Research Reports - Play-based interventions improve physical function for people with adult-acquired brain injury

Clin Rehabil. 2017 Feb;31(2):145-157. doi: 10.1177/0269215516631384. Epub 2016
Jul 10.

Saywell N(1), Taylor N(2), Rodgers E(3), Skinner L(4), Boocock M(1).

OBJECTIVE: To undertake a systematic review and meta-analysis of the
effectiveness of play-based interventions compared to traditional therapy in
rehabilitation of adults with adult-acquired brain injury.
DATA SOURCES: The search was performed using Medline; Cinahl Plus; Health Source
(Nursing/Academic Edition); Psychology and behavioural sciences collection;
Biomedical reference collection (basic).
REVIEW METHODS: Studies included were randomised controlled trials that
investigated the effect of play-based interventions on physical function of
adults with adult acquired brain injury. Two independent reviewers identified
eligible studies and assessed methodological quality using a modified Downs and
Black. Meta-analysis compared standardised differences in means, to determine
effect sizes for grouped functional outcome measures. The GRADE scoring system
was used to determine the level of clinical evidence.
RESULTS: Thirty studies met the inclusion criteria, 13 were considered high
quality and 17 moderate quality. Studies predominantly involved post-stroke
participants, with only three studies including participants with traumatic brain
injury. When compared to traditional therapy, dose-matched studies of play-based
interventions showed a significant effect on independence (Effect size (ES) =
0.6) and physical performance (ES = 0.43), as measured using the Fugl -Meyer. For
non-dose matched studies, play-based interventions showed a significant
improvement for balance (ES = 0.76) compared with traditional therapy. In all
studies that measured participant enjoyment, play-based therapy was rated as more
enjoyable than traditional therapy.
CONCLUSION: Play-based interventions for people with adult acquired brain injury
are more effective in improving balance and independence, which may be due to
them being more enjoyable than traditional therapy. 

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