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2.
Disabil Rehabil ; 36(8): 628-34, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23826882

RESUMO

PURPOSE: The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. METHOD: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. RESULTS: Eight randomised controlled trials involving 213 patients (age range: 16-36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score≥3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. CONCLUSIONS: The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.


Assuntos
Anorexia/terapia , Bulimia Nervosa/reabilitação , Modalidades de Fisioterapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Disabil Rehabil ; 35(26): 2191-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23594056

RESUMO

PURPOSE: Since a distorted body experience and a sedentary lifestyle are central in the course of binge eating disorder (BED), physical therapy might be an interesting add-on treatment. The aim of this study was to systematically review randomised controlled trials (RCTs) evaluating physical therapy on binge eating and physical and mental health in BED patients. METHOD: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Library were searched from their inception until 15 August 2012 for relevant RCTs comparing physical therapy with a placebo condition, control intervention or standard care. RESULTS: Three RCTs involving 211 female community patients (age range: 25-63 years) met all selection criteria. Review data demonstrate that aerobic and yoga exercises reduce the number of binges and the body mass index (BMI) of BED patients. Aerobic exercise also reduces depressive symptoms. Only combining cognitive behavioural therapy (CBT) with aerobic exercise and not CBT alone reduces BMI. Combining aerobic exercise with CBT is more effective in reducing depressive symptoms than CBT alone. CONCLUSIONS: The limited number of available studies and the heterogeneity of the interventions limit overall conclusions and highlight the need for further research. IMPLICATIONS FOR REHABILITATION: Because of severe co-morbid psychiatric and physical conditions, binge eating disorder is one of the most difficult psychiatric conditions to treat. Both yoga and aerobic exercise have shown promise in reducing binge eating pathology and weight. Combining aerobic exercise with cognitive behavioural therapy seems more effective in reducing depressive symptoms than cognitive behavioural therapy alone.


Assuntos
Transtorno da Compulsão Alimentar/terapia , Terapia por Exercício/métodos , Exercício Físico , Yoga , Transtorno da Compulsão Alimentar/psicologia , Índice de Massa Corporal , Humanos , Atividade Motora , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
4.
Phys Ther ; 92(1): 11-23, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22052946

RESUMO

BACKGROUND: Although schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown. PURPOSE: The purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia. DATA SOURCES: EMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used. STUDY SELECTION: Two reviewers independently determined study eligibility on the basis of inclusion criteria. DATA EXTRACTION: Reviewers rated study quality and extracted information about study methods, design, intervention, and results. DATA SYNTHESIS: Ten RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress. LIMITATIONS: The heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research. CONCLUSIONS: Physical therapy offers added value in the multidisciplinary care of people with schizophrenia.


Assuntos
Prestação Integrada de Cuidados de Saúde , Terapia por Exercício/métodos , Modalidades de Fisioterapia , Esquizofrenia/reabilitação , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
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