Efectividad de la Terapia Restrictiva del Miembro Sano en pacientes hemipléjicos tras un ACV. Revisión sistemática.
Fecha
2016-06-16
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Jaén: Universidad de Jaén
Resumen
[ES] Objetivo: Identificar, reunir y evaluar las evidencias disponibles en la actualidad sobre la
Terapia Restrictiva del Miembro Sano (CIMT) en el tratamiento de pacientes hemipléjicos
tras un ACV.
Material y métodos: Se realizó una búsqueda bibliográfica en las bases de datos PUBMED,
PEDro y Scopus. Se incluyeron ensayos clínicos aleatorizados, publicados en los últimos 5
años, en inglés o español, con pacientes hemipléjicos tras un ACV mayores de 19 años.
Resultados: Tras la búsqueda bibliográfica, se consideraron de interés 646 artículos de los
cuales, después de la eliminación de duplicados y atendiendo a los criterios de inclusión y
exclusión, se escogieron 13 para la revisión a texto completo. Estos estudios se analizaron
seleccionándolos en 5 grupos: aplicación de CIMT en el hogar, restricción en CIMT, CIMT
frente a tratamiento bimanual, CIMT frente a tratamiento convencional y CIMT frente a
otras terapias.
Conclusión: Existe evidencia leve en el uso de CIMT en el hogar, en el uso de CIMT frente la
terapia bimanual, frente a la terapia convencional y de que tanto CIMT, como la mFUT y la
terapia con Wii son potencialmente válidas para la rehabilitación de pacientes tras un ACV.
También se halló evidencia contradictoria en la efectividad de la restricción de la CIMT.
Se necesitan más estudios de alta calidad metodológica y mayor tamaño muestral para
comprobar la efectividad de la Terapia Restrictiva del Miembro Sano.
[EN] Aim: To identify, collect and evaluate the currently available evidence on Constraint Induced Movement Therapy (CIMT) in the treatment of hemiplegic patients after a stroke. Methods: A literatura review was performed in PubMed, PEDro and Scopus database. Randomized clinical trials published in the last 5 years, in English or Spanish, with hemiplegic patients after a stroke over 19 years were included. Results: After the literature review, 646 were considered articles of interest which, after removing duplicates and addressing the inclusion and exclusion criteria, 13 were selected for full text review. These studies were analyzed into 5 groups: HOMECIMT application, restriction in CIMT, CIMT against bimanual treatment, CIMT versus conventional treatment and CIMT compared to other therapies. Conclusions: There is slight evidence on the use of HOMECIMT, in the use of CIMT versus bimanual therapy, versus conventional and both CIMT, such as mFUT and Wii therapy are potentially valid for the rehabilitation of patients after a stroke therapy. It was also found conflicting evidence on the effectiveness of the restriction of the CIMT. More studies of high methodological quality and larger participants are needed to verify the effectiveness of the CIMT.
[EN] Aim: To identify, collect and evaluate the currently available evidence on Constraint Induced Movement Therapy (CIMT) in the treatment of hemiplegic patients after a stroke. Methods: A literatura review was performed in PubMed, PEDro and Scopus database. Randomized clinical trials published in the last 5 years, in English or Spanish, with hemiplegic patients after a stroke over 19 years were included. Results: After the literature review, 646 were considered articles of interest which, after removing duplicates and addressing the inclusion and exclusion criteria, 13 were selected for full text review. These studies were analyzed into 5 groups: HOMECIMT application, restriction in CIMT, CIMT against bimanual treatment, CIMT versus conventional treatment and CIMT compared to other therapies. Conclusions: There is slight evidence on the use of HOMECIMT, in the use of CIMT versus bimanual therapy, versus conventional and both CIMT, such as mFUT and Wii therapy are potentially valid for the rehabilitation of patients after a stroke therapy. It was also found conflicting evidence on the effectiveness of the restriction of the CIMT. More studies of high methodological quality and larger participants are needed to verify the effectiveness of the CIMT.