Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.
until further notice
SourceArchives of Physical Medicine and Rehabilitation, 88, 11, (2007), pp. 1452-1464
Article / Letter to editor
Display more detailsDisplay less details
Epidemiology, Biostatistics & HTA
Centre for Quality of Care Research
Archives of Physical Medicine and Rehabilitation
SubjectDCN 1: Perception and Action; DCN 2: Functional Neurogenomics; EBP 2: Effective Hospital Care; EBP 4: Quality of Care; NCEBP 10: Human Movement & Fatigue; NCEBP 2: Evaluation of complex medical interventions; NCEBP 6:Quality of nursing and allied health care; UMCN 3.1: Neuromuscular development and genetic disorders; UMCN 3.2 Cognitive Neurosciences; EBP 2: Effective Hospital Care; NCEBP 10: Human Movement & Fatigue
OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL, EMBASE (Rehabilitation and Physical Medicine), and reference lists of reviews and articles. STUDY SELECTION: Randomized clinical trials (RCTs), controlled clinical trials (CCTs), and other designs were included. Study participants had to have any of the following types of NMD: motoneuron diseases, disorders of the motor nerve roots or peripheral nerves, neuromuscular transmission disorders, or muscle diseases. All types of exercise therapy and other physical therapy modalities were included. Outcome measures had to be at the level of body functions, activities, or participation according to the definitions of the International Classification of Functioning, Disability and Health (ICF). DATA EXTRACTION: Two reviewers independently decided on inclusion or exclusion of articles and rated the methodologic quality of the studies included. All RCTs, CCTs, and other designs only if of sufficient methodologic quality were included in a best evidence synthesis. A level of evidence was attributed for each subgroup of NMD and each type of intervention. DATA SYNTHESIS: Initially 58 studies were included: 12 RCTs, 5 CCTs, and 41 other designs. After methodologic assessment, 19 other designs were excluded from further analysis. There is level II evidence ("likely to be effective") for strengthening exercises in combination with aerobic exercises for patients with muscle disorders. Level III evidence ("indications of effectiveness") was found for aerobic exercises in patients with muscle disorders and for the combination of muscle strengthening and aerobic exercises in a heterogeneous group of muscle disorders. Finally, there is level III evidence for breathing exercises for patients with myasthenia gravis and for patients with myotonic muscular dystrophy. Adverse effects of exercise therapy were negligible. CONCLUSIONS: The available evidence is limited, but relevant for clinicians. Future studies should be preferably multicentered, and use an international classification of the variables of exercise therapy and an ICF core set for NMD in order to improve comparability of results.
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.