Eficácia da reabilitação cognitiva na melhoria e manutenção das atividades de vida diária em pacientes com doença de Alzheimer: uma revisão sistemática da literatura

Background: There is no agreement about or understanding of what rehabilitation is; those who pay for it, those who provide it, and those who receive it all have different interpretations. Furthermore, within each group, there will be a variety of opinions. Definitions based on authority or on theory also vary and do not give a clear description of what someone buying, providing, or receiving rehabilitation can actually expect. Method: This editorial extracts information from systematic reviews that find rehabilitation to be effective, to discover the key features and to develop an empirical definition. Findings: The evidence shows that rehabilitation may benefit any person with a long-lasting disability, arising from any cause, may do so at any stage of the illness, at any age, and may be delivered in any setting. Effective rehabilitation depends on an expert multidisciplinary team, working within the biopsychosocial model of illness and working collaboratively towards agreed goals. The effective general interventions include exercise, practice of tasks, education of and self-management by the patient, and psychosocial support. In addition, a huge range of other interventions may be needed, making rehabilitation an extremely complex process; specific actions must be tailored to the needs, goals, and wishes of the individual patient, but the consequences of any action are unpredictable and may not even be those anticipated. Conclusion: Effective rehabilitation is a person-centred process, with treatment tailored to the individual patient’s needs and, importantly, personalized monitoring of changes associated with intervention, with further changes in goals and actions if needed.

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“…Diseases that are more inexorably progressive: Parkinson’s disease 17 and Alzheimer’s disease. 40 , 41 …”

Section: Contextmentioning

confidence: 99%

What is rehabilitation? An empirical investigation leading to an evidence-based description

2020

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“…Meta-analyses (MAs) have been conducted to summarize the efficacy of different types of non-pharmacologic therapies for AD (García-Casares et al, 2017;Cammisuli et al, 2018;Sá et al, 2019). However, strong conclusions have not been reached owing to the wide variation in scope, quality, and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Overview of Meta-Analyses of Five Non-pharmacological Interventions for Alzheimer's Disease

Wang

Pei

Zhan

et al. 2020

Front. Aging Neurosci.

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Background: Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive memory deficits, cognitive decline, and spatial disorientation. Non-pharmacological interventions to treat AD have been reported in many meta-analyses (MAs), but robust conclusions have not been made because of variations in the scope, quality, and findings of these reviews.Objective: This work aimed to review existing MAs to provide an overview of existing evidence on the effects of five non-pharmacological interventions in AD patients on three outcomes: Mini-Mental State Examination (MMSE), activities of daily living (ADL), and Alzheimer's Disease Assessment Scale-cognitive section (ADAS-cog).Methods: The databases PubMed, Cochrane Library, Embase, and Web of Science were searched to collect MAs of non-pharmacological interventions for AD. Two reviewers independently conducted literature screening, data extraction, and quality assessment. We assessed the quality of MAs with the Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 and assessed the evidence quality for significant outcomes using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.Results: We found 10 eligible MAs, which included between three (133 patients) and 15 randomized trials (1,217 patients), and five non-pharmacological interventions, namely, acupuncture therapy (40%), exercise intervention (30%), music therapy (10%), cognitive intervention (10%), and repetitive transcranial magnetic stimulation (rTMS) (10%). All the included MAs were critically low to low quality by AMSTAR 2. Acupuncture therapy and exercise intervention showed the preliminary potential to improve ADL and MMSE. rTMS and acupuncture therapy show benefits in decreasing ADAS-cog, and there were some evidence of improved MMSE with cognitive intervention. All these outcomes scored very low quality to moderate quality of evidence on the GRADE system.Conclusions: Non-pharmacological therapy shows promise for the treatment of AD, but there is still a lack of high-quality evidence. In the future, the quality of the original research needs to be improved, and strictly designed MAs should be carried out following methodological requirements.

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“…Esta preponderância significativa pela preferência por metodologias de trabalho em grupo contradiz a tese de que haveria uma tendência recente pela preferência por programas personalizados de reabilitação cognitiva realizados de forma individual (Gomes, 2016). De fato, ainda que de forma minoritária, a presença um artigo (Sánchez et al, 2016) onde se estabelece a preferência explícita por sessões de musicoterapia individualizadas corrobora o entendimento de que programas terapêuticos individuais tendem a proporcionar uma melhor comunicação entre o terapeuta e o paciente, onde podem ser estabelecidas metas de forma personalizada a partir das demandas específicas de cada indivíduo (Sá, Silva, Biongiari & Machado-Lima, 2019).…”

Section: Fonte: Autores (2022)unclassified

Impactos cognitivos da utilização de Intervenções Baseadas em Música em idosos com Doença de Alzheimer: uma revisão sistemática

Souza

Cavalcanti

Dantas

et al. 2022

RSD

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Objetivo: Investigar os benefícios cognitivos das Intervenções Baseadas em Música - IBM para idosos portadores de Doença de Alzheimer - DA a partir de uma Revisão Sistemática. Método: Coletaram-se publicações da Biblioteca Virtual de Saúde e PubMed a partir da questão norteadora: "IBM impactam positivamente na disfunção cognitiva de idosos com DA em comparação com outros tratamentos não-farmacológicos?". Consideraram-se os seguintes critérios de elegibilidade: acesso gratuito e integral nas bases de dados; publicação entre 01/01/2011 e 31/12/2021; idioma Inglês, Espanhol ou Português; seleção exclusiva de Ensaios Clínicos; score acima de 80% na escala Downs e Black (1998). Por fim, as duplicatas foram descartadas. A seleção final contou com 6 artigos, dos quais foram extraídos os seguintes dados: objetivos pretendidos; IBM utilizadas; principais resultados alcançados; autoria e recorte amostral das publicações; duração das intervenções; instrumentos de avaliação da disfunção cognitiva; score da escala Downs e Black (1998). Resultados: 50% dos estudos elencaram como objetivo primário a realização de alguma modalidade de avaliação do estado cognitivo de seus participantes. Por sua vez, a Memória e a Atenção foram as Funções Cognitivas priorizadas nas coletas de dados e análises empregadas pelos pesquisadores, com resultados positivos para a utilização das IBM. Conclusão: As IBM promovem benefícios significativos para os idosos portadores de DA, tanto em termos cognitivos como de forma ampliada, contribuindo para a produção de tratamentos com foco no bem-estar e qualidade de vida.

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Eficácia da reabilitação cognitiva na melhoria e manutenção das atividades de vida diária em pacientes com doença de Alzheimer: uma revisão sistemática da literatura

Cited by 4 publications

References 12 publications

What is rehabilitation? An empirical investigation leading to an evidence-based description

What is rehabilitation? An empirical investigation leading to an evidence-based description

Overview of Meta-Analyses of Five Non-pharmacological Interventions for Alzheimer's Disease

Impactos cognitivos da utilização de Intervenções Baseadas em Música em idosos com Doença de Alzheimer: uma revisão sistemática

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