Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.
Dev Med Child Neurol. 2020 Aug;62(8):906-916. doi: 10.1111/dmcn.14565. Epub 2020 May 30.
To summarize existing interventions and their outcomes in Rett syndrome (RTT) rehabilitation and identify gaps in the literature.
Five databases (Ovid MEDLINE, Ovid Embase Classic, Ovid PsycINFO, EBSCO CINAHL Plus, and ProQuest ERIC) were systematically searched up to 23rd July 2018 for studies describing rehabilitation interventions. Data on study participants, design, and outcomes were extracted.
Sixty-two articles were included in the final review. Evidence consistently demonstrated that females with RTT can improve their gross motor, fine motor, and communicative skills with rehabilitation. All 11 interventions targeting gross motor function, namely ambulation, achieved functional improvements. Twenty of 24 articles describing fine motor rehabilitation studies succeeded in decreasing stereotypies, improving functional hand use, and/or reducing self-injurious behaviors. Twenty-one of 22 studies describing communication interventions succeeded in training choice-making, communicative language, or socialization behavior. Other key findings include the positive interplay between physical and communicative rehabilitation outcomes, and the ability of females with RTT to improve their cognitive abilities during intervention.
Rehabilitation can impact the daily lives of females with RTT and their caregivers in clinically meaningful ways.
总结雷特综合征(RTT)康复治疗中现有的干预措施及其效果,并确定文献中的空白点。
系统检索了五个数据库(Ovid MEDLINE、Ovid Embase Classic、Ovid PsycINFO、EBSCO CINAHL Plus 和 ProQuest ERIC),截至 2018 年 7 月 23 日,以获取描述康复干预措施的研究。提取研究参与者、设计和结果的数据。
最终综述纳入了 62 篇文章。有证据一致表明,接受康复治疗的女性 RTT 患者可以改善其粗大运动、精细运动和沟通技能。所有 11 项针对粗大运动功能(即步行)的干预措施均实现了功能改善。24 篇描述精细运动康复研究的文章中有 20 篇成功减少了刻板行为,改善了功能性手部使用和/或减少了自伤行为。描述沟通干预的 22 篇研究中有 21 篇成功训练了选择能力、沟通语言或社交行为。其他重要发现包括身体和沟通康复效果之间的积极相互作用,以及 RTT 女性在干预过程中提高认知能力的能力。
康复可以以有临床意义的方式影响 RTT 女性及其照顾者的日常生活。