Abstract
Objective
This systematic review and meta-analysis aimed to review and quantify the changes
in gait parameters after therapeutic intervention in adults with neurological disorders.
Data Sources
A keyword search was performed in four databases: PubMed, CINAHL, Scopus, and Web
of Science (01/2000-12/2021). We performed the search algorithm including all possible
combinations of keywords. Full-text articles were examined further using forward/backward
search methods.
Study Selection
Studies were thoroughly screened using the following inclusion criteria: Study design:
Randomized Controlled Trial (RCT); adults ≥ 55 years old with a neurological disorder;
therapeutic intervention; spatiotemporal gait characteristics; and Language: English.
Data Extraction
A standardized data extraction form was used to collect the following methodological
outcome variables from each of the included studies: author, year, population, age,
sample size, and spatiotemporal gait parameters such as cadence, step length, step
width, or double limb support. A meta-analysis was performed among trials presenting
with similar characteristics, including study population and outcome measure. If heterogeneity
was > 50%, a random plot analysis was used, otherwise, a fixed plot analysis was done.
Data Synthesis
We included 25 out of 34 studies in our meta-analysis that examined gait in adults
with neurological disorders. All analyses used effect sizes and standard error and
a p < 0.05 threshold was considered statistically significant. Overall, we found that
sensory (SS) and electrical stimulation (ES) had the most significant effect on step
length (SS: z=5.44*, ES: z=2.42*) and gait speed (SS: z=6.19*, ES: z=7.38*) in adults
with Parkinson's disease (PD). Although balance or physical activity interventions
were not found to be effective in modifying step length in adults with PD, they showed
a significant effect on gait speed. Further, physical activity had the most significant
effect on cadence in adults with PD (z=2.84*) relative to sensory stimulation effect
on cadence (z=2.59*). For stroke, conventional physical therapy had the most significant
effect on step length (z=3.12*) and cadence (z=3.57*).
Conclusion
Sensory stimulation such as auditory and somatosensory stimulation while walking had
the most significant effect on step length in adults with PD. We also found that conventional
PT did improve spatial gait parameters relative to other physical activity interventions
in adults with PD and stroke.
Keywords
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Article Info
Publication History
Accepted:
June 5,
2022
Received in revised form:
May 31,
2022
Received:
July 20,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
