scholarly journals Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis

2016 ◽  
Vol 96 (12) ◽  
pp. 1938-1954 ◽  
Author(s):  
Noelle G. Moreau ◽  
Amy Winter Bodkin ◽  
Kristie Bjornson ◽  
Amy Hobbs ◽  
Mallary Soileau ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Resistance Training ◽  
Confidence Interval ◽  
Effect Size ◽  
Gait Speed ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Gait Training ◽  
Biofeedback Training ◽  
Children With Cerebral Palsy

AbstractBackgroundChildren with cerebral palsy (CP) have decreased gait speeds, which can negatively affect their community participation and quality of life. However, evidence for effective rehabilitation interventions to improve gait speed remains unclear.PurposeThe purpose of this study was to determine the effectiveness of interventions for improving gait speed in ambulatory children with CP.Data SourcesMEDLINE/PubMed, CINAHL, ERIC, and PEDro were searched from inception through April 2014.Study SelectionThe selected studies were randomized controlled trials or had experimental designs with a comparison group, included a physical therapy or rehabilitation intervention for children with CP, and reported gait speed as an outcome measure.Data ExtractionMethodological quality was assessed by PEDro scores. Means, standard deviations, and change scores for gait speed were extracted. General study information and dosing parameters (frequency, duration, intensity, and volume) of the intervention were recorded.Data SynthesisTwenty-four studies were included. Three categories of interventions were identified: gait training (n=8), resistance training (n=9), and miscellaneous (n=7). Meta-analysis showed that gait training was effective in increasing gait speed, with a standardized effect size of 0.92 (95% confidence interval=0.19, 1.66; P=.01), whereas resistance training was shown to have a negligible effect (effect size=0.06; 95% confidence interval=−0.12, 0.25; P=.51). Effect sizes from negative to large were reported for studies in the miscellaneous category.LimitationsGait speed was the only outcome measure analyzed.ConclusionsGait training was the most effective intervention in improving gait speed for ambulatory children with CP. Strength training, even if properly dosed, was not shown to be effective in improving gait speed. Velocity training, electromyographic biofeedback training, and whole-body vibration were effective in improving gait speed in individual studies and warrant further investigation.

scholarly journals Designing a Gait Enhancer and Determining its Effect on Standing Ability and Gait Speed of Children With Cerebral Palsy Spastic Diplegia

2021 ◽  
Vol 21 (4) ◽  
pp. 436-453
Author(s):  
Seyed Mehdi Hosseini ◽  
◽  
Saeid Fatorehchy ◽  
Seyed Ali Hosseini ◽  
Hojjat Allah Haghgoo ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Occupational Therapy ◽  
Effect Size ◽  
Gait Speed ◽  
Walking Speed ◽  
Spastic Diplegia ◽  
Cohen’S D ◽  
Children With Cerebral Palsy ◽  
Cohen's D ◽  
Therapy Sessions

Objective: This study aimed to design a “gait enhancer” and investigate its effect on standing ability and gait speed of children with cerebral palsy spastic diplegia. Materials & Methods: A new gate trainer was designed based on Theo Johnson mechanism. Johnson's two separate movement chains were placed on either side of the gate trainer body and attached to the lower limbs by a foot plate. To investigate the effect of the designed device, a single-item experimental study with baseline design, treatment and maintenance (ABA) was performed on four children with available spastic diplegia cerebral palsy. These children received routine occupational therapy sessions. Results: The designed “gait enhancer” increased standing ability and gait speed scores in all subjects. Non-overlapping measures also indicated the improvement in both variables. Measured by Cohen’s d, the effect size for standing ability were 1.95, 2.29, 1.83, and 2.3 for the child No. 1, 2, 3, and 4, respectively. Regarding walking speed, the effect size for these children, No. 1 to 4, were 1.13, 3.37, 2.15, and 2.21, respectively. Cohen’s d values were greater than 0.8, indicating the considerable effect of the intervention. Hedges’ g was also calculated due to the small sample size, which was greater than 0.8 for all subjects in standing ability and gait speed. Conclusion: Following the use of Gait Enhancer along with conventional occupational therapy, we observed an increase in the ability to stand and walk at children with cerebral palsy. Findings showed that the change in standing ability and walking speed occurred more during the period of using the designed device than other stages, which could be a consequence of using Gait Enhancer along with routine occupational therapy sessions at this stage of the study. However, it should be noted that this study was only a single case study and to prove the effectiveness of this tool in children with cerebral palsy, it is necessary to conduct clinical trial studies.

scholarly journals Robotic-Assisted Gait Training Effect on Function and Gait Speed in Subacute and Chronic Stroke Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 81 (3-4) ◽  
pp. 103-111 ◽  
Author(s):  
Jaya Shanker Tedla ◽  
Snehil Dixit ◽  
Kumar Gular ◽  
Mohammed Abohashrh
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Gait Speed ◽  
Meta Analysis ◽  
Gait Training ◽  
Chronic Stroke ◽  
Total Effect ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Subacute Stroke

Background: The review is intended to provide the effectiveness of robotic-assisted gait training (RAGT) for functional gait recovery in poststroke survivors through a systematic review and to provide evidence for gait speed improvements through the meta-analysis of randomized controlled trials (RCTs). Summary: In this systematic review, PubMed, Web of Science, Wiley Online Library, Science Direct, Science Robotics, Scopus, UpToDate, MEDLINE, Google Scholar, ­CINHAL, EMBASE, and EBSCO were reviewed to identify relevant RCTs. Articles included in the study were thoroughly examined by 2 independent reviewers. The included RCTs were having a PEDro score between 6 and 8 points. The initial database review yielded 1,371 studies and, following further screening; 9 studies finally were selected for systematic review and meta-analysis. Out of the 9 studies, 4 were on chronic stroke and 5 were on subacute stroke. The meta-analysis of gait speed showed an effect size value ranging between –0.91 and 0.64, with the total effect size of all the studies being –0.12. During subgroup analysis, the subacute stroke total effect size was identified as –0.48, and the chronic stroke total effect size was noted as 0.04. Meta-analysis revealed no significant differences between RAGT and conventional gait training (CGT). Key Messages: Our systematic review revealed that the RAGT application demonstrated a better or similar effect to that of CGT in a poststroke population. A meta-analysis of gait speed involving all the studies identified here indicated no significant differences between RAGT and CGT. However, the subanalysis of chronic stroke survivors showed a slight positive effect of RAGT on gait speed.

scholarly journals Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 98 (1) ◽  
pp. 63-77 ◽  
Author(s):  
Yuping Chen ◽  
HsinChen D Fanchiang ◽  
Ayanna Howard
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Effect Size ◽  
Literature Search ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy

Abstract Background Researchers recently investigated the effectiveness of virtual reality (VR) in helping children with cerebral palsy (CP) to improve motor function. A systematic review of randomized controlled trials (RCTs) using a meta-analytic method to examine the effectiveness of VR in children with CP was thus needed. Purpose The purpose of this study was to update the current evidence about VR by systematically examining the research literature. Data Sources A systematic literature search of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, ERIC, PsycINFO, and Web of Science up to December 2016 was conducted. Study Selection Studies with an RCT design, children with CP, comparisons of VR with other interventions, and movement-related outcomes were included. Data Extraction A template was created to systematically code the demographic, methodological, and miscellaneous variables of each RCT. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the study quality. Effect size was computed and combined using meta-analysis software. Moderator analyses were also used to explain the heterogeneity of the effect sizes in all RCTs. Data Synthesis . The literature search yielded 19 RCT studies with fair to good methodological quality. Overall, VR provided a large effect size (d = 0.861) when compared with other interventions. A large effect of VR on arm function (d = 0.835) and postural control (d = 1.003) and a medium effect on ambulation (d = 0.755) were also found. Only the VR type affected the overall VR effect: an engineer-built system was more effective than a commercial system. Limitations The RCTs included in this study were of fair to good quality, had a high level of heterogeneity and small sample sizes, and used various intervention protocols. Conclusions Then compared with other interventions, VR seems to be an effective intervention for improving motor function in children with CP.

Enhancement and retention of locomotor function in children with cerebral palsy after robotic gait training

2009 ◽  
Vol 30 ◽  
pp. S9-S10 ◽  
Author(s):  
Benjamin Patritti ◽  
Fernanda Romaguera ◽  
Lynn Deming ◽  
Anat Mirelman ◽  
Marlena Pelliccio ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Gait Training ◽  
Locomotor Function ◽  
Children With Cerebral Palsy ◽  
Robotic Gait

scholarly journals Changes of Ankle Dorsiflexion Using Compression Tissue Flossing: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-9
Author(s):  
Devin S. Kielur ◽  
Cameron J. Powden
Keyword(s):  
Confidence Interval ◽  
Range Of Motion ◽  
Effect Size ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Lower Extremity Injury ◽  
Level Of Evidence ◽  
Physically Active ◽  
Evidence Database

Context: Impaired dorsiflexion range of motion (DFROM) has been established as a predictor of lower-extremity injury. Compression tissue flossing (CTF) may address tissue restrictions associated with impaired DFROM; however, a consensus is yet to support these effects. Objectives: To summarize the available literature regarding CTF on DFROM in physically active individuals. Evidence Acquisition: PubMed and EBSCOhost (CINAHL, MEDLINE, and SPORTDiscus) were searched from 1965 to July 2019 for related articles using combination terms related to CTF and DRFOM. Articles were included if they measured the immediate effects of CTF on DFROM. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The level of evidence was assessed using the Strength of Recommendation Taxonomy. The magnitude of CTF effects from pre-CTF to post-CTF and compared with a control of range of motion activities only were examined using Hedges g effect sizes and 95% confidence intervals. Randomeffects meta-analysis was performed to synthesize DFROM changes. Evidence Synthesis: A total of 6 studies were included in the analysis. The average Physiotherapy Evidence Database score was 60% (range = 30%–80%) with 4 out of 6 studies considered high quality and 2 as low quality. Meta-analysis indicated no DFROM improvements for CTF compared with range of motion activities only (effect size = 0.124; 95% confidence interval, −0.137 to 0.384; P = .352) and moderate improvements from pre-CTF to post-CTF (effect size = 0.455; 95% confidence interval, 0.022 to 0.889; P = .040). Conclusions: There is grade B evidence to suggest CTF may have no effect on DFROM when compared with a control of range of motion activities only and results in moderate improvements from pre-CTF to post-CTF. This suggests that DFROM improvements were most likely due to exercises completed rather than the band application.

Effect of Individualized High-Velocity Resistance Training on Balance Performance in Children with Cerebral Palsy

2015 ◽  
Vol 47 ◽  
pp. 310
Author(s):  
Moataz Eltoukhy ◽  
Gabriela Wagener ◽  
Andrew Ordille ◽  
Kelly Drozdowicz ◽  
Casey Epstein ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Resistance Training ◽  
High Velocity ◽  
Balance Performance ◽  
Children With Cerebral Palsy

scholarly journals The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta-analysis

2018 ◽  
Vol 60 (9) ◽  
pp. 866-883 ◽  
Author(s):  
Adam T C Booth ◽  
Annemieke I Buizer ◽  
Pieter Meyns ◽  
Irene L B Oude Lansink ◽  
Frans Steenbrink ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Cerebral Palsy ◽  
Meta Analysis ◽  
Gait Training ◽  
Children And Young Adults ◽  
Functional Gait

Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness

2021 ◽  
pp. 1-13
Author(s):  
Darin Pauley ◽  
Pim Cuijpers ◽  
Davide Papola ◽  
Clara Miguel ◽  
Eirini Karyotaki
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Effect Size ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Wait List ◽  
Digital Interventions ◽  
Significant Difference

Abstract Background Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68–0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: −0.01 to 0.30]. Conclusion The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.

scholarly journals Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities

2020 ◽  
Vol 34 (10) ◽  
pp. 871-880
Author(s):  
Danique L. M. Radder ◽  
Ana Lígia Silva de Lima ◽  
Josefa Domingos ◽  
Samyra H. J. Keus ◽  
Marlies van Nimwegen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Resistance Training ◽  
Meta Analysis ◽  
Gait Training ◽  
Strategy Training ◽  
Treatment Modalities ◽  
Motor Symptoms ◽  
Nordic Walking ◽  
Conventional Physiotherapy

Background Physiotherapy is a commonly prescribed intervention for people with Parkinson’s disease (PD). Conventional types of physiotherapy have been studied extensively, while novel modalities are being developed and evaluated. Objective To evaluate the effectiveness of conventional and more recent physiotherapy interventions for people with PD. The meta-analysis performed as part of the 2014 European Physiotherapy Guideline for PD was used as the starting point and updated with the latest evidence. Methods We performed a systematic search in PubMed, CINAHL, Embase, and Web of Science. Randomized controlled trials comparing any physiotherapy intervention with no intervention or sham treatment were included. Trials were classified into 12 categories: conventional physiotherapy, resistance training, treadmill training, strategy training, dance, martial arts, aerobic exercises, hydrotherapy, balance and gait training, dual tasking, exergaming, and Nordic walking. Outcomes included motor symptoms, balance, gait, and quality of life, and are presented as standardized mean differences. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to systematically appraise methodological quality. Results A total of 191 trials with 7998 participants were included. Conventional physiotherapy significantly improved motor symptoms, gait, and quality of life. Resistance training improved gait. Treadmill training improved gait. Strategy training improved balance and gait. Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait. Exergaming improved balance and quality of life. Hydrotherapy improved balance. Finally, dual task training did not significantly improve any of the outcomes studied. Conclusions This meta-analysis provides a comprehensive overview of the evidence for the effectiveness of different physiotherapy interventions in the management of PD, allowing clinicians and patients to make an evidence-based decision for specific treatment modalities. Further work is needed to directly compare the relative efficacy of the various treatments.

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