RESUMO
BACKGROUND: Biofeedback has been used by rehabilitation professionals in the treatment of poststroke function impairments. PURPOSE: Investigate the efficacy of any type of biofeedback intervention for the treatment of upper limb function in individuals following stroke. STUDY DESIGN: Systematic review of literature with meta-analysis. METHODS: Literature searches were conducted using MESH terms and text words in PubMed, Lilacs, Scielo, Scopus, PEDro, and Web of Science databases. The main outcome was improvement in upper limb's motor function and motor function in activities of daily living. We calculated the Mean Difference and Standardized Mean Difference for the assessment scales reported as primary outcome. The methodological quality of included studies was assessed using PEDro scale. The overall quality of the evidence was assessed using GRADE system. RESULTS: From 1360 articles identified, 16 were included in the review (09 in the meta-analysis). Three forest plots of hemiparesis and one of hemiplegia showed that biofeedback therapy associated with conventional therapy has a greater improvement in participants upper limb motor function when compared to isolated conventional therapy. Two forest plots of hemiparesis and one of hemiplegia showed no superiority in participants improvement for biofeedback associated with conventional therapy when compared to isolated conventional therapy. CONCLUSION: Biofeedback therapy associated with conventional therapy showed a small clinical effect when associated to conventional therapy and very low quality of evidence. Although further research with higher quality evidence is needed.
RESUMO
Introdução: O trismo, limitação da abertura da boca, é uma das morbidades que acarreta limitações funcionais. Objetivo: Descrever o efeito da fisioterapia por meio da terapia manual e exercícios com depressores de língua na abertura máxima bucal de paciente com trismo secundário ao câncer de glândula salivar. Métodos: Relato de caso de paciente com trismo cujo tratamento consistiu em 15 atendimentos de fisioterapia por meio da terapia manual (liberação miofascial e mobilização articular) e exercícios com depressores de língua, com 40 minutos de duração cada, para ganho de abertura bucal. A abertura máxima bucal foi avaliada por meio do paquímetro e números de depressores de língua. Resultados: A paciente apresentou aumento da abertura máxima bucal entre o primeiro e o último atendimento (11,5mm - 21,2mm) e aumento na quantidade de depressores de língua utilizados (12 17,5). Conclusão: A atuação fisioterapêutica foi eficaz para o tratamento do trismo. (AU)
Introduction: Trismus, a mouth opening amplitude limitation, is one of the morbidities that causes functional limitations. Objective: To describe the effect of physical therapy intervention utilizing manual therapy and wooden tongue depressors exercises in maximum mouth opening in a patient with trismus secondary to salivary gland cancer. Methods: Case report of a patient whose physical therapy intervention consisted in 15 sessions of manual therapy (myofascial liberation and articular mobilization) and wooden tongue depressors exercises, with 40 minutes duration each, to improve mouth opening. Maximum mouth opening was assessed with a paquimeter and number of wood tongue depressors. Results: The patient presented improvements in maximal mouth opening between the first and last assessment (11,5mm - 21,2mm) and increase in number of wood tongue depressors used. Conclusion: Physical therapy approach was an effective treatment for trismus. (AU)
