Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research.

BACKGROUND: There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. METHODS: The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. RESULTS: Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. CONCLUSIONS: The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results.

Game-Based Virtual Reality Interventions to Improve Upper Limb Motor Function and Quality of Life After Stroke: Systematic Review and Meta-analysis.

Stroke is the main cause of disability in adulthood. Recent advances in virtual reality (VR) technologies have led to its increased use in the rehabilitation of stroke patients. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effectiveness of game-based reality on upper limb (UL) motor function and quality of life after stroke. In March 2018, a search of the following databases was performed: PubMed, PEDro, Web of Science, Scopus, The Cochrane Library, and Medline at EBSCO. The selection criteria were all RCTs published in English or Spanish during the past 10 years. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 20 clinical trials were included in the systemic review, of which 15 contributed information to the meta-analysis. Favorable results were found for VR interventions on UL motor function (Fugl-Meyer Assessment for upper extremity, standardized mean difference [SMD] = 1.53, 95% CI [0.51-2.54]) and quality of life (functional independence measure, SMD = 0.77, 95% CI [0.05-1.49]). The results demonstrate the potential benefits of VR interventions on the recovery of UL motor function and on quality of life after stroke.

Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revisión sistemática y metaanálisis / Effects of virtual reality on balance and gait in stroke: a systematic review and meta-analysis

Introducción. El ictus es la mayor causa de discapacidad en los adultos. En los últimos años, la mejora en las tecnologías de realidad virtual ha propiciado su uso para la rehabilitación de pacientes de ictus. Objetivo. Analizar las evidencias científicas existentes sobre la efectividad del uso de realidad virtual frente a la terapia convencional en la mejora de la marcha y el equilibrio de pacientes que han sufrido un ictus. Pacientes y métodos. Se ha realizado una revisión sistemática y un metaanálisis durante marzo de 2018 en las siguientes bases de datos: PubMed, PEDro, Web of Science, Scopus, Cochrane Library y Medline vía EBSCO. Los principales criterios de selección fueron ensayos clínicos controlados aleatorizados, publicados en inglés o español, durante los últimos diez años (2008-2018). La calidad metodológica de los estudios se evaluó mediante la escala PEDro. Se incluyó un total de 14 ensayos clínicos aleatorizados con intervenciones de realidad virtual en la revisión sistemática, 10 de ellos en el metaanálisis. Resultados. Se han obtenido resultados favorables de las intervenciones de realidad virtual sobre el equilibrio (Berg Balance Scale: diferencia de medias estandarizada, DME: -1,89; intervalo de confianza al 95%, IC 95%: -2,72 a -1,07; Timed Up & Go: DME: 1,42; IC 95%: 1,03 a 1,81) y la marcha (GaitRite: cadencia, DME: -1,51, IC 95%: -2,05 a -0,97; longitud del paso, DME: -1,63, IC 95%: -2,18 a -1,08; longitud de la zancada, DME: -1,63, IC 95%: -2,18 a -1,08; velocidad, DME: -1,58, IC 95%: -2,97 a -0,18). Conclusión. Los resultados obtenidos muestran el beneficio potencial de la realidad virtual sobre la recuperación de la marcha y equilibrio en sujetos que han sufrido ictus

Introduction. Stroke is the leading cause of disability in adulthood. Recently the improvement of virtual reality technologies has been used in the rehabilitation of stroke patients. Aim. To review published research literature on the effects of the virtual reality interventions vs conventional therapy on balance and gait in stroke. Patients and methods. A systematic and a meta-analysis of randomized controlled trials was performed during March 2018 in the databases: PubMed, PEDro, Web of Science, Scopus, Cochrane Library and Medline at EBSCO. The selection criteria were: randomized controlled trials published in English or Spanish during the past ten years. The PEDro scale evaluated the quality of the methods used in the studies. A total of 14 clinical trials were included in the systemic review, of which 10 contributed information to the meta-analysis. Results. Favourable results were found on balance (Berg Balance Scale: standardized mean difference, SMD = -1.89; 95% CI: -2.72 to -1.07; Timed Up & Go, SMD: 1.42; 95% CI: 1.03-1.81), and gait (GaitRite platform: cadence, SMD: -1.51, 95% CI: -2.05 to -0.97; step length, SMD: -1.63, 95% CI: -2.18 to -1.08; stride length, SMD: -1.63, 95% CI: -2.18 to -1.08; velocity, SMD: -1.58, 95% CI: -2.97 to -0.18). Conclusion. The results show the potential benefit of virtual reality interventions to recover balance and gait after stroke