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远程康复及其对中风后的影响:系统评价的伞状综述

Telerehabilitation and Its Impact Following Stroke: An Umbrella Review of Systematic Reviews.

作者信息

Alwadai Bayan, Lazem Hatem, Almoajil Hajar, Hall Abigail J, Mansoubi Maedeh, Dawes Helen

机构信息

Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, Medical School, University of Exeter, Exeter EX1 2LU, UK.

Physical Therapy Department, College of Applied Medical Sciences, Najran University, Najran 11001, Saudi Arabia.

出版信息

J Clin Med. 2024 Dec 26;14(1):50. doi: 10.3390/jcm14010050.

Abstract

: To summarize the impact of various telerehabilitation interventions on motor function, balance, gait, activities of daily living (ADLs), and quality of life (QoL) among patients with stroke and to determine the existing telerehabilitation interventions for delivering physiotherapy sessions in clinical practice. : Six electronic databases were searched to identify relevant quantitative systematic reviews (SRs). Due to substantial heterogeneity, the data were analysed narratively. : A total of 28 systematic reviews ( = 245 primary studies) were included that examined various telerehabilitation interventions after stroke. Motor function was the most studied outcome domain across the reviews (20 SRs), followed by ADL (18 SRs), and balance (14 SRs) domains. For primary outcomes, our findings highlight moderate- to high-quality evidence showing either a significant effect or no significant difference between telerehabilitation and other interventions. There was insufficient evidence to draw a conclusion regarding feasibility outcomes, including participant satisfaction, adherence to treatment, and cost. Most reviews under this umbrella included patients with stroke in the subacute or chronic phase (12 SRs). Simple and complex telerehabilitation interventions such as telephone calls, videoconferencing, smartphone- or tablet-based mobile health applications, messaging, virtual reality, robot-assisted devices, and 3D animation videos, either alone or in combination with other interventions, were included across reviews. : Various telerehabilitation interventions have shown either a significant effect or no significant difference compared to other interventions in improving upper and lower limb motor function, balance, gait, ADLs, and QoL, regardless of whether simple or complex approaches were used. Further research is needed to support the delivery of rehabilitation services through telerehabilitation intervention following a stroke.

摘要

总结各种远程康复干预措施对中风患者运动功能、平衡能力、步态、日常生活活动能力(ADL)和生活质量(QoL)的影响,并确定临床实践中用于提供物理治疗课程的现有远程康复干预措施。:检索了六个电子数据库以识别相关的定量系统评价(SR)。由于存在大量异质性,对数据进行了叙述性分析。:共纳入28项系统评价(=245项原始研究),这些评价考察了中风后的各种远程康复干预措施。运动功能是各项评价中研究最多的结局领域(20项SR),其次是ADL(18项SR)和平衡能力(14项SR)领域。对于主要结局,我们的研究结果突出了中高质量的证据,表明远程康复与其他干预措施之间有显著效果或无显著差异。关于可行性结局,包括参与者满意度、治疗依从性和成本,没有足够的证据得出结论。此范围内的大多数评价纳入了亚急性或慢性期的中风患者(12项SR)。简单和复杂的远程康复干预措施,如电话、视频会议、基于智能手机或平板电脑的移动健康应用程序、消息传递、虚拟现实、机器人辅助设备和3D动画视频,单独或与其他干预措施结合使用,均在各项评价中有所涉及。:与其他干预措施相比,各种远程康复干预措施在改善上肢和下肢运动功能、平衡能力、步态、ADL和QoL方面,无论使用简单还是复杂的方法,均显示出显著效果或无显著差异。需要进一步的研究来支持中风后通过远程康复干预提供康复服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1aa/11721391/037bbe68bd65/jcm-14-00050-g001.jpg

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