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, PubM...

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Main Authors:	Sallehuddin, Hakimah, Ong, Terence, Md. Said, Salmiah, Ahmad Tarmizi, Noor Azleen, Loh, Siew Ping, Wan, Chieh Lim, Nadarajah, Reena, Lim, Hong Tak, Mohd Zambri, Nurul Huda, Shariff Ghazali, Sazlina
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Published:	Public Library of Science 2022
Online Access:	http://psasir.upm.edu.my/id/eprint/102327/ https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263935
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spelling	my.upm.eprints.1023272023-06-08T02:14:36Z http://psasir.upm.edu.my/id/eprint/102327/ Non-pharmacological interventions for bone health after stroke: a systematic review Sallehuddin, Hakimah Ong, Terence Md. Said, Salmiah Ahmad Tarmizi, Noor Azleen Loh, Siew Ping Wan, Chieh Lim Nadarajah, Reena Lim, Hong Tak Mohd Zambri, Nurul Huda Mohd Zambri, Nurul Huda Shariff Ghazali, Sazlina 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 Md. Said, Salmiah and Ahmad Tarmizi, Noor Azleen and Loh, Siew Ping and Wan, Chieh Lim and Nadarajah, Reena and Lim, Hong Tak and Mohd Zambri, Nurul Huda and Mohd Zambri, Nurul Huda and Shariff Ghazali, Sazlina (2022) Non-pharmacological interventions for bone health after stroke: a systematic review. PL o S One, 17. pp. 1-17. ISSN 1932-6203 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263935 10.1371/journal.pone.0263935
institution	Universiti Putra Malaysia
building	UPM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Putra Malaysia
content_source	UPM Institutional Repository
url_provider	http://psasir.upm.edu.my/
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 Md. Said, Salmiah Ahmad Tarmizi, Noor Azleen Loh, Siew Ping Wan, Chieh Lim Nadarajah, Reena Lim, Hong Tak Mohd Zambri, Nurul Huda Mohd Zambri, Nurul Huda Shariff Ghazali, Sazlina
spellingShingle	Sallehuddin, Hakimah Ong, Terence Md. Said, Salmiah Ahmad Tarmizi, Noor Azleen Loh, Siew Ping Wan, Chieh Lim Nadarajah, Reena Lim, Hong Tak Mohd Zambri, Nurul Huda Mohd Zambri, Nurul Huda Shariff Ghazali, Sazlina Non-pharmacological interventions for bone health after stroke: a systematic review
author_facet	Sallehuddin, Hakimah Ong, Terence Md. Said, Salmiah Ahmad Tarmizi, Noor Azleen Loh, Siew Ping Wan, Chieh Lim Nadarajah, Reena Lim, Hong Tak Mohd Zambri, Nurul Huda Mohd Zambri, Nurul Huda Shariff Ghazali, Sazlina
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://psasir.upm.edu.my/id/eprint/102327/ https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263935
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score	13.211869

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

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