Staff View: Non-pharmacological interventions for bone health after stroke: A systematic review

Non-pharmacological interventions for bone health after stroke: A systematic review

Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed...

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Main Authors:	Sallehuddin, Hakimah, Ong, Terence, Said, Salmiah Md., Tarmizi, Noor Azleen Ahmad, Loh, Siew Ping, Lim, Wan Chieh, Nadarajah, Reena, Lim, Hong Tak, Zambri, Nurul Huda Mohd, Ho, Yun Ying, Ghazali, Sazlina Shariff
Format:	Article
Published:	Public Library of Science 2022
Subjects:	Q Science (General)
Online Access:	http://eprints.um.edu.my/41754/
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spelling	my.um.eprints.417542023-10-20T01:44:54Z http://eprints.um.edu.my/41754/ Non-pharmacological interventions for bone health after stroke: A systematic review Sallehuddin, Hakimah Ong, Terence Said, Salmiah Md. Tarmizi, Noor Azleen Ahmad Loh, Siew Ping Lim, Wan Chieh Nadarajah, Reena Lim, Hong Tak Zambri, Nurul Huda Mohd Ho, Yun Ying Ghazali, Sazlina Shariff Q Science (General) Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. Methods A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWIM) was used for result synthesis. Results Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. Conclusion There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required. Public Library of Science 2022-02-23 Article PeerReviewed Sallehuddin, Hakimah and Ong, Terence and Said, Salmiah Md. and Tarmizi, Noor Azleen Ahmad and Loh, Siew Ping and Lim, Wan Chieh and Nadarajah, Reena and Lim, Hong Tak and Zambri, Nurul Huda Mohd and Ho, Yun Ying and Ghazali, Sazlina Shariff (2022) Non-pharmacological interventions for bone health after stroke: A systematic review. PLoS ONE, 17 (2). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0263935 <https://doi.org/10.1371/journal.pone.0263935>. 10.1371/journal.pone.0263935
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	Q Science (General)
spellingShingle	Q Science (General) Sallehuddin, Hakimah Ong, Terence Said, Salmiah Md. Tarmizi, Noor Azleen Ahmad Loh, Siew Ping Lim, Wan Chieh Nadarajah, Reena Lim, Hong Tak Zambri, Nurul Huda Mohd Ho, Yun Ying Ghazali, Sazlina Shariff Non-pharmacological interventions for bone health after stroke: A systematic review
description	Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. Methods A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWIM) was used for result synthesis. Results Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. Conclusion There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.
format	Article
author	Sallehuddin, Hakimah Ong, Terence Said, Salmiah Md. Tarmizi, Noor Azleen Ahmad Loh, Siew Ping Lim, Wan Chieh Nadarajah, Reena Lim, Hong Tak Zambri, Nurul Huda Mohd Ho, Yun Ying Ghazali, Sazlina Shariff
author_facet	Sallehuddin, Hakimah Ong, Terence Said, Salmiah Md. Tarmizi, Noor Azleen Ahmad Loh, Siew Ping Lim, Wan Chieh Nadarajah, Reena Lim, Hong Tak Zambri, Nurul Huda Mohd Ho, Yun Ying Ghazali, Sazlina Shariff
author_sort	Sallehuddin, Hakimah
title	Non-pharmacological interventions for bone health after stroke: A systematic review
title_short	Non-pharmacological interventions for bone health after stroke: A systematic review
title_full	Non-pharmacological interventions for bone health after stroke: A systematic review
title_fullStr	Non-pharmacological interventions for bone health after stroke: A systematic review
title_full_unstemmed	Non-pharmacological interventions for bone health after stroke: A systematic review
title_sort	non-pharmacological interventions for bone health after stroke: a systematic review
publisher	Public Library of Science
publishDate	2022
url	http://eprints.um.edu.my/41754/
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score	13.211869

Non-pharmacological interventions for bone health after stroke: A systematic review

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