[Effects of virtual reality on balance and gait in stroke: a systematic review and meta-analysis]. / Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revision sistematica y metaanalisis.

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 and 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.

TITLE: Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revision sistematica y metaanalisis.Introduccion. El ictus es la mayor causa de discapacidad en los adultos. En los ultimos años, la mejora en las tecnologias de realidad virtual ha propiciado su uso para la rehabilitacion de pacientes de ictus. Objetivo. Analizar las evidencias cientificas 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 metodos. Se ha realizado una revision sistematica y un metaanalisis durante marzo de 2018 en las siguientes bases de datos: PubMed, PEDro, Web of Science, Scopus, Cochrane Library y Medline via EBSCO. Los principales criterios de seleccion fueron ensayos clinicos controlados aleatorizados, publicados en ingles o español, durante los ultimos diez años (2008-2018). La calidad metodologica de los estudios se evaluo mediante la escala PEDro. Se incluyo un total de 14 ensayos clinicos aleatorizados con intervenciones de realidad virtual en la revision sistematica, 10 de ellos en el metaanalisis. 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 and 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). Conclusion. Los resultados obtenidos muestran el beneficio potencial de la realidad virtual sobre la recuperacion de la marcha y equilibrio en sujetos que han sufrido ictus.

Physical therapy in Down syndrome: systematic review and meta-analysis.

BACKGROUND: Down syndrome is the most common chromosomal abnormality, with a worldwide incidence of around 0.1% in live births. It is related to several conditions in which the physical therapy could take action-preventing co-morbidities. This study aims to evaluate the effectiveness of physical therapy in Down syndrome, to know and compare the effectiveness of different physical therapy interventions in this population. METHODS: A systematic review and a meta-analysis of randomised controlled trials were conducted. The search was performed during June 2018 in the following databases: PubMed, Web of Science, Physiotherapy Evidence Database and Scopus. The studies were selected using predefined inclusion and exclusion criteria. The Physiotherapy Evidence Database scale evaluated the quality of the methods used in the studies. Subsequently, the data were extracted, and statistical analysis was performed when possible. RESULTS: A total of 27 articles were included, of which nine contributed information to the meta-analysis. Statistical analysis showed favourable results for the strength of upper and lower limbs [standardised mean difference (SMD) = 1.46; 95% confidence interval (CI): (0.77-2.15); and SMD = 2.04; 95% CI: (1.07-3.01)] and mediolateral oscillations of balance [SMD = -3.30; 95% CI: (-5.34 to -1.26)]. CONCLUSIONS: The results show the potential benefit of certain types of physical therapy interventions, specifically in strength and balance, in people with Down syndrome. There are still many aspects to clarify and new lines of research.

[Effects of hypotherapy on the motor function of persons with Down's syndrome: a systematic review]. / Efectos de la hipoterapia sobre la funcion motora en personas con sindrome de Down: revision sistematica.

INTRODUCTION: Down's syndrome is the main cause of intellectual disability and the most common human genetic alteration. Motor impairments are among the most important alterations presented by Down's syndrome subjects. Hippotherapy is a treatment on and with a horse, and it is currently being used as a therapy to correct those dysfunctions. AIM: To review published research literature on the effect exerted by hippotherapy on the gross motor function of people with Down's syndrome. SUBJECTS AND METHODS: The bibliography in the following databases has been widely searched: CINAHL, Medline, The Cochrane Library, PEDro, Scopus, and Web of Science. The journals Fisioterapia and Cuestiones de Fisioterapia have also been consulted. The electronic literature search strategy was addressed in two thematic fields: Down's syndrome and hippotherapy. Studies selection was carried out following inclusion and exclusion criteria and rejecting duplicate papers. That search included articles published between 2000 and 2016. RESULTS: For this work, 23 articles were found, 15 of which were discarded for different reasons, leaving 8 valid ones. CONCLUSIONS: There is no strong evidence on the improvement of gross motor function in people with Down's syndrome after treatment with hippotherapy. More studies with higher methodological quality, are needed to verify the effectiveness of hippotherapy in the treatment of gross motor function in subjects with Down's syndrome.

TITLE: Efectos de la hipoterapia sobre la funcion motora en personas con sindrome de Down: revision sistematica.Introduccion. El sindrome de Down es la principal causa de discapacidad intelectual y la alteracion genetica humana mas comun. Entre las alteraciones mas importantes que se presentan se encuentran las deficiencias motoras. La hipoterapia es un tratamiento sobre el caballo y con el caballo, y se usa en la actualidad como terapia en la correccion de dichas disfunciones. Objetivo. Analizar las evidencias cientificas existentes sobre el efecto que la hipoterapia ejerce en la funcion motora de personas con sindrome de Down. Sujetos y metodos. Se efectuo una amplia busqueda de la bibliografia en las siguientes bases de datos: CINAHL, Medline, The Cochrane Library, PEDro, Scopus y Web of Science. Ademas, se consultaron las revistas Fisioterapia y Cuestiones de Fisioterapia. Las busquedas se realizaron incluyendo los articulos publicados entre los años 2000 y 2016. La estrategia de busqueda electronica se planteo en dos bloques tematicos: sindrome de Down e hipoterapia. La seleccion de articulos se llevo a cabo siguiendo unos criterios de inclusion y exclusion, y se eliminaron los articulos duplicados. Resultados. En la busqueda realizada para esta investigacion se encontraron 23 articulos, y quedaron como validos ocho despues de excluir el resto por diferentes motivos. Conclusiones. No existen evidencias solidas sobre la mejora o no de la funcion motora en personas con sindrome de Down tras el tratamiento con hipoterapia. Son necesarios mas estudios, y de mayor calidad metodologica, para poder constatar la efectividad de la hipoterapia en el tratamiento de la funcion motora gruesa en sujetos con sindrome de Down.