Eficacia de los métodos de fisioterapia empleados en la reeducación de la marcha y el equilibrio en pacientes adultos con ictus: revisión sistemática

Abstract

[Abstract] Background: stroke or cerebrovascular accident (CVA) which may be hemorrhagic or ischemic origin, is the development of clinical signs indicative of disorder of brain function, with a high incidence and prevalence, constituting one of the leading causes of disability and dependence. Objective: To deep into the knowledge and to analyze the efficiency of the different methods of treatment of physical therapy used in the reeducation of gait and balance, in adult patients after suffering a cerebro-vascular accident or ictus. Material and methods: the search was conducted in the databases Cochrane Library Plus, PubMed, PEDro, Cinhal and Web of Science around the month of March 2016, only articles with high methodological quality (PEDro scale) publised in the last 5 years in Spanish, English and Portuguese language were included Results: In the search in the databases mentioned above, 23 clinical trials Among these trials, are up to 9 methods of treatment with different degree of efficiency, y, measured by scales and test of valuation as Berg's scale, the test Up and Go, 6 minutes gait and 10 meters gait among others. Conclusions: There is great diversity in the applications of physiotherapy treatment methods used for gait and balance training, scales of valuation used in all studies were very useful to verify effectiveness, having been the most used the Berg scale; interventions were effective in most cases , the most used were active exercise and electrotherapy .[Resumo] Introdución: o ictus ou accidente cerebrovascular (ACV) que pode ser de orixe hemorrágico ou isquémico, consiste no desenvolvemento de signos clínicos indicativos de trastorno da función cerebral. Presenta una alta incidencia e prevalencia, e constitúe un dos primeiros motivos de discapacidade e dependencia. Obxectivo: Afondar no coñecemento e analizar a eficacia dos diferentes métodos de fisioterapia empregados no tratamento da marcha e o equilibrio, en pacientes adultos que tiveron un accidente vascular cerebral ou ictus. Material e métodos: A procura realizouse nas bases de datos Biblioteca Cochrane Plus, Pubmed, Pedro, Cinhal e Web of Science en torno ó mes de marzo de 2016. Só incluíronse traballos de alta calidade metodológica (escala PEDro) publicados nos últimos 5 anos en lingua española, inglesa e portuguesa. Resultados: Na procura nas bases de datos anteriormente mencionadas, atopáronse 23 ensaios clínicos que cumprisen os criterios de inclusión. Entre estes ensaios, aparecen ata 9 métodos de tratamento con distintos grados de eficacia, medíndose esta mediante escalas e test de valoración como a escala de Berg, o test Up and Go, 6 minutos marcha e 10 metros marcha entre outras. Conclusións: Existe unha gran diversidade nas aplicacións de métodos de tratamento fisioterápico utilizados para a reeducación da marcha e o equilibrio, as escalas de valoración empregadas en todos os estudos, foron moi útiles para verificar a eficacia, sendo a más empleada a escala de Berg; as intervencións foron eficaces na maioría dos casos, sendo as máis empregadas o exercicio activo e a electroterapia.