Merali Saira, Cameron Jill I, Barclay Ruth, Salbach Nancy M
Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
Health Soc Care Community. 2016 Nov;24(6):e101-e116. doi: 10.1111/hsc.12282. Epub 2015 Oct 7.
A scoping review was conducted to characterise evaluations of community-based exercise programmes (CBEPs) delivered by fitness instructors to people with neurological conditions. Literature published from 1946 to April 2014 in MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and the grey literature were searched. Search terms included community, programme, exercise, adult, brain disease and spinal cord disease. Two reviewers independently screened titles and abstracts for inclusion. One author reviewed full-text articles to evaluate eligibility. Studies were included if the study objective was to evaluate an exercise programme, the programme was community-based and delivered by fitness instructors, exercise participants were ≥18 years of age and had a neurological condition, and a full-text article was available and written in English. After reviewing 1785 titles and abstracts, 18 (1.01%) articles describing 15 studies were included in the review. One author completed data abstraction from the included studies. A second reviewer independently verified the extracted data for accuracy. Exercise programmes most commonly included people with stroke (47%) and Parkinson's disease (40%), incorporated a stand-alone (80%), multi-component (20%), group (67%), individual (20%) and combined format (13%), strength training (40%) and functional/task-oriented training (40%), reported a minimum walking requirement (67%), and involved a healthcare professional (HCP) with various roles (53%), including training (27%), advising and supporting (33%). The most commonly examined participant outcomes were health-related quality of life (60%) and functional balance (47%). More research is needed to develop CBEPs targeting individuals with low ambulatory function and multiple neurological conditions, to develop recommendations for the involvement of HCPs in CBEPs and document their involvement, and to evaluate system-level outcomes such as cost, healthcare utilisation and impact on caregivers. The findings support a number of considerations to guide future research into CBEPs delivered by fitness instructors for individuals with neurological conditions.
开展了一项范围综述，以描述健身教练为神经疾病患者提供的社区锻炼计划（CBEP）的评估情况。检索了1946年至2014年4月发表在MEDLINE、EMBASE、CINAHL、Cochrane系统评价数据库及灰色文献中的文献。检索词包括社区、计划、锻炼、成人、脑部疾病和脊髓疾病。两名评审员独立筛选标题和摘要以确定是否纳入。一名作者审查全文文章以评估其合格性。若研究目的是评估一项锻炼计划、该计划以社区为基础且由健身教练提供、锻炼参与者年龄≥18岁且患有神经疾病、有全文文章且为英文撰写，则纳入该研究。在审查了1785个标题和摘要后，18篇（1.01%）描述15项研究的文章被纳入综述。一名作者完成了对纳入研究的数据提取。另一名评审员独立核实提取数据的准确性。锻炼计划最常纳入中风患者（47%）和帕金森病患者（40%），采用独立形式（80%）、多成分形式（20%）、团体形式（67%）、个体形式（20%）和组合形式（13%），包括力量训练（40%）和功能/任务导向训练（40%），报告了最低步行要求（67%），并涉及担任各种角色的医疗保健专业人员（HCP）（53%），包括培训（27%）、咨询和支持（33%）。最常检查的参与者结局是健康相关生活质量（60%）和功能平衡（47%）。需要开展更多研究，以制定针对低步行功能和多种神经疾病患者的CBEP，制定HCP参与CBEP的建议并记录其参与情况，以及评估系统层面的结局，如成本、医疗保健利用情况和对护理人员的影响。这些发现支持了一些考虑因素，以指导未来针对健身教练为神经疾病患者提供的CBEP的研究。
