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Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy
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Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 46468

Special Issue Editors

Dr. Marco Tramontano

E-Mail Website
Guest Editor
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40136 Bologna, Italy
Interests: vestibular rehabilitation; osteopathic manipulative treatment; neurorehabilitation, balance disorders
Special Issues, Collections and Topics in MDPI journals
Dr. Giovanni Galeoto

E-Mail Website
Guest Editor
Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
Interests: epidemiology; rehabilitation in orthopedics and neurology; validation of measuring tools; rehabilitation; psychometric and outcome measures validity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last few decades, neurorehabilitation research has seen significant progress. Many neurological patients suffer from impaired balance, loss of range of motion or function, and muscle weakness, all of which can have a significant impact on their activities of daily living. Physiotherapist is a part of a multiprofessional and interdisciplinary team targeted at improving activities of daily living and quality of life and preventing secondary complications and comorbidities. There are numerous effective treatment modalities available for neurorehabilitation that include physiotherapy. Indeed, physiotherapy could stimulate the neurological system through various cognitive motor strategies and exercises to increase strength, mobility, balance, and coordination. Challenging innovative therapeutic approaches tailored on patients’ needs have progressed substantially recently.

A strong heterogeneity of validated tools among various national contexts can be seen. This heterogeneity can be assumed to have a positive meaning if one thinks about the multiple needs of the clinical context; however, clinicians have conflicting or incomplete information available to use when making decisions in patient care. Furthermore, the lack of consistency and the deficiency of standardization in outcome assessment have hindered comparative research and meta-analysis.

With this Special Issue, we would like to offer the opportunity to increase and improve evidence about the role of physiotherapy in the management and treatment of patients with neurological disorders through conventional and innovative therapeutic approaches. On the other hand, we encourage the validity and the use of practical and appropriate outcome measures allowing comparisons and meta-analysis of high-quality randomized controlled trials.

Dr. Marco Tramontano
Dr. Giovanni Galeoto
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • physiotherapy
  • rehabilitation
  • outcome measures
  • neurologic disorders

Published Papers (11 papers)

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Research

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8 pages, 555 KiB  
Article
The Effects of Sternocleidomastoid Muscle Taping on Postural Control in Healthy Young Adults: A Pilot Crossover Study
by Alex Martino Cinnera, Alessandro Antonio Princi, Enza Leone, Serena Marrano, Alessandra Pucello, Stefano Paolucci, Marco Iosa and Giovanni Morone
Healthcare 2022, 10(5), 946; https://doi.org/10.3390/healthcare10050946 - 20 May 2022
Cited by 1 | Viewed by 1653
Abstract
Background: Postural control is a complex ability, also controlled by the somatosensory connection of the neck muscles with the vestibular nuclei. This circuit seems to be interested in maintaining head stabilization during movements. The sternocleidomastoid (SCM) muscle is the dominant source of the [...] Read more.
Background: Postural control is a complex ability, also controlled by the somatosensory connection of the neck muscles with the vestibular nuclei. This circuit seems to be interested in maintaining head stabilization during movements. The sternocleidomastoid (SCM) muscle is the dominant source of the vestibular afferents as confirmed by neurophysiological acquisition. The aim of this study is to evaluate whether the application of kinesio-tape on the SCM muscle can induce a perturbation of the standing postural control by altering the somatosensory system of the neck muscles. Methods: Thirteen healthy participants (age: 24.46 ± 3.04 yrs; 9 female) were enrolled, and the four kinesio-tape (KT) conditions were performed in a random order: without KT application (Ctrl); right KT application (R-SCM); left KT application (L-SCM); and bilateral KT application (B-SCM). All conditions were performed three times with open eyes and closed eyes. Results: There was a significant increase in the length of the centre of pressure (CoP), in the maximal oscillation, and in the anteroposterior root mean square between the three tape application conditions with respect to the Ctrl condition with open eyes. The same parameters were statistically different when the participants were blindfolded in the B-SCM condition with respect to the Ctrl condition. A statistical decrease in the difference in weight distribution between the two feet was observed in the B-SCM group with respect to the Ctrl group in both open and closed eyes conditions. Conclusions: Our results suggest that KT on the SCM muscles may involve some space-time parameters of postural control. Bilateral KT improved the weight distribution between the feet but showed a parallel increase in anteroposterior oscillations and in the length of the CoP with respect to the Ctrl condition. The perturbation seems to be greater in the somatosensory system when it is working coupled with visual afferences during an upright position. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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8 pages, 942 KiB  
Article
Identification of Determinants of Biofeedback Treatment’s Efficacy in Treating Migraine and Oxidative Stress by ARIANNA (ARtificial Intelligent Assistant for Neural Network Analysis)
by Irene Ciancarelli, Giovanni Morone, Maria Giuliana Tozzi Ciancarelli, Stefano Paolucci, Paolo Tonin, Antonio Cerasa and Marco Iosa
Healthcare 2022, 10(5), 941; https://doi.org/10.3390/healthcare10050941 - 19 May 2022
Cited by 4 | Viewed by 1714
Abstract
Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. [...] Read more.
Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. Evidence shows a complex relationship between nitric oxide (NO) and superoxide anions, and their modification could lead to an effective treatment. Conventional analyses may fail in highlighting the complex, nonlinear relationship among factors and outcomes. The aim of the present study was to verify if an artificial neural network (ANN) named ARIANNA could verify if the serum levels of the decomposition products of NO—nitrite and nitrate (NOx)—the superoxide dismutase (SOD) serum levels, and the Migraine Disability Assessment Scores (MIDAS) could constitute prognostic variables predicting biofeedback’s efficacy in migraine treatment. Twenty women affected by chronic migraine were enrolled and underwent an EMG-biofeedback treatment. The results show an accuracy for the ANN of 75% in predicting the post-treatment MIDAS score, highlighting a statistically significant correlation (R = −0.675, p = 0.011) between NOx (nitrite and nitrate) and MIDAS only when the peroxide levels in the serum were within a specific range. In conclusion, the ANN was proven to be an innovative methodology for interpreting the complex biological phenomena and biofeedback treatment in migraines. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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10 pages, 261 KiB  
Article
The Effect of Music-Based Rhythmic Auditory Stimulation on Balance and Functional Outcomes after Stroke
by Samira Gonzalez-Hoelling, Gloria Reig-Garcia, Carme Bertran-Noguer and Rosa Suñer-Soler
Healthcare 2022, 10(5), 899; https://doi.org/10.3390/healthcare10050899 - 12 May 2022
Cited by 3 | Viewed by 2483
Abstract
Purpose: the purpose of this paper was to evaluate the effects of music-based rhythmic auditory stimulation on balance and motor function after stroke and whether there are differences depending on the affected hemisphere, lesion site and age. Materials and Methods: This study was [...] Read more.
Purpose: the purpose of this paper was to evaluate the effects of music-based rhythmic auditory stimulation on balance and motor function after stroke and whether there are differences depending on the affected hemisphere, lesion site and age. Materials and Methods: This study was an observational and longitudinal study. Adult stroke survivors (n = 28), starting no later than 3 weeks after a stroke, conducted 90 min sessions of music-based rhythmic auditory stimulation 3 days a week, in addition to 60 min a day of conventional physiotherapy. Balance ability was evaluated using the Mini Best Test and the Tinetti Test; motor function was evaluated using the Motor Assessment Scale. Results: All of the participants significantly improved their balance ability and motor function variables upon comparing scores at discharge and admission. Intragroup differences were observed upon comparing subgroups of patients by lesion site and by the degree of motor impairment. Age, stroke type and affected hemisphere seemed not to be directly related to the amount of improvement. Conclusions: This study suggests that the effects of music-based rhythmic auditory stimulation (RAS) on balance ability and motor function varies depending on the scale or test used for evaluation and on the variables that the tests measure. Patients with hemiparesis seemed to improve more than those with hemiplegia. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
10 pages, 1459 KiB  
Article
The Effectiveness of Equine Therapy Intervention on Activities of Daily Living, Quality of Life, Mood, Balance and Gait in Individuals with Parkinson’s Disease
by Anna Berardi, Giorgia Di Napoli, Monica Ernesto, Giovanni Fabbrini, Antonella Conte, Gina Ferrazzano, Fabio Viselli and Giovanni Galeoto
Healthcare 2022, 10(3), 561; https://doi.org/10.3390/healthcare10030561 - 17 Mar 2022
Cited by 5 | Viewed by 3327
Abstract
Objectives: The objective of this study was to evaluate the efficacy of equine therapy (ET) to detect changes in the activities of daily living, quality of life, mood, balance, and gait in individuals with Parkinson’s disease (PD). Material and Methods: In the study, [...] Read more.
Objectives: The objective of this study was to evaluate the efficacy of equine therapy (ET) to detect changes in the activities of daily living, quality of life, mood, balance, and gait in individuals with Parkinson’s disease (PD). Material and Methods: In the study, 17 participants with PD were recruited to participate in 10 sessions of ET. The inclusion criteria of the study were: second and third stages of the Hoehn and Yahr scale, Mini-Mental State Examination (MMSE) greater than or equal to 24 points, and age up to 85 years. The outcome measures administered at the beginning and the end of treatment relied on measurements from the Rivermead ADL scale, Parkinson’s Disease Questionnaire-39 (PDQ-39), Zung Self-Rating Depression Scale (SDS), unified Parkinson’s disease rating scale (UPDRS), and Tinetti balance assessment. Data from the stabilometric platform were also collected to objectify the value obtained by the Tinetti balance assessment. The ET program included 10 biweekly 45 min sessions. Results: The results obtained included statistically significant increases in measurements from the Rivermead ADL, PDQ-39, UPDRS, SDS, and Tinetti balance assessment scales. The stabilometric platform did not report significant changes in data. Conclusion: ET that was used as a supportive therapy for traditional treatments resulted in statistically significant improvements in the occupational performance, mood, quality of life, gait, and balance of the participants. Data from the stabilometric platform did not show significant changes. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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16 pages, 1408 KiB  
Article
Effect of Intensive Rehabilitation Program in Thermal Water on a Group of People with Parkinson’s Disease: A Retrospective Longitudinal Study
by Roberto Di Marco, Francesca Pistonesi, Valeria Cianci, Roberta Biundo, Luca Weis, Lucrezia Tognolo, Alfonc Baba, Maria Rubega, Giovanni Gentile, Chiara Tedesco, Miryam Carecchio, Angelo Antonini and Stefano Masiero
Healthcare 2022, 10(2), 368; https://doi.org/10.3390/healthcare10020368 - 14 Feb 2022
Cited by 4 | Viewed by 3125
Abstract
The main objective of this study is to test the effect of thermal aquatic exercise on motor symptoms and quality of life in people with Parkinson’s Disease (PD). Fourteen participants with diagnosis of idiopathic PD completed the whole rehabilitation session and evaluation protocol [...] Read more.
The main objective of this study is to test the effect of thermal aquatic exercise on motor symptoms and quality of life in people with Parkinson’s Disease (PD). Fourteen participants with diagnosis of idiopathic PD completed the whole rehabilitation session and evaluation protocol (Hoehn and Yahr in OFF state: 2–3; Mini Mental State Examination >24; stable pharmacological treatment in the 3 months prior participating in the study). Cognitive and motor status, functional abilities and quality of life were assessed at baseline and after an intensive rehabilitation program in thermal water (12 sessions of 45 min in a 1.4 m depth pool at 32–36 ∘C). The Mini Balance Evaluation System Test (Mini-BESTest) and the PD Quality of Life Questionnaire (PDQ-39) were considered as main outcomes. Secondary assessment measures evaluated motor symptoms and quality of life and psychological well-being. Participants kept good cognitive and functional status after treatment. Balance of all the participants significantly improved (Mini-BESTest: p<0.01). The PDQ-39 significantly improved after rehabilitation (p=0.038), with significance being driven by dimensions strongly related to motor status. Thermal aquatic exercise may represent a promising rehabilitation tool to prevent the impact of motor symptoms on daily-life activities of people with PD. PDQ-39 improvement foreshows good effects of the intervention on quality of life and psychological well-being. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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14 pages, 2937 KiB  
Article
Neurogenic Bowel Dysfunction Changes after Osteopathic Care in Individuals with Spinal Cord Injuries: A Preliminary Randomized Controlled Trial
by Federica Tamburella, Alessandro Antonio Princi, Jacopo Piermaria, Matteo Lorusso, Giorgio Scivoletto, Marcella Masciullo, Giovanni Cardilli, Paola Argentieri and Marco Tramontano
Healthcare 2022, 10(2), 210; https://doi.org/10.3390/healthcare10020210 - 21 Jan 2022
Cited by 1 | Viewed by 5817
Abstract
Background: Neurogenic bowel dysfunction (NBD) indicates bowel dysfunction due to a lack of nervous control after a central nervous system lesion. Bowel symptoms, such as difficulties with evacuation, constipation, abdominal pain and swelling, are experienced commonly among individuals with spinal cord injury (SCI). [...] Read more.
Background: Neurogenic bowel dysfunction (NBD) indicates bowel dysfunction due to a lack of nervous control after a central nervous system lesion. Bowel symptoms, such as difficulties with evacuation, constipation, abdominal pain and swelling, are experienced commonly among individuals with spinal cord injury (SCI). Consequentially, individuals with SCI experience a general dissatisfaction with the lower perceived quality of life (QoL). Several studies have demonstrated the positive effects of manual therapies on NBD, including Osteopathic Manipulative Treatment (OMT). This study aimed to explore OMT effects on NBD in individuals with SCI compared with Manual Placebo Treatment (MPT). Methods: The study was a double-blind randomized controlled trial composed of three phases, each one lasting 30 days (i: NBD/drugs monitoring; ii: four OMT/MPT sessions; iii: NBD/drug monitoring and follow-up evaluation). Results: the NBD scale, the QoL on worries and concerns sub-questionnaire, and the perception of abdominal swelling and constipation significantly improved after treatments compared to baseline only for individuals who underwent OMT. Conclusion: These preliminary results showed positive effects of OMT on bowel function and QoL in individuals with SCI, but further studies are needed to confirm our results. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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Review

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8 pages, 558 KiB  
Review
The Clinical Use of the Suppression Head Impulse Paradigm in Patients with Vestibulopathy: A Systematic Review
by Leonardo Manzari, Sara De Angelis, Alessandro Antonio Princi, Giovanni Galeoto and Marco Tramontano
Healthcare 2022, 10(7), 1182; https://doi.org/10.3390/healthcare10071182 - 24 Jun 2022
Cited by 10 | Viewed by 1351
Abstract
Background: This review aims to explore the potential clinical application of the suppression head impulse paradigm (SHIMP) in patients with unilateral and bilateral vestibulopathy. Methods: An electronic search was conducted by two independent reviewers in the following databases: Embase, MEDLINE (PubMed), and Scopus. [...] Read more.
Background: This review aims to explore the potential clinical application of the suppression head impulse paradigm (SHIMP) in patients with unilateral and bilateral vestibulopathy. Methods: An electronic search was conducted by two independent reviewers in the following databases: Embase, MEDLINE (PubMed), and Scopus. The screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers. The included studies were quality appraised using a modified version of the Newcastle–Ottawa Scale. Results: The results were reported following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Our search yielded 935 unique records, of which 16 remained after screening titles and abstracts. A total of 11 studies were included, covering a total of 418 participants (230 patients and 188 healthy participants). Conclusion: SHIMP could be a useful tool to diagnose a VOR alteration in patients with vestibulopathy in both the acute and chronic phases of vestibulopathy. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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13 pages, 1827 KiB  
Review
Effectiveness of Constraint-Induced Movement Therapy (CIMT) on Balance and Functional Mobility in the Stroke Population: A Systematic Review and Meta-Analysis
by Jaya Shanker Tedla, Kumar Gular, Ravi Shankar Reddy, Arthur de Sá Ferreira, Erika Carvalho Rodrigues, Venkata Nagaraj Kakaraparthi, Giles Gyer, Devika Rani Sangadala, Mohammed Qasheesh, Rakesh Krishna Kovela and Gopal Nambi
Healthcare 2022, 10(3), 495; https://doi.org/10.3390/healthcare10030495 - 8 Mar 2022
Cited by 13 | Viewed by 5939
Abstract
Constraint-induced movement therapy (CIMT) is one of the most popular treatments for enhancing upper and lower extremity motor activities and participation in patients following a stroke. However, the effect of CIMT on balance is unclear and needs further clarification. The aim of this [...] Read more.
Constraint-induced movement therapy (CIMT) is one of the most popular treatments for enhancing upper and lower extremity motor activities and participation in patients following a stroke. However, the effect of CIMT on balance is unclear and needs further clarification. The aim of this research was to estimate the effect of CIMT on balance and functional mobility in patients after stroke. After reviewing 161 studies from search engines including Google Scholar, EBSCO, PubMed, PEDro, Science Direct, Scopus, and Web of Science, we included eight randomized controlled trials (RCT) in this study. The methodological quality of the included RCTs was verified using PEDro scoring. This systematic review showed positive effects of CIMT on balance in three studies and similar effects in five studies when compared to the control interventions such as neuro developmental treatment, modified forced-use therapy and conventional physical therapy. Furthermore, a meta-analysis indicated a statistically significant effect size by a standardized mean difference of 0.51 (P = 0.01), showing that the groups who received CIMT had improved more than the control groups. However, the meta-analysis results for functional mobility were statistically insignificant, with an effect size of −4.18 (P = 0.16), indicating that the functional mobility improvements in the investigated groups were not greater than the control group. This study’s findings demonstrated the superior effects of CIMT on balance; however, the effect size analysis of functional mobility was statistically insignificant. These findings indicate that CIMT interventions can improve balance-related motor function better than neuro developmental treatment, modified forced-use therapy and conventional physical therapy in patients after a stroke. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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16 pages, 2407 KiB  
Review
Effectiveness of Physiotherapy in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis
by Luca Pontone Gravaldi, Francesca Bonetti, Simona Lezzerini and Fernando De Maio
Healthcare 2022, 10(1), 132; https://doi.org/10.3390/healthcare10010132 - 10 Jan 2022
Cited by 12 | Viewed by 8441
Abstract
This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were [...] Read more.
This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = −0.37, 95% CI, −0.64; −0.11; p < 0.001, I2 = 71.25%, n = 629), and functional capacity (standardised mean difference = −0.36, 95% CI, −0.61; −0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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13 pages, 1556 KiB  
Review
International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review
by Marco Tramontano, Federica Tamburella, Fulvio Dal Farra, Andrea Bergna, Christian Lunghi, Mattia Innocenti, Fabio Cavera, Federica Savini, Vincenzo Manzo and Giandomenico D’Alessandro
Healthcare 2022, 10(1), 28; https://doi.org/10.3390/healthcare10010028 - 24 Dec 2021
Cited by 23 | Viewed by 7769
Abstract
Background: Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in [...] Read more.
Background: Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. Methods: A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the “Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews” (PRISMA-ScR). Results: A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. Conclusions: Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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Other

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16 pages, 1611 KiB  
Systematic Review
Effect of Transcranial Direct Current Stimulation Combined with Rehabilitation on Arm and Hand Function in Stroke Patients: A Systematic Review and Meta-Analysis
by Joo-Hyun Lee, Yu-Jin Jeun, Hae Yean Park and Young-Jin Jung
Healthcare 2021, 9(12), 1705; https://doi.org/10.3390/healthcare9121705 - 8 Dec 2021
Cited by 5 | Viewed by 3192
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases [...] Read more.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653], p < 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003], p < 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909], p < 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients. Full article
(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)
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