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Outcomes of Physical Therapy, Speech Pathology, and Occupational Therapy for People with Motor Neuron Disease: A Systematic Review

the School of Physiotherapy, The University of Melbourne, Victoria, Australia, Centre for Clinical Research Excellence in Clinical Gait Analysis and Gait Rehabilitation, School of Physiotherapy, The University of Melbourne, Victoria, Australia, Rehabilitation and Aged Care Program, Southernhealth, Victoria, Australia, m.morris{at}unimelb.edu.au

Alison Perry, PhD

School Human Communication Sciences, Faculty of Health Sciences, La Trobe University, Victoria, Australia

Belinda Bilney, PhD

Centre for Clinical Research Excellence in Clinical Gait Analysis and Gait Rehabilitation, School of Physiotherapy, The University of Melbourne, Victoria, Australia, Ballarat Health Care Services, Ballarat, Victoria, Australia

Andrea Curran

Centre for Clinical Research Excellence in Clinical Gait Analysis and Gait Rehabilitation, School of Physiotherapy, The University of Melbourne, Victoria, Australia, Yooralla, Victoria, Australia

Karen Dodd, PhD

School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, Australia

Joanne E. Wittwer

School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, Australia

Gregory W. Dalton

Centre for Clinical Research Excellence in Clinical Gait Analysis and Gait Rehabilitation, School of Physiotherapy, The University of Melbourne, Victoria, Australia, Department of Human Services, Victoria, Australia (GWD).

This article describes a systematic review and critical evaluation of the international literature on the effects of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease (PwMND). The results were interpreted using the framework of the International Classification of Functioning, Disability and Health. This enabled us to summarize therapy outcomes at the level of body structure and function, activity limitations, participation restrictions, and quality of life. Databases searched included MEDLINE, PUBMED, CINAHL, PSYCInfo, Data base of Abstracts of Reviews of Effectiveness (DARE), The Physiotherapy Evidence data base (PEDro), Evidence Based Medicine Reviews (EMBASE), the Cochrane database of systematic reviews, and the Cochrane Controlled Trials Register. Evidence was graded according to the Harbour and Miller classification. Most of the evidence was found to be at the level of "clinical opinion" rather than of controlled clinical trials. Several nonrandomized small group and "observational studies" provided low-level evidence to support physical therapy for improving muscle strength and pulmonary function. There was also some evidence to support the effectiveness of speech pathology interventions for dysarthria. The search identified a small number of studies on occupational therapy for PwMND, which were small, noncontrolled pre-post-designs or clinical reports.

Key Words: Motor neuron disease • Amyotrophic lateral sclerosis • Physical therapy • Speech pathology • Occupational therapy • Rehabilitation • Systematic review.

Neurorehabilitation and Neural Repair, Vol. 20, No. 3, 424-434 (2006)
DOI: 10.1177/1545968305285092


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