Objective The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. Methods Medline/Pubmed, EMBASE and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations and contexts, where the intervention to be evaluated is telerehabilitation by physical therapy were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively by tables and figures. Results Fifty-three systematic reviews were included of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions and 13 on neurorehabilitation. Other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no-rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. Conclusions Despite the contradictory results, telerehabilitation in physical therapy could be comparable to in-person rehabilitation or better than no-rehabilitation for conditions such as osteoarthritis, low back pain, hip and knee replacement, multiple sclerosis, and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. Impact Providing with the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore better clinical outcomes for patients, both in these times of covid-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.

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Resumen Fundamento: El ictus es la segunda causa de muerte y la primera causa de discapacidad en Europa. El número de pacientes con ictus muestra una tendencia de crecimiento rápido debido al aumento de la población anciana. El objetivo de este metaanálisis es estimar la prevalencia e incidencia de ictus en Europa. Método: Se buscaron artículos en las bases de datos MEDLINE, SCOPUS, CINAHL Complete y EMBASE con los términos “ stroke ”, “ cerebrovascular accident ” combinadas con “ epidemiology ”, “ prevalence ”, “ incidence ” y “ Europe ”. La calidad y el riesgo de sesgo se analizó con las escalas Hoy modificada y Newcastle Ottawa para los artículos de prevalencia e incidencia, respectivamente. El metaanálisis utilizó un modelo de efectos aleatorios con intervalos de confianza del 95% (IC95%) y el estadístico I 2 para estimar la heterogeneidad. Resultados: La prevalencia de ictus en Europa ajustada por sexo fue 9,2% (IC95%: 4,4-14,0); en hombres fue 9,1% (IC95%: 4,7-16,6) y en mujeres 9,2% (IC95%: 4,1-14,4); se encontró una tendencia creciente con el aumento de la edad. La incidencia de ictus ajustada por sexo fue 191,9 por 100.000 personas-año (IC95%: 156,4-227,3); en hombres fue de 195,7 por 100.000 personas-año (IC95%: 142,4-249,0) y en mujeres 188,1 por 100.000 personas-año (IC95%: 138,6-237,7), con igual tendencia creciente con el aumento de la edad. Conclusiones: La prevalencia de ictus en Europa alcanza un 9,2%. La incidencia se sitúa en 191,9 por 100.000 personas-año. La prevalencia de ictus ha aumentado mientras que la incidencia se mantiene estable en comparación con estudios realizados a comienzos del siglo XXI.

To cite: Fuentes-Aspe et al. Risk factors associated with the loss of physical functioning in critical care patients. A protocol of overview of systematic reviews and metaanalysis. Inplasy protocol 202090069.

Background The 2019 coronavirus disease outbreak (COVID-19) spread rapidly around the world. The extent and ultimate effect are still unclear, as it is an ongoing and constantly evolving pandemic. Aims To compile the literature and synthesize in Spanish-Latin American language the available international information describing the etiological, pathophysiological, epidemiological and management aspects of COVID-19. Methods Narrative review, using specific sections created in the databases. The criteria for selecting studies depended on the specific area addressed: etiological, pathophysiological, epidemiological aspects, treatment alternatives, etc. References in Spanish and English were included. Results The World Health Organization reports that COVID-19 is a disease of zoonotic origin that was transmitted to a human host. The first cases were identified in late 2019 and January 2020, in Wuhan city, China. It was categorized as highly contagious and transmissible between humans, which is attributed to the structural features of this novel coronavirus. The clinical presentation is variable and nonspecific, as well as its severity. With a clear tropism for the respiratory system, the most severe cases may develop pneumonia, respiratory failure, multiorgan failure and thus death. It occurs in all age groups, with a lower percentage in children under 19 years of age (2.4%). Mortality varies between countries and regions (between 1.5 to 9.3% over the total of reported cases). Associated risk factors are the presence of comorbidities, advanced age, and immunosuppression. Conclusions To date there have been thousands of scientific articles that attempt to explain the onset, progression, possible treatment options and global impact of the disease. There is still no certainty about the level or quality of this evidence. It is essential to generate documents synthesized and translated into Spanish or other languages that can bring this information to all the places and countries that are being impacted by this disease.