ABSTRACT
PURPOSE: To systematically evaluate and quantify the effects of Tai Chi/Qigong (TCQ) on motor (UPDRS III, balance, falls, Timed-Up-and-Go, and 6-Minute Walk) and non-motor (depression and cognition) function, and quality of life (QOL) in patients with Parkinson's disease (PD). METHODS: A systematic search in 7 electronic databases targeted clinical studies evaluating TCQ for individuals with PD published through August 2016. Meta-analysis was used to estimate effect sizes (Hedges's g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed by two raters. RESULTS: Our search identified 21 studies, 15 of which were RCTs with a total of 735 subjects. For RCTs, comparison groups included no treatment (n = 7, 47%) and active interventions (n = 8, 53%). Duration of TCQ ranged from 2 to 6 months. Methodological bias was low in 6 studies, moderate in 7, and high in 2. Fixed-effect models showed that TCQ was associated with significant improvement on most motor outcomes (UPDRS III [ES = -0.444, p < 0.001], balance [ES = 0.544, p < 0.001], Timed-Up-and-Go [ES = -0.341, p = 0.005], 6 MW [ES = -0.293, p = 0.06], falls [ES = -0.403, p = 0.004], as well as depression [ES = -0.457, p = 0.008] and QOL [ES = -0.393, p < 0.001], but not cognition [ES = -0.225, p = 0.477]). I2 indicated limited heterogeneity. Funnel plots suggested some degree of publication bias. CONCLUSION: Evidence to date supports a potential benefit of TCQ for improving motor function, depression and QOL for individuals with PD, and validates the need for additional large-scale trials.
Subject(s)
Parkinson Disease , Qigong/methods , Quality of Life/psychology , Tai Ji/methods , Parkinson Disease/complications , Parkinson Disease/psychology , Parkinson Disease/rehabilitationABSTRACT
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Subject(s)
Humans , Male , Female , Ethics, Professional/education , Personnel Selection/ethics , Personnel Selection/methods , /instrumentation , Ethics, Professional/history , Personnel Selection/standards , Personnel Selection , /organization & administration , /trendsABSTRACT
Objetivo. La terapia física es fundamental en el tratamiento de pacientes con parálisis cerebral infantil (PCI). Se han utilizado diferentes métodos fisioterápicos: Temple-Fay, Doman-Delacato, Bobath, Kabat, etc. Declaraciones recientes en los medios de comunicación han generado aumento de la demanda de información sobre los posibles beneficios con la terapia de los Institutos para el Logro del Potencial Humano (Método Doman-Delacato). El objetivo de nuestro estudio es revisar la literatura existente sobre el Método Doman-Delacato como tratamiento de la PCI, para determinar la existencia o no de evidencia científica acerca de su eficacia. Estrategia de búsqueda. Se realiza búsqueda bibliográfica en diferentes bases de datos (PubMed, Tripdatabase, Cochrane, PEDro) con las palabras clave Doman-Delacato y parálisis cerebral hasta junio de 2009. Selección de artículos. Se seleccionan 15 artículos adecuados a nuestra búsqueda, incluyendo declaraciones de la Sociedad Americana de Pediatría y de la Sociedad Española de Fisioterapia en Pediatría. Síntesis de resultados y conclusiones. Se trata de un método basado en la teoría de la recapitulación, rechazada por la biología actual, que exige mucha dedicación horaria y que los padres actúen como coterapeutas. Los artículos que propugnan el método adolecen de fallos metodológicos; en los estudios comparativos no existen diferencias significativas entre la aplicación de este método con respecto a otros métodos fisioterápicos estándar. Con base en los estudios realizados hasta la fecha, no se puede determinar la eficacia del método. Son necesarios estudios bien diseñados y con un adecuado nivel de evidencia y grado de recomendación (AU)
Aim. Physical therapy constitutes a fundamental part of the treatment for patients with infant cerebral palsy (ICP). Different methods of physical therapy have been used: Temple-Fay, Doman-Delacato, Bobath, Kabat, Rood, Pëto, Le Mitáyer, Votja, etc. Some recent statements in the media increased parents demand for information regarding the possible benefits of the Doman-Delacato Method. The aim of our study is to look through the existing literature on the Doman-Delacato Method as a treatment for ICP, in order to prove, or to deny, the existence of scientific evidence regarding its effectiveness. Search strategy. A bibliographic review has been carried out on different databases (PubMed, Tripdatabase, Cochrane, PEDro) with the key words Doman-Delacato and cerebral palsy. Then, the articles founded have been analysed. Study selection. Various articles have been chosen, including statements from the American Academy of Paediatrics, from the Spanish Society of Physiotherapy and former studies that had already been carried out. Conclusions. This is a method based on a theory (recapitulation theory) denied by current biology, hard to put into practice, which demands a lot of hours dedicated to it and demands that the parents, themselves, should act like co-therapists. The articles advocating the method suffer from methodological failures. In those based on comparative studies, there are no significant differences regarding the application of this method compared to other standard methods of physical therapy. The studies need to be well organized and with an adequate level of evidence and recommendation (AU)
