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Efficacy studies in neurological physiotherapy: is a new point of view possible?
Maiocchi S, Sirtori V, Guariento E
Italian Journal of Physiotherapy 2011 Mar;1(1):27-35
systematic review

The aim of this paper was to describe neurological physiotherapy literature and to analyze whether similar treatments are used to obtain the same objectives in patients with different diseases. Medline and Embase databases were consulted until December 2007. All types of studies on the effectiveness of physiotherapy in adults with a central nervous system lesion were included. The articles selected were catalogued with respect to title, author, journal, year of publication, type of study and pathology. In order to verify whether the same treatments were used for the same objectives in different pathologies, controlled trials concerning the most frequently studied neurological diseases were classified according to treatment and objective. The number of articles and journals in which the articles were published has increased over years, reaching a total of 3 065 articles published in 589 journals. The most studied diseases are stroke (1,304 articles), spinal cord injuries (SCI, 644), Parkinson's disease (PD, 230) and multiple sclerosis (MS, 175). From the classification of the controlled trials on these four diseases, it emerges that a specific treatment has been frequently applied to obtain the same outcome in more than one disease (69 times for a total of 549 articles). The literature shows an increasing trend towards rehabilitation treatments based on motor deficit rather than on etiology. These data may favour a clinical approach based primarily on motor signs not strictly related to pathology, achieving a stronger association between evidence-based medicine (EBM) and evidence-based practice (EBP).

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