Efecto de un programa de intervención fisioterapéutica en niños con distrofia muscular de Duchenne.
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Fecha
2022
Autores
Polo de La Rosa, Jhaisbeth Karina
Serna Martínez, Daniela Carolina
Rodríguez Mármol, Nicoll
Villalobos Henríquez, Adriana Carolina
Beltrán, Andrés
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Editor
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de las Salud
Facultad de Ciencias de las Salud
Resumen
Objetivos: En esta revisión sistemática se tiene por objetivo el evaluar la efectividad
de la intervención fisioterapéutica en los diferentes niños que padecen de Distrofia
Muscular de Duchenne (DMD), como así también, identificar las deficiencias y
limitaciones de las funciones; determinar esos instrumentos de medición de la
capacidad funcional de los pacientes y por último especificar que modalidades
fisioterapéuticas son efectivas para los diferentes niños con DMD. Materiales y
métodos: Se realizó una evaluación de manera ordenada y explicita de la
literatura científica partiendo de una pregunta de investigación relacionada con un
análisis crítico y un resumen cualitativo de la evidencia. Esta revisión sistemática es
de tipo intervención debido a la evaluación de la efectividad de intervención, lo que
involucra estudios experimentales. Cabe resaltar que la población que aborda esta
revisión son niños que padecen de distrofia muscular de Duchenne. De esta
manera, se estudiaron diferentes artículos en los idiomas inglés, portugués y
español publicados desde los años 2010 hasta 2022. Se planteó la siguiente
pregunta pico: El programa de intervención fisioterapéutica en niños con
enfermedad de distrofia muscular de Duchenne ¿Puede ayudar a controlar y reducir
la gravedad de los síntomas? Por otro lado, se usaron diferentes bases de datos
que sirvieron para redactar de manera satisfactoria dicha revisión sistemática como
lo es: PubMed, Scielo, Google académico, ScienceDirect. Se utilizó la escala de
PEDro para así evaluar la calidad de los diferentes artículos utilizados.
Resultados: Se hizo revisión de 36 artículos científicos diferentes, los cuales se
utilizaron solo 8 de estos, cada uno de estos artículos seleccionados están
enfocados de diferente manera en la intervención adecuada para dichos pacientes.
En cuanto a los resultados de esta revisión sistemática, se evidencia las diferentes
deficiencias más comunes en estos pacientes como lo es; la debilidad muscular y
la disminución del rango de movimiento de manera activa y pasiva, entre las
limitaciones funcionales que presentan son; dificultad al levantarse de las diferentes
posiciones como acostarse y subir escaleras. Así mismo, se evidenció que el
instrumento más usado por los fisioterapeutas son la caminata de 6 minutos sin
ayuda, la dinamometría, el análisis de la marcha, entre otros. Según la literatura
científica, el fisioterapeuta interviene de manera eficaz con diferentes técnicas y
ejercicios como lo son: los isométricos e isotónicos de miembro inferiores, ejercicios
aeróbicos en forma de bicicleta ergométrica, fisioterapia acuática, ejercicios de
entrenamiento de la fuerza y masaje específicamente en las pantorrillas.
Conclusiones: Es de suma importancia la intervención que ofrece un fisioterapeuta
para que haya una mayor calidad de vida y mejoría en las capacidades funcionales
de los pacientes con DMD, para ello, es necesario estar actualizado con la última
evidencia científica. Entre las recomendaciones, es fundamental que dichos
pacientes tengan el apoyo de sus familiares, siendo recomendable para mantener
una adecuada capacidad funcional la intervención fisioterapéutica mediante
diferentes modalidades como ejercicios aeróbicos, así como también ejercicios
respiratorios donde fortalecerán la musculatura respiratoria, masoterapia y también
los masajes en la musculatura que está comprometida. Es importante el trabajo
interdisciplinario con profesionales de la Fonoaudiología y Terapia Ocupacional.
Objectives: The objective of this systematic review is to evaluate the effectiveness of physiotherapeutic intervention in different children suffering from Duchenne Muscular Dystrophy (DMD), as well as to identify the deficiencies and limitations of the functions; determine these instruments for measuring the functional capacity of patients and finally specify which physiotherapeutic modalities are effective for different children with DMD. Materials and methods: An orderly and explicit evaluation of the scientific literature was carried out based on a research question related to a critical analysis and a qualitative summary of the evidence. This systematic review is of the intervention type due to the evaluation of the effectiveness of the intervention, which involves experimental studies. It should be noted that the population addressed in this review are children with Duchenne Muscular Dystrophy. In this way, different articles in the English, Portuguese and Spanish languages published from 2010 to 2022 were studied. The following main question was posed: Can the physiotherapy intervention program in children with Duchenne Muscular Dystrophy Disease help to control and reduce the severity of symptoms? On the other hand, different databases were used that served to satisfactorily write this systematic review, such as: PubMed, Scielo, Google Scholar, ScienceDirect. The PEDro scale was used to assess the quality of the different articles used. Results: A review of 36 different scientific articles was made, which only 8 of these were used, each of these selected articles are focused in a different way on the appropriate intervention for said patients. Regarding the results of this systematic review, the different most common deficiencies in these patients are evident, such as: muscle weakness and decreased range of motion actively and passively, among the functional limitations they present are; difficulty getting up from different positions such as lying down and climbing stairs. Likewise, it was evidenced that the instruments most used by physiotherapists are the 6-minute walk without help, dynamometry, gait analysis, among others. According to the scientific literature, the physiotherapist intervenes effectively with different techniques and exercises such as: isometric and isotonic exercises for the lower limbs, aerobic exercises in the form of an ergometric bicycle, aquatic physiotherapy, strength training exercises and massage specifically in the calf. Conclusions: The intervention offered by a physiotherapist is of the utmost importance so that there is a better quality of life and improvement in the functional capacities of patients with DMD, for this, it is necessary to be updated with the latest scientific evidence. Among the recommendations, it is essential that these patients have the support of their relatives, being recommended to maintain adequate functional capacity physiotherapeutic intervention through different modalities such as aerobic exercises, as well as respiratory exercises where they will strengthen the respiratory muscles, massage therapy and also massages. in the musculature that is compromised. Interdisciplinary work with Speech Therapy and Occupational Therapy professionals is important.
Objectives: The objective of this systematic review is to evaluate the effectiveness of physiotherapeutic intervention in different children suffering from Duchenne Muscular Dystrophy (DMD), as well as to identify the deficiencies and limitations of the functions; determine these instruments for measuring the functional capacity of patients and finally specify which physiotherapeutic modalities are effective for different children with DMD. Materials and methods: An orderly and explicit evaluation of the scientific literature was carried out based on a research question related to a critical analysis and a qualitative summary of the evidence. This systematic review is of the intervention type due to the evaluation of the effectiveness of the intervention, which involves experimental studies. It should be noted that the population addressed in this review are children with Duchenne Muscular Dystrophy. In this way, different articles in the English, Portuguese and Spanish languages published from 2010 to 2022 were studied. The following main question was posed: Can the physiotherapy intervention program in children with Duchenne Muscular Dystrophy Disease help to control and reduce the severity of symptoms? On the other hand, different databases were used that served to satisfactorily write this systematic review, such as: PubMed, Scielo, Google Scholar, ScienceDirect. The PEDro scale was used to assess the quality of the different articles used. Results: A review of 36 different scientific articles was made, which only 8 of these were used, each of these selected articles are focused in a different way on the appropriate intervention for said patients. Regarding the results of this systematic review, the different most common deficiencies in these patients are evident, such as: muscle weakness and decreased range of motion actively and passively, among the functional limitations they present are; difficulty getting up from different positions such as lying down and climbing stairs. Likewise, it was evidenced that the instruments most used by physiotherapists are the 6-minute walk without help, dynamometry, gait analysis, among others. According to the scientific literature, the physiotherapist intervenes effectively with different techniques and exercises such as: isometric and isotonic exercises for the lower limbs, aerobic exercises in the form of an ergometric bicycle, aquatic physiotherapy, strength training exercises and massage specifically in the calf. Conclusions: The intervention offered by a physiotherapist is of the utmost importance so that there is a better quality of life and improvement in the functional capacities of patients with DMD, for this, it is necessary to be updated with the latest scientific evidence. Among the recommendations, it is essential that these patients have the support of their relatives, being recommended to maintain adequate functional capacity physiotherapeutic intervention through different modalities such as aerobic exercises, as well as respiratory exercises where they will strengthen the respiratory muscles, massage therapy and also massages. in the musculature that is compromised. Interdisciplinary work with Speech Therapy and Occupational Therapy professionals is important.
Descripción
Palabras clave
Distrofia muscular de Duchenne, Intervención fisioterapéutica, Revisión sistemática
