Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
Aging Research Center, Centre de Recherche sur le Vieillissement du CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada.
Int J Environ Res Public Health. 2023 Feb 14;20(4):3367. doi: 10.3390/ijerph20043367.
Around 500/100,000 Canadians experience a traumatic brain injury (TBI) resulting in long-term disabilities and premature death. Physiotherapy is known to positively impact the prognosis of young adults following a TBI.
This is a scoping review that aimed to identify research topics in physiotherapy interventions for seniors after a TBI, describe potential knowledge gaps, and uncover needs for future research.
Ten databases were interrogated (January-March 2022). We included texts published after 2010, in English or French, scientific papers, guidelines, and gray literature sources targeting in-hospital, acute-to-subacute interventions for people aged ≥55 years old with a moderate-to-severe TBI. The outcomes sought were physical/functional capacities, injury severity, and quality of life.
From 1296 articles, 16 were selected. The number of participants from the studies altogether was 248,794. We identified eight retrospectives studies, three clinical trials, and five articles from the gray literature. Articles were classified according to the nature of their analysis and outcomes: (1) interventional studies including physiotherapy (at least 10 types of rehabilitative or preventive interventions were identified); (2) studies evaluating prognostic factors (five factors identified); and (3) recommendations from clinical practical guidelines and other sources (gray literature). Our results provide evidence that physiotherapy is effective in TBI acute rehabilitation for the elderly to prevent complications arising from the primary injury and to improve functional capacities.
The heterogeneity of our results does not allow us to infer the effectiveness of one intervention over another. However, we found that the elderly population benefits from physiotherapy interventions as much as adults, but the gap must be filled with higher-quality studies to make definite recommendations.
在加拿大，约有 500/100,000 人经历创伤性脑损伤（TBI），导致长期残疾和过早死亡。物理疗法已被证明对 TBI 后年轻成年人的预后有积极影响。
这是一项范围界定审查，旨在确定针对 TBI 后老年人的物理疗法干预研究课题，描述潜在的知识空白，并揭示未来研究的需求。
10 个数据库（2022 年 1 月至 3 月）进行了检索。我们纳入了 2010 年后发表的、以英语或法语撰写的科学论文、指南和针对 55 岁及以上、中度至重度 TBI 患者的院内、急性至亚急性干预的灰色文献来源。研究的结果是身体/功能能力、损伤严重程度和生活质量。
从 1296 篇文章中，选择了 16 篇。这些研究的参与者总数为 248794 人。我们确定了 8 项回顾性研究、3 项临床试验和 5 篇灰色文献文章。文章根据其分析和结果的性质进行分类：（1）包括物理疗法的干预研究（至少确定了 10 种康复或预防干预类型）；（2）评估预后因素的研究（确定了 5 个因素）；（3）临床实践指南和其他来源（灰色文献）的建议。我们的结果表明，在 TBI 急性康复中，物理疗法对老年人有效，可以预防原发性损伤引起的并发症，并改善功能能力。
我们的结果存在异质性，因此无法推断一种干预措施比另一种更有效。然而，我们发现老年人群与成年人一样受益于物理疗法干预，但必须通过更高质量的研究来填补空白，以做出明确的建议。
