Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis
BackgroundEvidence of the effectiveness of physiotherapy, including muscle strength training, coordination training, aerobic exercise, cycling regimen, balance training, gait training, and activity of daily living training, in patients with degenerative cerebellar ataxia (DCA) was insufficient for c...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1491142/full |
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| author | Akiyoshi Matsugi Kyota Bando Yuki Kondo Yutaka Kikuchi Kazuhiro Miyata Yuichi Hiramatsu Yuya Yamanaka Hiroaki Tanaka Yuta Okuda Koshiro Haruyama Yuichiro Yamasaki |
| author_facet | Akiyoshi Matsugi Kyota Bando Yuki Kondo Yutaka Kikuchi Kazuhiro Miyata Yuichi Hiramatsu Yuya Yamanaka Hiroaki Tanaka Yuta Okuda Koshiro Haruyama Yuichiro Yamasaki |
| author_sort | Akiyoshi Matsugi |
| collection | DOAJ |
| description | BackgroundEvidence of the effectiveness of physiotherapy, including muscle strength training, coordination training, aerobic exercise, cycling regimen, balance training, gait training, and activity of daily living training, in patients with degenerative cerebellar ataxia (DCA) was insufficient for clinical decision making. We aimed to explore clinical outcomes and examine the parameters associated with physical impairment and activity in people with DCA based on preregistration (PROSPERO: CRD42024493883).MethodsThe PubMed, Cochrane Library, CHINAL, and PEDro databases were searched for relevant randomized controlled trials (RCTs). Data extraction, quality assessment, and heterogeneity analyses were conducted. The Grading of Recommendations Assessment, Development, and Evaluation framework (GRADE) was used to assess the quality of evidence, and a meta-analysis was performed.ResultsEighteen RCTs, which included 398 participants, showed a serious risk of bias (RoB) and low certainty of evidence for this primary outcome. For meta-analysis, 315 patients assessed based on the Scale for Assessment and Rating of Ataxia (SARA) were included. Overall, physiotherapy significantly reduced SARA scores (MD = −1.41, [95% CI: −2.16, −0.66]); the subgroup analysis showed that the following interventions exerted significant effects: multi-aspect training program (5 studies, MD = −1.59, [95% CI: −5.15, −0.03]), balance training (3 studies, MD = −1.58, [95% CI: −2.55, −0.62]), and aerobic training (3 studies, MD = −1.65, [95% CI: −2.53, −0.77]). By contrast, vibration (2 studies, MD = −0.56, [95% CI: −2.05, 0.93]) and dual-task training (1 study, MD = 0.24, [95% CI: −6.4, 6.88]) exhibited no significant effects.ConclusionPhysical therapy, especially multi-aspect physical therapy such as muscle strengthening, coordination training, gait training, and ADL training, may reduce DCA symptoms. Further, balance and aerobic training can be added to the program. However, the estimated effect size may change in future studies because of the serious RoB, very low certainty of evidence, and high heterogeneity with SARA as the primary outcome. High-quality RCTs are required to establish evidence for the effectiveness of physical therapy in patients with DCA.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=493883, identifier: CRD42024493883. |
| format | Article |
| id | doaj-art-ae67b3a08e2c4b7fbd4e27d9a369b255 |
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| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-ae67b3a08e2c4b7fbd4e27d9a369b2552025-08-20T02:27:40ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.14911421491142Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysisAkiyoshi Matsugi0Kyota Bando1Yuki Kondo2Yutaka Kikuchi3Kazuhiro Miyata4Yuichi Hiramatsu5Yuya Yamanaka6Hiroaki Tanaka7Yuta Okuda8Koshiro Haruyama9Yuichiro Yamasaki10Faculty of Rehabilitation, Shijonawate Gakuen University, Osaka, JapanNational Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanNational Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels Mihara Memorial Hospital, Gunma, JapanDepartment of Physical Therapy, Ibaraki Prefectural University of Health Science, Ibaraki, JapanNeurorehabilitaion Research Institute, Morinomiya Hospital, Osaka, JapanDepartment of Rehabilitation, Osaka University Hospital, Osaka, JapanDepartment of Physical Medicine and Rehabilitation, Kansai Medical University Hospital, Osaka, JapanDepartment of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels Mihara Memorial Hospital, Gunma, JapanDepartment of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, JapanDepartment of Rehabilitation, Maruki Memorial Medical and Social Welfare Center, Saitama, JapanBackgroundEvidence of the effectiveness of physiotherapy, including muscle strength training, coordination training, aerobic exercise, cycling regimen, balance training, gait training, and activity of daily living training, in patients with degenerative cerebellar ataxia (DCA) was insufficient for clinical decision making. We aimed to explore clinical outcomes and examine the parameters associated with physical impairment and activity in people with DCA based on preregistration (PROSPERO: CRD42024493883).MethodsThe PubMed, Cochrane Library, CHINAL, and PEDro databases were searched for relevant randomized controlled trials (RCTs). Data extraction, quality assessment, and heterogeneity analyses were conducted. The Grading of Recommendations Assessment, Development, and Evaluation framework (GRADE) was used to assess the quality of evidence, and a meta-analysis was performed.ResultsEighteen RCTs, which included 398 participants, showed a serious risk of bias (RoB) and low certainty of evidence for this primary outcome. For meta-analysis, 315 patients assessed based on the Scale for Assessment and Rating of Ataxia (SARA) were included. Overall, physiotherapy significantly reduced SARA scores (MD = −1.41, [95% CI: −2.16, −0.66]); the subgroup analysis showed that the following interventions exerted significant effects: multi-aspect training program (5 studies, MD = −1.59, [95% CI: −5.15, −0.03]), balance training (3 studies, MD = −1.58, [95% CI: −2.55, −0.62]), and aerobic training (3 studies, MD = −1.65, [95% CI: −2.53, −0.77]). By contrast, vibration (2 studies, MD = −0.56, [95% CI: −2.05, 0.93]) and dual-task training (1 study, MD = 0.24, [95% CI: −6.4, 6.88]) exhibited no significant effects.ConclusionPhysical therapy, especially multi-aspect physical therapy such as muscle strengthening, coordination training, gait training, and ADL training, may reduce DCA symptoms. Further, balance and aerobic training can be added to the program. However, the estimated effect size may change in future studies because of the serious RoB, very low certainty of evidence, and high heterogeneity with SARA as the primary outcome. High-quality RCTs are required to establish evidence for the effectiveness of physical therapy in patients with DCA.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=493883, identifier: CRD42024493883.https://www.frontiersin.org/articles/10.3389/fneur.2024.1491142/fullcerebellumataxiadegenerative cerebellar ataxiaphysical therapyphysical rehabilitationsystematic review |
| spellingShingle | Akiyoshi Matsugi Kyota Bando Yuki Kondo Yutaka Kikuchi Kazuhiro Miyata Yuichi Hiramatsu Yuya Yamanaka Hiroaki Tanaka Yuta Okuda Koshiro Haruyama Yuichiro Yamasaki Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis Frontiers in Neurology cerebellum ataxia degenerative cerebellar ataxia physical therapy physical rehabilitation systematic review |
| title | Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis |
| title_full | Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis |
| title_fullStr | Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis |
| title_full_unstemmed | Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis |
| title_short | Effects of physiotherapy on degenerative cerebellar ataxia: a systematic review and meta-analysis |
| title_sort | effects of physiotherapy on degenerative cerebellar ataxia a systematic review and meta analysis |
| topic | cerebellum ataxia degenerative cerebellar ataxia physical therapy physical rehabilitation systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1491142/full |
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