Complementary and integrative health interventions in post-stroke rehabilitation: a systematic PRISMA review

Author: Alysha A Walter1, Marieke Van Puymbroeck2, Pamela Bosch3, Arlene A Schmid4
Author Information:
1 Department of Recreation Sciences, East Carolina University, Greenville, SC, USA.
2 Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA.
3 Department of Neurology, University of Arizona, Phoenix, AZ, USA.
4 Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA.
Conference/Journal: Disabil Rehabil
Date published: 2020 Oct 12
Other: Special Notes: doi: 10.1080/09638288.2020.1830440. , Word Count: 390


Aim:
Researchers have reported measurable improvements in emotional and physical health among adults post-stroke after participating in complementary and integrative health techniques. The aim of this manuscript was to systematically review the effectiveness of active complementary and integrative health interventions as a treatment modality for adults post-stroke.

Method:
For this review, active interventions were defined as those that required participants to be in control of initiating their own body movement. Five active complementary and integrative health techniques were reviewed and included: Feldenkrais Method, qigong, Pilates, Tai Chi, and yoga. A key word search was conducted in Medline, Cochrane Library, EBSCO, Google Scholar, and PubMed. Inclusion criteria for studies were (1) randomized controlled trials on the effects of active complementary and integrative health interventions, (2) all participants had to be post-stroke, and (3) studies appeared in English in a peer-reviewed journal.

Results:
Articles in this review included one Qigong, five Pilates, nine Tai Chi, and five yoga studies. All 20 manuscripts reported improvements for participants. Participants in Pilates experienced improvements in quality of life. Improvements in functional balance, standing and dynamic balance, reaction time, maximum excursion, and quality of life were reported in the Pilates studies. Participants in the TC studies experienced a range of positive results including center of gravity, increased reaction time, improved aerobic endurance, fewer falls, sway length and velocity, functional reach, dynamic gait, walking speed, and static and dynamic balance. Improvements after participation in the yoga manuscripts consisted of reduced depression, decreased state and trait anxiety, improved balance, reduction in fear of falling, and enhanced quality of life.

Conclusion:
Based on the small number of randomized controlled trials, this systematic review reported the effectiveness of four active mind-body interventions for individuals post-stroke. The strongest evidence was for the use of Tai Chi, followed by Pilates and yoga. Implications for rehabilitation Clinicians should consider the benefits of qigong, Pilates, Tai Chi, and yoga to best meet individual patient needs and goals. Clinicians who offer qigong, Pilates, Tai Chi, and/or yoga should be qualified to instruct the specific active complementary and integrative health technique or refer patients to those who are qualified. Locate qigong, Pilates, Tai Chi, and yoga classes that are appropriate for people post-stroke in the community to help integrate patients into a program after treatment.

Keywords: Complementary and integrative health; Pilates; Qigong; Tai Chi; and yoga; stroke.

PMID: 33044872 DOI: 10.1080/09638288.2020.1830440

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