Physical therapy for the management of global function, fatigue and quality of life in amyotrophic lateral sclerosis: systematic review and meta-analyses.

Autor:	Silva ST; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil stephano.tomaz@gmail.com., Costa IM; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil., Souza AA; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil., Pondofe K; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil., Melo LP; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil., Resqueti VR; Fisioterapia, Laboratório de Inovação Tecnológica em Reabilitação e PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil., Valentim R; Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil., Gonçalves F; Portuguese Association of Amyotrophic Lateral Sclerosis, Faculty of Health Sciences, University of A Coruna, A Coruna, Spain., Ribeiro TS; Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Aug 25; Vol. 14 (8), pp. e076541. Date of Electronic Publication: 2024 Aug 25.
DOI:	10.1136/bmjopen-2023-076541
Abstrakt:	Objectives: To critically evaluate the effectiveness of physical therapy interventions in improving global function, quality of life and fatigue in individuals with amyotrophic lateral sclerosis (ALS). Design: Systematic review and meta-analyses. Data Sources: MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro) were searched through 31 January 2023. Eligibility Criteria: We included randomised clinical trials (RCTs) that compared physical therapy interventions that act on global function, fatigue and quality of life in individuals with ALS with any other non-physiotherapeutic methods and techniques, placebo or non-intervention. The primary outcome measure was the evaluation of global function. Secondary outcomes were quality of life, fatigue and adverse events. Data Extraction and Synthesis: Two independent authors used a researcher-developed extraction form and the Rayyan software to search, screen and code included studies. The risk of bias was assessed using the PEDro scale. Meta-analyses were conducted employing random effects. Outcomes were succinctly presented in Grading of Recommendations, Assessment, Development and Evaluation evidence profiles. Results: Our searches identified 39 415 references. After study selection, three studies were included in the review. Such studies involved 62 participants with a mean age of 54.6 years. In the evaluated trials, 40 were male, while 22 participants were female. Regarding the type of onset of the disease, 58 participants had spinal onset of ALS, and four had bulbar. Conclusions: Physical therapy intervention may improve the global function of individuals with ALS in the short term; however, clinically, it was inconclusive. In terms of quality of life and fatigue, physical therapy intervention is not more effective than control in the short term. Adverse events are not increased by physical therapy intervention in the short term. Due to significant methodological flaws, small sample sizes, wide CIs and clinical interpretation, our confidence in the effect estimate is limited. Prospero Registration Number: CRD42021251350. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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