Login
Communauté Vinci
Extérieur
Si votre nom d'utilisateur ne se termine pas par @vinci.be ou @student.vinci.be, utilisez le formulaire ci-dessous pour accéder à votre compte de lecteur.
Titre : | Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis (2015) |
Auteurs : | Hilary Gunn ; Sophie Markevics ; Bernhard Haas |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2015/10, 2015) |
Article en page(s) : | pp. 18981912 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Rééducation et réadaptation ; Revue de la littérature ; Sclérose en plaques ; Traitement par les exercices physiques |
Mots-clés: | Accidental falls ; Chutes accidentelles ; Exercise therapy ; Multiple sclerosis ; Physical therapy modalities ; Techniques de physiothérapie ; Postural balance ; Équilibre postural ; Review |
Résumé : |
Objectives To evaluate the effectiveness of interventions in reducing falls and/or improving balance as a falls risk in multiple sclerosis (MS). Data Sources Computer-based and manual searches included the following medical subject heading keywords: Multiple Sclerosis AND accidental falls OR Multiple Sclerosis AND postural balance OR Multiple Sclerosis AND exercise OR Multiple Sclerosis AND physical/physio therapy NOT animals. All literature published to November 2014 with available full-text details were included. Study Selection Studies were reviewed against the PICO (participants, interventions, comparisons, outcomes) selection criteria: P, adults with MS; I, falls management/balance rehabilitation interventions; C, randomized/quasi-randomized studies comparing intervention with usual care or placebo control; O, falls outcomes and measures of balance. Fifteen articles of the original 529 search results were included. Data Extraction Two reviewers independently extracted data and assessed methodological quality using the Cochrane Risk of Bias tool. Data Synthesis Random-effects meta-analysis indicated a small decrease in falls risk (risk ratio, .74), although the 95% confidence interval (CI) crossed 1 (95% CI, .124.38). The pooled standardized mean difference (SMD) for balance outcomes was .55 (95% CI, .35.74). SMD varied significantly between exercise subgroupings; gait, balance, and functional training interventions yielded the greatest pooled effect size (ES) (SMD=.82; 95% CI, 0.551.10). There was a moderate positive correlation between program volume (min/wk) and ES (Cohen's d) (r=.70, P=.009), and a moderate negative correlation between program duration in weeks and ES (r=−.62, P=.03). Variations in interventions and outcomes and methodological limitations mean that results must be viewed with caution. Conclusions This review suggests that balance may improve through exercise interventions, but that the magnitude of the improvements achieved in existing programs may not be sufficient to impact falls outcomes. Supporting participants to achieve an appropriate intensity of practice of highly challenging balance activities appears to be critical to maximizing effectiveness. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999315004554 |