Arch Phys Med Rehabil. 2022 Jul 1:S0003-9993(22)00485-3. doi: 10.1016/j.apmr.2022.06.003. Online ahead of print.
ABSTRACT
OBJECTIVE: This systematic review and meta-analysis aimed to review and quantify the changes in gait parameters after therapeutic intervention in adults with neurological disorders.
DATA SOURCES: A keyword search was performed in four databases: PubMed, CINAHL, Scopus, and Web of Science (01/2000-12/2021). We performed the search algorithm including all possible combinations of keywords. Full-text articles were examined further using forward/backward search methods.
STUDY SELECTION: Studies were thoroughly screened using the following inclusion criteria: Study design: Randomized Controlled Trial (RCT); adults ≥ 55 years old with a neurological disorder; therapeutic intervention; spatiotemporal gait characteristics; and Language: English.
DATA EXTRACTION: A standardized data extraction form was used to collect the following methodological outcome variables from each of the included studies: author, year, population, age, sample size, and spatiotemporal gait parameters such as cadence, step length, step width, or double limb support. A meta-analysis was performed among trials presenting with similar characteristics, including study population and outcome measure. If heterogeneity was > 50%, a random plot analysis was used, otherwise, a fixed plot analysis was done.
DATA SYNTHESIS: We included 25 out of 34 studies in our meta-analysis that examined gait in adults with neurological disorders. All analyses used effect sizes and standard error and a p < 0.05 threshold was considered statistically significant. Overall, we found that sensory (SS) and electrical stimulation (ES) had the most significant effect on step length (SS: z=5.44*, ES: z=2.42*) and gait speed (SS: z=6.19*, ES: z=7.38*) in adults with Parkinson’s disease (PD). Although balance or physical activity interventions were not found to be effective in modifying step length in adults with PD, they showed a significant effect on gait speed. Further, physical activity had the most significant effect on cadence in adults with PD (z=2.84*) relative to sensory stimulation effect on cadence (z=2.59*). For stroke, conventional physical therapy had the most significant effect on step length (z=3.12*) and cadence (z=3.57*).
CONCLUSION: Sensory stimulation such as auditory and somatosensory stimulation while walking had the most significant effect on step length in adults with PD. We also found that conventional PT did improve spatial gait parameters relative to other physical activity interventions in adults with PD and stroke.
PMID:35787837 | DOI:10.1016/j.apmr.2022.06.003
