{"title":"行动观察疗法对步态、平衡和行动障碍的疗效：系统回顾与元分析》。","authors":"Michela Picardi, Federico Temporiti, Chiara Salamone, Peppino Tropea, Giovanni Buccino, Massimo Corbo, Roberto Gatti","doi":"10.1002/pri.70006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Action Observation Therapy (AOT) has been proposed to improve gait, balance and mobility in subjects with neurological and musculoskeletal disorders. The current review aimed to investigate AOT effects in subjects with gait, balance and mobility impairments.</p><p><strong>Methods: </strong>A systematic literature search was performed using PubMed/MEDLINE, EMBASE and Scopus databases from inception until May 2023. Randomized controlled trials investigating effects of AOT on gait, balance and mobility in subjects with any type of clinical condition were included. Two reviewers performed data extraction and methodological quality assessment using the revised Cochrane risk of bias tool for randomized trials. The overall effects were reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI).</p><p><strong>Results: </strong>Thirty-one studies were included. Low evidence supported AOT to enhance walking speed (SMD: 0.40; 95% CI: 0.17, 0.62; I<sup>2</sup> = 0%), stride length (SMD: 0.35; 95% CI 0.05, 0.66; I<sup>2</sup> = 0%) and single limb support duration (MD: 4.1%; 95% CI: 1.0, 7.2, I<sup>2</sup> = 0%) after stroke. Low evidence supported AOT to improve walking distance (MD: 56.8 m; 95% CI; 39.2, 74.4 m) and dynamic (SMD: 0.40; 95% CI: 0.04, 0.76; I<sup>2</sup> = 0%) and static (SMD: 0.69; 95% CI: 0.32, 1.05; I<sup>2</sup> = 0%) balance, while very low evidence supported AOT to enhance mobility (MD: -1.48 s; 95% CI; -2.2, -0.8 s; I<sup>2</sup> = 0%) after stroke. Moderate evidence supported AOT to improve dynamic balance in subjects with Parkinson's disease (SMD: 0.44; 95% CI: 0.09, 0.79; I<sup>2</sup> = 28%), while low evidence supported AOT to enhance dynamic balance (SMD: 0.61; 95% CI: 0.15, 1.08; I<sup>2</sup> = 27%) and mobility (MD: -2.08 s; 95% CI; -3.5, -0.6 s; I<sup>2</sup> = 0%) in patients with orthopedic conditions.</p><p><strong>Conclusion: </strong>AOT improved gait, balance and mobility after stroke, dynamic balance in patients with Parkinson's disease and dynamic balance and mobility in patients with orthopedic conditions. However, evidence certainty was generally low and further high-quality studies are needed.</p><p><strong>Trial registration: </strong>PROSPERO International Prospective Register of Systematic Reviews (n. CRD42021240626).</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 1","pages":"e70006"},"PeriodicalIF":1.5000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of Action Observation Therapy on Gait, Balance and Mobility Impairments: A Systematic Review and Meta-Analysis.\",\"authors\":\"Michela Picardi, Federico Temporiti, Chiara Salamone, Peppino Tropea, Giovanni Buccino, Massimo Corbo, Roberto Gatti\",\"doi\":\"10.1002/pri.70006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Action Observation Therapy (AOT) has been proposed to improve gait, balance and mobility in subjects with neurological and musculoskeletal disorders. The current review aimed to investigate AOT effects in subjects with gait, balance and mobility impairments.</p><p><strong>Methods: </strong>A systematic literature search was performed using PubMed/MEDLINE, EMBASE and Scopus databases from inception until May 2023. Randomized controlled trials investigating effects of AOT on gait, balance and mobility in subjects with any type of clinical condition were included. Two reviewers performed data extraction and methodological quality assessment using the revised Cochrane risk of bias tool for randomized trials. The overall effects were reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI).</p><p><strong>Results: </strong>Thirty-one studies were included. Low evidence supported AOT to enhance walking speed (SMD: 0.40; 95% CI: 0.17, 0.62; I<sup>2</sup> = 0%), stride length (SMD: 0.35; 95% CI 0.05, 0.66; I<sup>2</sup> = 0%) and single limb support duration (MD: 4.1%; 95% CI: 1.0, 7.2, I<sup>2</sup> = 0%) after stroke. Low evidence supported AOT to improve walking distance (MD: 56.8 m; 95% CI; 39.2, 74.4 m) and dynamic (SMD: 0.40; 95% CI: 0.04, 0.76; I<sup>2</sup> = 0%) and static (SMD: 0.69; 95% CI: 0.32, 1.05; I<sup>2</sup> = 0%) balance, while very low evidence supported AOT to enhance mobility (MD: -1.48 s; 95% CI; -2.2, -0.8 s; I<sup>2</sup> = 0%) after stroke. Moderate evidence supported AOT to improve dynamic balance in subjects with Parkinson's disease (SMD: 0.44; 95% CI: 0.09, 0.79; I<sup>2</sup> = 28%), while low evidence supported AOT to enhance dynamic balance (SMD: 0.61; 95% CI: 0.15, 1.08; I<sup>2</sup> = 27%) and mobility (MD: -2.08 s; 95% CI; -3.5, -0.6 s; I<sup>2</sup> = 0%) in patients with orthopedic conditions.</p><p><strong>Conclusion: </strong>AOT improved gait, balance and mobility after stroke, dynamic balance in patients with Parkinson's disease and dynamic balance and mobility in patients with orthopedic conditions. However, evidence certainty was generally low and further high-quality studies are needed.</p><p><strong>Trial registration: </strong>PROSPERO International Prospective Register of Systematic Reviews (n. CRD42021240626).</p>\",\"PeriodicalId\":47243,\"journal\":{\"name\":\"Physiotherapy Research International\",\"volume\":\"30 1\",\"pages\":\"e70006\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physiotherapy Research International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/pri.70006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Research International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/pri.70006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
Efficacy of Action Observation Therapy on Gait, Balance and Mobility Impairments: A Systematic Review and Meta-Analysis.
Background and purpose: Action Observation Therapy (AOT) has been proposed to improve gait, balance and mobility in subjects with neurological and musculoskeletal disorders. The current review aimed to investigate AOT effects in subjects with gait, balance and mobility impairments.
Methods: A systematic literature search was performed using PubMed/MEDLINE, EMBASE and Scopus databases from inception until May 2023. Randomized controlled trials investigating effects of AOT on gait, balance and mobility in subjects with any type of clinical condition were included. Two reviewers performed data extraction and methodological quality assessment using the revised Cochrane risk of bias tool for randomized trials. The overall effects were reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI).
Results: Thirty-one studies were included. Low evidence supported AOT to enhance walking speed (SMD: 0.40; 95% CI: 0.17, 0.62; I2 = 0%), stride length (SMD: 0.35; 95% CI 0.05, 0.66; I2 = 0%) and single limb support duration (MD: 4.1%; 95% CI: 1.0, 7.2, I2 = 0%) after stroke. Low evidence supported AOT to improve walking distance (MD: 56.8 m; 95% CI; 39.2, 74.4 m) and dynamic (SMD: 0.40; 95% CI: 0.04, 0.76; I2 = 0%) and static (SMD: 0.69; 95% CI: 0.32, 1.05; I2 = 0%) balance, while very low evidence supported AOT to enhance mobility (MD: -1.48 s; 95% CI; -2.2, -0.8 s; I2 = 0%) after stroke. Moderate evidence supported AOT to improve dynamic balance in subjects with Parkinson's disease (SMD: 0.44; 95% CI: 0.09, 0.79; I2 = 28%), while low evidence supported AOT to enhance dynamic balance (SMD: 0.61; 95% CI: 0.15, 1.08; I2 = 27%) and mobility (MD: -2.08 s; 95% CI; -3.5, -0.6 s; I2 = 0%) in patients with orthopedic conditions.
Conclusion: AOT improved gait, balance and mobility after stroke, dynamic balance in patients with Parkinson's disease and dynamic balance and mobility in patients with orthopedic conditions. However, evidence certainty was generally low and further high-quality studies are needed.
Trial registration: PROSPERO International Prospective Register of Systematic Reviews (n. CRD42021240626).
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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