Alzahrani Abdullah
Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, SAU.
Cureus. 2024 Aug 7;16(8):e66349. doi: 10.7759/cureus.66349. eCollection 2024 Aug.
Patients with rare genetic muscle-wasting disorders (MWDs) often experience significant motor function impairments, making effective management strategies crucial for improving their quality of life. This systematic review and meta-analysis aimed to evaluate the impact of physiotherapeutic interventions on motor outcomes in this patient population. A comprehensive literature search was conducted to identify randomized controlled trials (RCTs) and cohort-based studies that assessed physiotherapeutic interventions in patients with rare genetic MWDs. The primary outcome measure was the 6-minute walk test (6MWT). A random effects model was employed to calculate the mean difference (MD) and 95% confidence interval (CI). Nine studies were selected for inclusion, and most demonstrated observable improvement in different facets of individuals with MWDs using physiotherapy. The meta-analysis of RCTs showed that physiotherapy statistically improved 6MWT performance (MD: -35.25 meters; 95% CI: -54.14 to -16.37) with low heterogeneity (Tau² = 0.00; Chi² = 0.48, df = 2, P = 0.79; I² = 0%). Similarly, the cohort-based studies demonstrated an overall MD (MD: -10.00; 95% CI: -11.07 to -8.93), with low heterogeneity (Tau² = 0.00; Chi² = 0.01, df = 1, P = 0.94; I² = 0%). Both analyses indicated significant improvements in 6MWT performance (RCTs: Z = 3.66, P = 0.0003; cohort-based: Z = 18.26, P < 0.00001). Physiotherapeutic interventions significantly enhanced motor function in patients with rare genetic MWDs, as evidenced by improved 6MWT performance. Exercise and intensive physiotherapy programs were particularly effective, although the benefits varied depending on the specific intervention and patient population. These findings support incorporating tailored physiotherapeutic strategies in MWD management to improve motor outcomes and overall quality of life.
患有罕见遗传性肌肉萎缩症（MWDs）的患者常常经历显著的运动功能障碍，因此有效的管理策略对于提高他们的生活质量至关重要。本系统综述和荟萃分析旨在评估物理治疗干预对该患者群体运动结局的影响。进行了全面的文献检索，以识别评估罕见遗传性MWDs患者物理治疗干预的随机对照试验（RCTs）和队列研究。主要结局指标是6分钟步行试验（6MWT）。采用随机效应模型计算平均差（MD）和95%置信区间（CI）。选择了9项研究纳入，大多数研究表明，使用物理治疗的MWDs患者在不同方面有明显改善。RCTs的荟萃分析表明，物理治疗在统计学上改善了6MWT表现（MD：-35.25米；95%CI：-54.14至-16.37），异质性较低（Tau² = 0.00；Chi² = 0.48，df = 2，P = 0.79；I² = 0%）。同样，队列研究显示总体MD（MD：-10.00；95%CI：-11.07至-8.93），异质性较低（Tau² = 0.00；Chi² = 0.01，df = 1，P = 0.94；I² = 0%）。两项分析均表明6MWT表现有显著改善（RCTs：Z = 3.66，P = 0.0003；队列研究：Z = 18.26，P < 0.00001）。如6MWT表现改善所示，物理治疗干预显著增强了罕见遗传性MWDs患者的运动功能。运动和强化物理治疗方案特别有效，尽管益处因具体干预措施和患者群体而异。这些发现支持在MWDs管理中纳入量身定制的物理治疗策略，以改善运动结局和总体生活质量。
