Physiotherapy Intervention in Alzheimer's Disease: Systematic Review and Meta-Analysis

Article type: Research Article

Authors: Zhu, Xi-Chen^a | Yu, Yang^b | Wang, Hui-Fu^a | Jiang, Teng^a | Cao, Lei^a | Wang, Chong^c | Wang, Jun^c | Tan, Chen-Chen^c | Meng, Xiang-Fei^c | Tan, Lan^{a; c; *} | Yu, Jin-Tai^{a; c; d; *}

Affiliations: [a] Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, China | [b] Department of Neurology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China | [c] Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China | [d] Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA

Correspondence: [*] Correspondence to: Dr. Lan Tan or Jin-Tai Yu, Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, No.5 Donghai Middle Road, Qingdao, Shandong Province 266071, China. E-mails: dr.tanlan@163.com (L. Tan); yu-jintai@163.com (J.T. Yu).

Abstract: Background:Many studies reported that physiotherapy interventions are available to treat Alzheimer's disease (AD), but the efficacy remains uncertain. Objective:To evaluate the effectiveness of physiotherapy intervention on AD. Methods:he data sources were searched from literature databases, journals, and reference lists from 1 January 1990 to the end of 1 April 2014. Randomized and non-randomized controlled trials with physiotherapy intervention were included in our meta-analysis. Jadad score and Newcastle-Ottawa scale were used to assess the quality of included trials. Outcome measures were cognition function, physical function, activity of daily life (ADL) and neuropsychiatric inventory (NPI). Results:23 trials met the inclusion standard finally. Significant changes were seen in cognitive function: Mini-Mental State Examination score (weighted mean difference (WMD): 1.84, 95% confidence interval (CI): [0.76, to, 2.93], p < 0.0001), and verbal fluency (standard mean difference (SMD): 0.34, 95% CI: [0.01 to 0.66], p = 0.04). Other outcomes are also significant, they were timed up and go test (SMD: 0.56, 95% CI: [0.30 to 0.83], p < 0.0001), berg functional balance scale (SMD: 1.11, 95% CI: [0.37 to 1.84], p = 0.003), 6-min walk distance test (SMD: 141.45, 95% CI: [11.72 to 271.18], p = 0.03), ADL (SMD: 0.78, 95% CI: [0.33 to 1.23], p = 0.0007) and NPI (SMD: −0.69, 95% CI: [−1.31 to −0.07], p = 0.03). Conclusion:The available data indicate that physiotherapy intervention may have benefits in AD. However, current data are not definitive; more carefully designed and conducted observational studies are needed to definitively establish that whether physiotherapy intervention can effectively alleviate symptoms of AD.

Keywords: Activity of daily life, Alzheimer's disease, cognitive function, meta-analysis, neuropsychiatric inventory, physical function, physiotherapy intervention

DOI: 10.3233/JAD-141377

Journal: Journal of Alzheimer's Disease, vol. 44, no. 1, pp. 163-174, 2015