masterThesis
Imagética motora para a recuperação funcional da marcha pósAVC: uma revisão sistemática com metanálise
Fecha
2019-03-28Registro en:
SILVA, Stephano Tomaz da. Imagética motora para a recuperação funcional da marcha pósAVC: uma revisão sistemática com metanálise. 2019. 136f. Dissertação (Mestrado em Fisioterapia) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2019.
Autor
Silva, Stephano Tomaz da
Resumen
Introduction: It is estimated that three months after the stroke, 70% of survivors walk
at a reduced speed and 20% remain wheelchair bound. Motor Imagery (MI) is defined
as a mentally rehearsed task in which movement is imagined but not executed.
Separately or combined with physical activity (where the movement is executed), has
demonstrated promising results for rehabilitating gait after a stroke, such as increased
gait speed. Objective: To assess the treatment effects of motor imagery for enhancing ability to
walk among people following stroke. Search methods: A search strategy for words and terms was used to identify articles on the following scientific bases: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO,
AMED, LILACS Bireme, SPORTDiscus, PEDRo and REHABDATA and in clinical
trial records the Cochrane Stroke Group, Clinical Trials and Stroke Trials Registry. The
study was carried out from July to October 2018, and the last search was made on
October 15, 2018. Selection criteria: We included studies in which the participants had a clinical
diagnosis of stroke, presenting gait deficit and studies that used MI to promote gait
improvement in stroke survivors. Data collection and analysis: Data extracted from the studies were used to analyze the risk of bias, the effect of treatment and the quality of the body of evidence.
Main results: Twenty-one studies were included, totaling 747 participants. The primary
outcome analyzed was ability to walk. Studies comparing MI alone or combined with
another therapy versus an active practice physical control, considering the immediate
effect (n = 330), were combined in meta-analysis. Regarding independent walking
speed (11 studies), the estimated effect in favor of therapy was not significant (mean
difference = 0.21; 95% CI -0.02 to 0.44). It was not possible to analyze the dichotomous
variable dependence on personal assistance. The twenty one included studies were
categorized as being at risk of low, high or uncertain bias, with a predominance of high
risk of bias, and the quality of the body of evidence was considered to be very low, low,
and moderate.
Author’s conclusions: There is insufficient evidence to prove that MI is more effective
than other therapies in the rehabilitation of gait after stroke. Despite the findings, the
choice of MI for the gait rehabilitation process after stroke should be stimulated. New
randomized clinical trials should be performed with a more rigorous methodological
quality, so that the evidence to be better evaluated.