Efectividad de la imaginería o práctica mental en la recuperación funcional tras el ictus: revisión sistemática / Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review

Introducción: En las últimas décadas han surgido diferentes métodos de tratamiento rehabilitador para pacientes con hemiparesia. Uno de ellos es la práctica mental (PM) del movimiento, consistente en la evocación de un movimiento o gesto por parte del sujeto con el fin de aprender o mejorar su ejecución. A pesar de que las técnicas de neuroimagen han demostrado que durante la PM se ejecutan patrones de activación neuronal similares a los que aparecen durante el movimiento, es necesario demostrar su efectividad clínica en la rehabilitación y recuperación funcional de pacientes. Desarrollo: Para ello, entre diciembre de 2011 y octubre de 2012 se realizó una búsqueda sistemática en las principales plataformas bibliográficas y bases, seleccionándose 23 ensayos clínicos referentes a distintos protocolos de PM en pacientes con hemiparesia. Conclusiones: La PM es efectiva cuando se combina con terapia convencional en la recuperación funcional del miembro tanto inferior como superior, así como para el entrenamiento de actividades y gestos cotidianos. Dada la heterogeneidad de los estudios en cuanto a la técnica de evocación mental, el volumen de entrenamiento, los sujetos incluidos…, se necesitan más estudios para determinar el tipo de paciente y el protocolo ideal de tratamiento

Introduction: In recent decades, many stroke rehabilitation methods have been developed. Mental practice (MP) is a dynamic state in which the subject evokes an imaginary representation of a motor action or skill in order to learn or perfect that action. Although functional imaging has shown that MP produces similar cortical activation patterns to those of movement, the clinical effectiveness of such methods in rehabilitation and functional recovery has yet to be demonstrated. Development: Systematic search of all clinical studies published in the main scientific databases between December 2011 and October 2012 concerning mental practice in stroke rehabilitation. We selected 23 clinical trials testing different MP protocols in patients with hemiparesis. Conclusions: MP is effective when used in conjunction with conventional physical therapy for functional rehabilitation of both upper and lower limbs, as well as for the recovery of daily activities and skills. Owing to the heterogeneity of the studies with regard to the intervention protocol, specific imagery technique, time spent practicing, patient characteristics, etc., more studies are needed in order to determine the optimal treatment protocol and patient profile

Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review.

INTRODUCTION: In recent decades, many stroke rehabilitation methods have been developed. Mental practice (MP) is a dynamic state in which the subject evokes an imaginary representation of a motor action or skill in order to learn or perfect that action. Although functional imaging has shown that MP produces similar cortical activation patterns to those of movement, the clinical effectiveness of such methods in rehabilitation and functional recovery has yet to be demonstrated. DEVELOPMENT: Systematic search of all clinical studies published in the main scientific databases between December 2011 and October 2012 concerning mental practice in stroke rehabilitation. We selected 23 clinical trials testing different MP protocols in patients with hemiparesis. CONCLUSIONS: MP is effective when used in conjunction with conventional physical therapy for functional rehabilitation of both upper and lower limbs, as well as for the recovery of daily activities and skills. Owing to the heterogeneity of the studies with regard to the intervention protocol, specific imagery technique, time spent practicing, patient characteristics, etc., more studies are needed in order to determine the optimal treatment protocol and patient profile.

Efectividad del entrenamiento de los músculos del suelo pélvico en la incontinencia urinaria: revisión sistemática / Effectiveness of pelvic floor muscle training in urinary incontinence: a systematic review

Objetivos Determinar el mejor modo de entrenamiento de los músculos del suelo pélvico (PFMT) y evaluar su eficacia preventiva contra la incontinencia urinaria durante el embarazo, así como sus efectos a medio/largo plazo. Métodos Se ha llevado a cabo una revisión sistemática en las bases de datos Pubmed, PEDro, ISI Web of Knowledge y CINAHL, incluyéndose aquellos estudios que solo aplican PFMT (pelvic floor muscle training).Resultados Se obtuvieron un total de 133 estudios en las 4 bases de datos que, tras aplicar los criterios de inclusión y exclusión, se redujeron a 21.ConclusionesEs más eficaz bajo supervisión del fisioterapeuta, no hay diferencias en realizarlo individualmente o en grupo, no hay consenso en cuanto a si previene la incontinencia urinaria realizándolo durante el embarazo, aunque sí tras el parto, y a medio/largo plazo no tiene tan buenos resultados, como a corto plazo, debido a la baja adhesión al entrenamiento años después (AU)

Objectives To determine the best way to perform pelvic floor muscle training (PFMT), to review the effectiveness of this training method in women with urinary incontinence (UI) during pregnancy, as well as its middle to long-term effects. Methods A systematic review of randomised controlled trials was performed using the databases: Pubmed, PEDro, ISI Web of Knowledge and CINAHL and searching up to September 2011. Trials were included if they assessed the effects of PFMT. Results A total of 133 studies were found. After inclusion/exclusion criteria were applied, only 21 were included in this review. Conclusions PFMT is more effective when it was performed under supervision. Individual treatment and group PFMT are equally effective. There was no consensus about its capacity to prevent UI when performed during pregnancy, but it was found to be effective after puerperium. Due to the low rate of patient adherence to training, better short-term effects have been found than in the long-term (AU)