Purpose: This study aims at understanding if the contextual factors play a role in the rehabilitation of individuals with ictus, Parkinson's disease and multiple sclerosis. In particular, we tried to the found for a taxonomy, aimed at facilitating clinicians in identifying the appropriate treatment for the patient, thus improving treatment outcomes. Materials and methods: A systematic review was conducted in the following 6 databases: Cochrane Library, EBSCO - CINAHL, EMBASE, PubMed, SCOPUS and Web of Science. The population included adult subjects with diagnosis of stroke, multiple sclerosis or Parkinson's disease explicitly exposed to contextual factors in the study. Only articles in Italian and English with abstract available were included, while no restrictions were considered on time frame of study publication of the studies. A two stages screening was run using the Rayyan software in two stages: first by title and abstract, then by full text. Methodological quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results: The review included thirteen qualitative articles that were divided according to diagnosis of patients enrolled: twelve on subject with stroke, one on patients with multiple sclerosis and none on Parkinson's disease. Topics investigated were various, mostly on the theme of relationship between therapist and patient, like the most explored domains in the musculoskeletal field. The risk of bias analysis showed good methodological quality of all studies: ten out of thirteen studies were rated as high quality, three as moderate quality. Conclusions: The present study highlighted the important role of contextual factors in the care of patient with stroke and multiple sclerosis, influencing the treatment outcome. Therefore, physiotherapists working in the neurological field are invited to consider the role and impact of contextual factors to improve the quality of decision-making and the treatment outcome. To date, literature on Parkinson's disease population is missing. Furthermore, this study, as the first addressing the topic of contextual factors in neurological conditions, provides useful hints for the definition of a taxonomy, which should consider among all the domains also the topic of "caregiver characteristics".
Obiettivo: L’obiettivo di questo progetto di tesi è quello di valutare se ed in che modo il contesto abbia un ruolo nel percorso di riabilitazione di soggetti con ictus, sclerosi multipla e malattia di Parkinson. In particolare, si è cercato di porre le basi per l’identificazione di una tassonomia, simile a quella già esistente in ambito muscolo-scheletrico, volta ad agevolare il clinico nell’individuazione del trattamento terapeutico più adatto al paziente e migliorare gli esiti del trattamento stesso. Materiali e metodi: È stata condotta una revisione sistematica all’interno delle seguenti 6 banche dati: Cochrane Library, EBSCO – CINAHL, EMBASE, PubMed, SCOPUS e Web of Science. La popolazione inclusa, comprende soggetti adulti affetti da ictus, sclerosi multipla o malattia di Parkinson che fossero stati esposti a fattori di contesto. Sono stati inclusi solamente gli articoli in lingua italiana ed inglese di cui fosse disponibile l’abstract, mentre non sono state poste limitazioni all’anno di pubblicazione. Il processo di selezione degli articoli è avvenuto utilizzando il software Rayyan in due fasi: la prima prevedeva la lettura di titolo ed abstract, la successiva degli articoli full text. È stata effettuata una valutazione metodologica della qualità degli studi inclusi utilizzando lo strumento del Critical Appraisal Skills Programme (CASP). Risultati: La revisione comprende tredici articoli qualitativi che si è deciso di suddividere sulla base della patologia analizzata: dodici riguardavano l’ictus, uno la sclerosi multipla, mentre nessuno è stato incluso per la malattia di Parkinson. I temi indagati sono stati di varia natura, la maggior parte di essi erano legati alla relazione tra terapista e paziente, in linea con i domini più esplorati anche in ambito muscolo-scheletrico. L’analisi del rischio di bias ha evidenziato una buona qualità metodologica nella totalità degli studi: dieci dei tredici studi sono stati valutati come di alta qualità, tre come di moderata qualità. Conclusioni: A fronte dei risultati ottenuti è possibile osservare come i fattori di contesto giochino uno ruolo importante nella presa in carico del paziente con ictus e sclerosi multipla. Si invitano dunque i fisioterapisti che lavorano in ambito neurologico a considerare il ruolo e l’impatto dei fattori di contesto al fine di migliorare la qualità del processo decisionale e l’esito del proprio trattamento. Risulta essere assente la letteratura in popolazioni con malattia di Parkinson. Inoltre, questo lavoro essendo il primo studio a trattare limiti e potenzialità del contesto in ambito neurologico, fornisce spunti utili per la creazione di una tassonomia in tale ambito, la quale dovrebbe considerare il tema delle “caratteristiche del caregiver” tra i domini.
Il ruolo dei fattori di contesto nella riabilitazione dei disordini neurologici: revisione sistematica
ZULIANELLO, CHIARA
2021/2022
Abstract
Purpose: This study aims at understanding if the contextual factors play a role in the rehabilitation of individuals with ictus, Parkinson's disease and multiple sclerosis. In particular, we tried to the found for a taxonomy, aimed at facilitating clinicians in identifying the appropriate treatment for the patient, thus improving treatment outcomes. Materials and methods: A systematic review was conducted in the following 6 databases: Cochrane Library, EBSCO - CINAHL, EMBASE, PubMed, SCOPUS and Web of Science. The population included adult subjects with diagnosis of stroke, multiple sclerosis or Parkinson's disease explicitly exposed to contextual factors in the study. Only articles in Italian and English with abstract available were included, while no restrictions were considered on time frame of study publication of the studies. A two stages screening was run using the Rayyan software in two stages: first by title and abstract, then by full text. Methodological quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results: The review included thirteen qualitative articles that were divided according to diagnosis of patients enrolled: twelve on subject with stroke, one on patients with multiple sclerosis and none on Parkinson's disease. Topics investigated were various, mostly on the theme of relationship between therapist and patient, like the most explored domains in the musculoskeletal field. The risk of bias analysis showed good methodological quality of all studies: ten out of thirteen studies were rated as high quality, three as moderate quality. Conclusions: The present study highlighted the important role of contextual factors in the care of patient with stroke and multiple sclerosis, influencing the treatment outcome. Therefore, physiotherapists working in the neurological field are invited to consider the role and impact of contextual factors to improve the quality of decision-making and the treatment outcome. To date, literature on Parkinson's disease population is missing. Furthermore, this study, as the first addressing the topic of contextual factors in neurological conditions, provides useful hints for the definition of a taxonomy, which should consider among all the domains also the topic of "caregiver characteristics".File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/38713