Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil
Department of Physical Therapy and Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil.
BMJ Open. 2024 Aug 25;14(8):e076541. doi: 10.1136/bmjopen-2023-076541.
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).
Systematic review and meta-analyses.
MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro) were searched through 31 January 2023.
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.
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.
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.
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.
CRD42021251350.
系统评价物理治疗干预对改善肌萎缩侧索硬化症（ALS）患者整体功能、生活质量和疲劳的疗效。
系统评价和荟萃分析。
通过 2023 年 1 月 31 日检索 MEDLINE、EMBASE、Cochrane 图书馆（CENTRAL）和物理治疗证据数据库（PEDro）。
我们纳入了比较物理治疗干预与任何其他非物理治疗方法、技术、安慰剂或非干预措施对 ALS 患者整体功能、疲劳和生活质量影响的随机临床试验（RCT）。主要结局指标是评估整体功能。次要结局指标为生活质量、疲劳和不良事件。
两名独立作者使用研究者开发的提取表和 Rayyan 软件进行搜索、筛选和编码纳入的研究。使用 PEDro 量表评估偏倚风险。采用随机效应进行荟萃分析。结果简洁地呈现于推荐、评估、发展和评估证据概况中。
我们的搜索共确定了 39415 条参考文献。经过研究选择，有三项研究纳入了综述。这些研究共纳入 62 名参与者，平均年龄为 54.6 岁。在评估的试验中，40 名参与者为男性，22 名参与者为女性。关于疾病的发病类型，58 名参与者为脊髓型 ALS，4 名为延髓型。
物理治疗干预可能在短期内改善 ALS 患者的整体功能，但临床效果不明确。在生活质量和疲劳方面，短期来看，物理治疗干预并不比对照组更有效。短期来看，物理治疗干预不会增加不良事件。由于方法学缺陷明显、样本量小、置信区间宽和临床解释的原因，我们对效应估计的信心有限。
CRD42021251350。
