Posts Tagged Physical function

[Abstract] Systematic Review and Meta-analysis of Home-Based Rehabilitation on Improving Physical Function Among Home-dwelling Patients with a Stroke

Abstract

Objective

To evaluate the effects of home-based rehabilitation on improving physical function in home-dwelling patients after a stroke.

Data sources

Various electronic databases, including PubMed, CINAL, Embase, the Cochrane Central Register of Controlled Trials, and two Chinese datasets (i.e., Chinese Electronic Periodical Services and China Knowledge Resource Integrated) were searched for studies published before March 20, 2019.

Study selection

Randomized controlled trials conducted to examine the effect of home-based rehabilitation on improving physical function in home-dwelling patients with a stroke and published in English or Chinese were included. In total, 49 articles in English (n=23) and Chinese (n=26) met the inclusion criteria.

Data extraction

Data related to patient characteristics, study characteristics, intervention details, and outcomes were extracted by two independent reviewers.

Data synthesis

A random-effects model with a sensitivity analysis showed that home-based rehabilitation exerted moderate improvements on physical function in home-dwelling patients with a stroke (g = 0.58, 95% confidence interval [CI] 0.45∼0.70). Moderator analyses revealed that those stroke patients of a younger age, of a male gender, with a first-ever stroke episode, in the acute stage, and receiving rehabilitation training from their caregiver showed greater improvements in physical function.

Conclusions

Home rehabilitation can improve functional outcome in stroke survivors and should be considered appropriate during discharge planning if continuation care is required.

via Systematic Review and Meta-analysis of Home-Based Rehabilitation on Improving Physical Function Among Home-dwelling Patients with a Stroke – Archives of Physical Medicine and Rehabilitation

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[Abstract] Play-based interventions improve physical function for people with adult-acquired brain injury: a systematic review and meta-analysis of randomised controlled trials [with consumer summary] – PEDro 

Saywell N, Taylor N, Rodgers E, Skinner L, Boocock M

Clinical Rehabilitation 2016 Feb 11:Epub ahead of print

systematic review

 

OBJECTIVE: To undertake a systematic review and meta-analysis of the effectiveness of play-based interventions compared to traditional therapy in rehabilitation of adults with adult-acquired brain injury.

DATA SOURCES: The search was performed using Medline; CINAHL Plus; Health Source (Nursing/Academic Edition); Psychology and Behavioural Sciences Collection; Biomedical Reference Collection (Basic).

REVIEW METHODS: Studies included were randomised controlled trials that investigated the effect of play-based interventions on physical function of adults with adult acquired brain injury. Two independent reviewers identified eligible studies and assessed methodological quality using a modified Downs and Black. Meta-analysis compared standardised differences in means, to determine effect sizes for grouped functional outcome measures. The GRADE scoring system was used to determine the level of clinical evidence.

RESULTS: Thirty studies met the inclusion criteria, 13 were considered high quality and 17 moderate quality. Studies predominantly involved post-stroke participants, with only three studies including participants with traumatic brain injury. When compared to traditional therapy, dose-matched studies of play-based interventions showed a significant effect on independence (effect size (ES) 0.6) and physical performance (ES 0.43), as measured using the Fugl-Meyer. For non-dose matched studies, play-based interventions showed a significant improvement for balance (ES 0.76) compared with traditional therapy. In all studies that measured participant enjoyment, play-based therapy was rated as more enjoyable than traditional therapy.

CONCLUSION: Play-based interventions for people with adult acquired brain injury are more effective in improving balance and independence, which may be due to them being more enjoyable than traditional therapy.

Full text (sometimes free) may be available at these link(s):

PEDro

Source: PEDro – Search Detailed Search Results

 

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[Abstract] Play-based interventions improve physical function for people with adult-acquired brain injury: A systematic review and meta-analysis of randomised controlled trials

Abstract

Objective: To undertake a systematic review and meta-analysis of the effectiveness of play-based interventions compared to traditional therapy in rehabilitation of adults with adult-acquired brain injury.

Data sources: The search was performed using Medline; Cinahl Plus; Health Source (Nursing/Academic Edition); Psychology and behavioural sciences collection; Biomedical reference collection (basic).

Review methods: Studies included were randomised controlled trials that investigated the effect of play-based interventions on physical function of adults with adult acquired brain injury. Two independent reviewers identified eligible studies and assessed methodological quality using a modified Downs and Black. Meta-analysis compared standardised differences in means, to determine effect sizes for grouped functional outcome measures. The GRADE scoring system was used to determine the level of clinical evidence.

Results: Thirty studies met the inclusion criteria, 13 were considered high quality and 17 moderate quality. Studies predominantly involved post-stroke participants, with only three studies including participants with traumatic brain injury. When compared to traditional therapy, dose-matched studies of play-based interventions showed a significant effect on independence (Effect size (ES) = 0.6) and physical performance (ES = 0.43), as measured using the Fugl –Meyer. For non-dose matched studies, play-based interventions showed a significant improvement for balance (ES = 0.76) compared with traditional therapy. In all studies that measured participant enjoyment, play-based therapy was rated as more enjoyable than traditional therapy.

Conclusion: Play-based interventions for people with adult acquired brain injury are more effective in improving balance and independence, which may be due to them being more enjoyable than traditional therapy.

Source: Play-based interventions improve physical function for people with adult-acquired brain injury: A systematic review and meta-analysis of randomised controlled trials

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[ARTICLE] Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

Highlights

  • This study focused on technologies, safety and efficacy of exergames for older adults
  • Exergames show good potential as an exercise or rehabilitation tool for older adults
  • Based on the review, recommendations for practice and further research are provided
  • Exergames need to be personalized, safe and address multiple physical functions
  • Future studies should include longer follow-up, social aspects and game adherence

Abstract

Background: There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames.

Objectives: This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. Methods: We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included “game”, “exercise”, and “aged”, and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function.

Results: Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several studies found positive effects of exergaming on balance and gait, while none reported negative effects.

Conclusion: Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between studies in terms of intervention protocols and outcome measures, as well as several methodological limitations, recommendations for both practice and further research are provided in order to successfully establish exergames as an exercise and rehabilitation tool for older adults.

Source: Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

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