Physiotherapy intervention in Alzheimer's disease: systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Many studies reported that physiotherapy interventions are available to treat Alzheimer's disease (AD), but the efficacy remains uncertain. OBJECTIVE: To evaluate the effectiveness of physiotherapy intervention on AD. METHODS: The data sources were searched from literature databases, journals, and reference lists from 1 January 1990 to the end of 1 April 2014. Randomized and non-randomized controlled trials with physiotherapy intervention were included in our meta-analysis. Jadad score and Newcastle-Ottawa scale were used to assess the quality of included trials. Outcome measures were cognition function, physical function, activity of daily life (ADL) and neuropsychiatric inventory (NPI). RESULTS: 23 trials met the inclusion standard finally. Significant changes were seen in cognitive function Mini-Mental State Examination score (weighted mean difference (WMD) 1.84, 95% confidence interval (CI) [0.76, to, 2.93], p < 0.0001), and verbal fluency (standard mean difference (SMD) 0.34, 95% CI [0.01 to 0.66], p = 0.04). Other outcomes are also significant, they were timed up and go test (SMD 0.56, 95% CI [0.30 to 0.83], p < 0.0001), berg functional balance scale (SMD 1.11, 95% CI [0.37 to 1.84], p = 0.003), 6-min walk distance test (SMD 141.45, 95% CI [11.72 to 271.18], p = 0.03), ADL (SMD 0.78, 95% CI [0.33 to 1.23], p = 0.0007) and NPI (SMD -0.69, 95% CI [-1.31 to -0.07], p = 0.03). CONCLUSION: The available data indicate that physiotherapy intervention may have benefits in AD. However, current data are not definitive; more carefully designed and conducted observational studies are needed to definitively establish that whether physiotherapy intervention can effectively alleviate symptoms of AD.