|
Abstract
|
OBJECTIVE: To summarize the effectiveness of physical therapy (PT) interventions to reduce fear of falling (FOF) among individuals living with neurological diseases.
DATA SOURCES: PubMed, PEDro, Scopus, Web of Science, PsycINFO, CINAHL, and SportDiscuss were searched from inception until December 2019.
STUDY SELECTION: Clinical trials with either the primary or secondary aim to reduce FOF among adults with neurological diseases were selected.
DATA EXTRACTION: Potential papers were screened for eligibility and data extracted by two independent researchers. Risk of bias was assessed by the Cochrane Risk of Bias tool for randomized clinical trials and the NIH Quality Assessment Tool for pre-post studies. A meta-analysis was performed among trials presenting with similar clinical characteristics. The Grading Recommendations, Assessment, Development and Evaluation- GRADE was used to rate the overall quality of evidence.
RESULTS: Sixty-one trials/3954 participants were included in the review and 53 trials/3524 participants in the meta-analysis. The included studies presented, in general, with a low to high risk of bias. A combination of gait and balance training was found to be significantly more effective compared to gait training alone in reducing FOF among individuals with Parkinson's Disease (PD) (Mean Difference- MD = 11.80, 95% CI, 8.22 - 15.38; p < 0.001). Home-based exercise and leisure exercise demonstrated significant improvement in reducing FOF over usual care in multiple sclerosis (MS) (MD = 15.27, 95% CI, 6.15 - 24.38, p = 0.001). No statistically significant between-groups differences were reported among individuals with stroke and spinal cord injury (SCI). The overall quality of evidence presented in this review ranges from very low to moderate according to the assessment with the GRADE approach.
CONCLUSION: Gait with lower limb training combined with balance training is effective in reducing FOF in individuals with PD. Also, home-based or leisure exercise is effective among individuals with MS. However, due to several limitations of the included studies, further research is needed to examine the effectiveness of FOF intervention among individuals with neurological diseases.
Language: en |