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[Abstract + References] Epilepsy, Physical Activity and Sports: A Narrative Review

Abstract

People with epilepsy (PWE) are less physically active compared with the general population. Explanations include prejudice, overprotection, unawareness, stigma, fear of seizure induction and lack of knowledge of health professionals. At present, there is no consensus on the role of exercise in epilepsy. This paper reviews the current evidence surrounding the risks and benefits associated with physical activity (PA) in this group of patients. In the last decade, several publications indicate significant benefits in physiological and psychological health parameters, including mood and cognition, physical conditioning, social interaction, quality of life, as well as potential prevention of seizure presentation. Moreover, experimental studies suggest that PA provides mechanisms of neuronal protection, related to biochemical and structural changes including release of β-endorphins and steroids, which may exert an inhibitory effect on the occurrence of abnormal electrical activity. Epileptic discharges can decrease or disappear during exercise, which may translate into reduced seizure recurrence. In some patients, exercise may precipitate seizures. Available evidence suggests that PA should be encouraged in PWE in order to promote wellbeing and quality of life. There is a need for prospective randomized controlled studies that provide stronger clinical evidence before definitive recommendations can be made.

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[A Systematic Review] The Clinical, Quality of Life and Economic Outcomes of Inpatient Rehabilitation – Full Text PDF

Abstract

Objective: To systematically review the clinical, functional and economic benefits of Inpatient Rehabilitation for the most common disorders of the nervous system: stroke, spinal cord injury, and multiple sclerosis.

Methodology: PubMed, Embase, Scopus, CEA Registry, and NHS EED databases were searched using combinations of three sets of keywords using various terms for rehabilitation, benefits, and treatments. The outcomes considered included measures of independence in activities of daily living (ADL), motor function, disability, handicap,
gait velocity, quality of life, and economics. Following the initial literature search, the abstracts and full texts of the identified studies were reviewed and assessed for inclusion by two independent researchers based on pre-determined criteria. The data of selected studies were extracted into a data extraction form and consequently were synthesized.

Results: Forty-six articles met the inclusion criteria. Particularly, 21 studies evaluated inpatient rehabilitation after (or following) stroke, 15 studies evaluated inpatient rehabilitation after SCI, and seven studies evaluated inpatient rehabilitation for MS patients. The remaining three studies referred to mixed patient population. The majority of studies indicated that inpatient rehabilitation can provide clinical and functional benefits for all patient groups under consideration. Moreover, economic evaluations indicate that rehabilitation may be cost saving or cost-effective in certain patient groups such as those with fractures and stroke.

Conclusion: The results of the present review demonstrate that inpatient rehabilitation may deliver significant health and economic benefits for patients suffering from stroke, spinal cord injury, or multiple sclerosis and for health systems. Further research is needed to improve the consistency and robustness of the available evidence.

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