randomized controlled trials are needed.

scholarly journals Determining the influence of intervention characteristics on implementation success requires reliable and valid measures: Results from a systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952199419
Author(s):  
Cara C Lewis ◽  
Kayne Mettert ◽  
Aaron R Lyon
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Systematic Reviews ◽  
Quality Measures ◽  
Measure Development ◽  
Relative Advantage ◽  
Design Quality ◽  
High Quality ◽  
Evidence Strength

Background: Despite their inclusion in Rogers’ seminal diffusion of innovations theory, few implementation studies empirically evaluate the role of intervention characteristics. Now, with growing evidence on the role of adaptation in implementation, high-quality measures of characteristics such as adaptability, trialability, and complexity are needed. Only two systematic reviews of implementation measures captured those related to the intervention or innovation and their assessment of psychometric properties was limited. This manuscript reports on the results of eight systematic reviews of measures of intervention characteristics with nuanced data regarding a broad range of psychometric properties. Methods: The systematic review proceeded in three phases. Phase I, data collection, involved search string generation, title and abstract screening, full text review, construct assignment, and citation searches. Phase II, data extraction, involved coding psychometric information. Phase III, data analysis, involved two trained specialists independently rating each measure using PAPERS (Psychometric And Pragmatic Evidence Rating Scales). Results: Searches identified 16 measures or scales: zero for intervention source, one for evidence strength and quality, nine for relative advantage, five for adaptability, six for trialability, nine for complexity, and two for design quality and packaging. Information about internal consistency and norms was available for most measures, whereas information about other psychometric properties was most often not available. Ratings for psychometric properties fell in the range of “poor” to “good.” Conclusion: The results of this review confirm that few implementation scholars are examining the role of intervention characteristics in behavioral health studies. Significant work is needed to both develop new measures (e.g., for intervention source) and build psychometric evidence for existing measures in this forgotten domain. Plain Language Summary Intervention characteristics have long been perceived as critical factors that directly influence the rate of adopting an innovation. It remains unclear the extent to which intervention characteristics including relative advantage, complexity, trialability, intervention source, design quality and packaging, evidence strength and quality, adaptability, and cost impact implementation of evidence-based practices in behavioral health settings. To unpack the differential influence of these factors, high quality measures are needed. Systematic reviews can identify measures and synthesize the data regarding their quality to identify gaps in the field and inform measure development and testing efforts. Two previous reviews identified measures of intervention characteristics, but they did not provide information about the extent of the existing evidence nor did they evaluate the host of evidence available for identified measures. This manuscript summarizes the results of nine systematic reviews (i.e., one for each of the factors listed above) for which 16 unique measures or scales were identified. The nuanced findings will help direct measure development work in this forgotten domain.

scholarly journals Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

AbstractGait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

scholarly journals Measurement properties of patient-reported outcome measures (PROMs) in hyperhidrosis: a systematic review

2021 ◽  
Author(s):  
Michaela Gabes ◽  
Helge Knüttel ◽  
Gesina Kann ◽  
Christina Tischer ◽  
Christian J. Apfelbacher
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
High Quality ◽  
High Quality Evidence ◽  
Patient Reported ◽  
Quality Evidence

Abstract Purpose To critically appraise, compare and summarize the quality of all existing PROMs that have been validated in hyperhidrosis to at least some extend by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Thereby, we aim to give a recommendation for the use of PROMs in future clinical trials in hyperhidrosis. Methods We considered studies evaluating, describing or comparing measurement properties of PROMs as eligible. A systematic literature search in three big databases (MEDLINE, EMBASE and Web of Science) was performed. We assessed the methodological quality of each included study using the COSMIN Risk of Bias checklist. Furthermore, we applied predefined quality criteria for good measurement properties and finally, graded the quality of the evidence. Results Twenty-four articles reporting on 13 patient-reported outcome measures were included. Three instruments can be further recommended for use. They showed evidence for sufficient content validity and moderate- to high-quality evidence for sufficient internal consistency. The methodological assessment showed existing evidence gaps for eight other PROMs, which therefore require further validation studies to make an adequate decision on their recommendation. The Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) and the short-form health survey with 36 items (SF-36) were the only questionnaires not recommended for use in patients with hyperhidrosis due to moderate- to high-quality evidence for insufficient measurement properties. Conclusion Three PROMs, the Hyperhidrosis Quality of Life Index (HidroQoL), the Hyperhidrosis Questionnaire (HQ) and the Sweating Cognitions Inventory (SCI), can be recommended for use in future clinical trials in hyperhidrosis. Results obtained with these three instruments can be seen as trustworthy. Nevertheless, further validation of all three PROMs is desirable. Systematic review registration PROSPERO CRD42020170247

scholarly journals Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1288
Author(s):  
Marilia Carabotti ◽  
Francesca Falangone ◽  
Rosario Cuomo ◽  
Bruno Annibale
Keyword(s):  
Systematic Review ◽  
Diverticular Disease ◽  
Dietary Habits ◽  
Acute Diverticulitis ◽  
High Quality ◽  
Eligibility Criteria ◽  
Diverticular Bleeding ◽  
Recurrent Diverticulitis ◽  
Increased Risk

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding.

scholarly journals The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Fateme Pol ◽  
Mohammad Ali Salehinejad ◽  
Hamzeh Baharlouei ◽  
Michael A. Nitsche
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Cortical Excitability ◽  
Experimental Studies ◽  
Gait Rehabilitation ◽  
Direct Current Stimulation

Abstract Background Gait problems are an important symptom in Parkinson’s disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD. Results Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD. Conclusions tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

scholarly journals Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Keely Jordan ◽  
Todd P. Lewis ◽  
Bayard Roberts
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Point Of Care ◽  
System Level ◽  
System Quality ◽  
High Quality ◽  
Humanitarian Settings ◽  
Quality Health

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

The effectiveness of exergames on fear of falling in community-dwelling older adults: a systematic review

2021 ◽  
pp. 1-12
Author(s):  
Lanying Ge ◽  
Tai-Te Su ◽  
Yu An ◽  
Shannon T. Mejía
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals A Systematic Review of the Efficacy of Gait Rehabilitation Strategies for Spinal Cord Injury

2007 ◽  
Vol 13 (1) ◽  
pp. 32-57 ◽  
Author(s):  
Tania Lam ◽  
Janice Eng ◽  
Dalton Wolfe ◽  
Jane Hsieh ◽  
Maura Whittaker
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Gait Rehabilitation ◽  
Cord Injury ◽  
Rehabilitation Strategies

Robotic-assisted gait rehabilitation following stroke: a systematic review of current guidelines and practical clinical recommendations

2021 ◽  
Vol 57 (3) ◽  
Author(s):  
Rocco S. CALABRÒ ◽  
Gregorio SORRENTINO ◽  
Anna CASSIO ◽  
Davide MAZZOLI ◽  
Elisa ANDRENELLI ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gait Rehabilitation ◽  
Robotic Assisted ◽  
Clinical Recommendations ◽  
Current Guidelines
Sign in / Sign up

Export Citation Format

Share Document