Affichage des articles dont le libellé est revue systématique. Afficher tous les articles
Affichage des articles dont le libellé est revue systématique. Afficher tous les articles

11 juillet 2024

L'effet de la thérapie par l'exercice physique sur les troubles du spectre de l'autisme: une revue systématique et une méta-analyse

 Aperçu: G.M.

Résumé 

Contexte :
La thérapie par l'exercice physique (TEP) est de plus en plus utilisée dans le traitement des troubles du spectre de l'autisme (TSA), mais les preuves empiriques de son efficacité restent ambiguës. Cette étude systématique et cette méta-analyse ont pour but d'étudier l'efficacité de la thérapie par l'exercice physique pour les personnes avec un diagnosti de TSA, afin de fournir un soutien factuel à la recherche clinique et scientifique.

Méthodes :
Nous avons effectué des recherches systématiques dans quatre bases de données internationales (Medline via PubMed, Embase, Cochrane Libraries et Web of Science) et trois bases de données chinoises (CNKI, Wanfang et VIP Libraries) jusqu'au 31 juillet 2023. La recherche a été effectuée en anglais et en chinois pour trouver des articles de recherche originaux utilisant des essais contrôlés randomisés (ECR) pour étudier les effets de la TEP sur les personnes ayant reçu un diagnostic de TSA selon les critères du DSM ou d'autres critères établis. Les résultats coprimaires étaient axés sur la gravité globale de l'autisme, tandis que les résultats secondaires comprenaient des mesures des comportements stéréotypés, des déficits sociaux, des aptitudes sociales et des fonctions exécutives. Les données des études incluses ont été synthétisées et analysées à l'aide de RevMan 5.4. Cette revue systématique est enregistrée auprès de PROSPERO (CRD42023443951).

Résultats :
Au total, 28 ECR comprenant 1 081 participants ont été analysés. Seules trois de ces études répondaient à des normes de haute qualité.
Comparativement aux groupes témoins, le TEP a montré une amélioration d'au moins un symptôme central de l'autisme, y compris la performance motrice (SMD=1,72, 95%CI[1,01, 2,44], I2=90%), les comportements répétitifs restreints (SMD=-0,81, 95%CI[-1,00, -0,62], I2=0%), le dysfonctionnement social (SMD=-0,76, 95%CI[-1,06, -0,46], I2=47%).

Conclusions :
La TEP peut permettre de réduire la gravité globale et les symptômes associés chez les personnes avec un diagnostic de TSA. Toutefois, compte tenu du risque global élevé de biais dans les études incluses, ces résultats doivent être interprétés avec prudence.

 

. 2024 Jul 6:339:116074.
doi: 10.1016/j.psychres.2024.116074. Online ahead of print.

The effect of physical exercise therapy on autism spectrum disorder:a systematic review and meta-analysis

Yifan Wu  1 , Lu Ding  2 , Qiao Zhang  2 , Yu Dong  2 , Chenyang Tao  2 , Zhenyuan Li  3 , Zhaowei Li  1 , Liming Lu  4
Affiliations

Abstract

Background: Physical Exercise Therapy (PET) is increasingly applied in the treatment of Autism Spectrum Disorders (ASD), yet the empirical evidence supporting its efficacy remains ambiguous. This systematic review and meta-analysis aimed to investigate the effectiveness of PET for individuals with ASD, providing evidence-based support for clinical and scientific research.

Methods: We systematically searched four international databases (Medline via PubMed, Embase, Cochrane Libraries, and Web of Science) and three Chinese databases (CNKI, Wanfang, and VIP Libraries) up to July 31, 2023. The search was conducted in both English and Chinese for original research articles employing randomized-controlled-trial (RCT) designs to study PET's effects on individuals diagnosed with ASD according to DSM or other established criteria. Co-primary outcomes focused on the overall severity of autism, while secondary outcomes included measures of stereotyped behaviors, social deficits, social skills, and executive functioning. Data from the included studies were synthesized and analyzed using RevMan 5.4. This systematic review is registered with PROSPERO (CRD42023443951).

Results: A total of 28 RCTs comprising 1081 participants were analyzed. Of these, only three studies met high-quality standards. Compared to control groups, PET showed improvement in at least one core symptom of autism, including Motor Performance (SMD=1.72, 95%CI[1.01, 2.44], I2=90%), Restricted Repetitive Behaviors (SMD=-0.81, 95%CI[-1.00, -0.62], I2=0%), Social Dysfunction (SMD=-0.76, 95%CI[-1.06, -0.46], I2=47%).

Conclusions: PET may offer benefits in reducing the overall severity and associated symptoms in individuals with ASD. However, given the high overall risk of bias in the included studies, these findings should be interpreted with caution.

Keywords: Autism spectrum disorder; Meta-analysis; Physical exercise therapy; Systematic review.


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25 juillet 2023

Interventions pour la santé mentale des jeunes enfants : une revue de revues

 Aperçu: G.M.

. 2023 Jul 24.  doi: 10.1007/s10567-023-00443-6. 

Interventions for Young Children's Mental Health: A Review of Reviews

Jennifer L Hudson  1 , Savannah Minihan  2 , Wenting Chen  2 , Talia Carl  2   3 , Michele Fu  2 , Lucy Tully  3 , Maria Kangas  4 , Linda Rosewell  4 , Emma A McDermott  2 , Yiwen Wang  5 , Thomas Stubbs  5 , Alexandra Martiniuk  5
Affiliations

Résumé

Afin de déterminer l'efficacité des programmes d'intervention pour les jeunes enfants (4-9 ans) ayant des besoins émergents en matière de santé mentale, nous avons effectué une revue des revues méta-analytiques et systématiques de la littérature sur les interventions.
Sur les 41 061 résumés identifiés et les 15 076 sélectionnés, 152 articles de synthèse répondaient aux critères d'inclusion. Nous avons examiné les interventions dans plusieurs disciplines ciblant : 

  1. les problèmes généraux de santé mentale ; 
  2. les symptômes d'intériorisatio;
  3. les symptômes d'extériorisation ; 
  4. l'anxiété ; 
  5. la dépression ; 
  6. les traumatismes ; 
  7. les symptômes du trouble déficitaire de l'attention/hyperactivité ; et 
  8. les problèmes de santé mentale associés au trouble du spectre de l'autisme. 

Des preuves substantielles ont été trouvées pour l'efficacité des interventions comportementales et cognitivo-comportementales pour les problèmes généraux de santé mentale, les symptômes d'extériorisation (en général, ainsi que le TDAH, la conduite et d'autres symptômes comportementaux) et les symptômes d'intériorisation (en général, ainsi que l'anxiété) chez les enfants âgés de 4 à 9 ans. 

Des données émergentes ont été identifiées pour les interventions ciblant les symptômes de traumatisme, les symptômes de dépression et les symptômes sociaux, émotionnels et comportementaux des troubles du spectre de l'autisme chez les enfants âgés de 4 à 9 ans. 

À l'heure actuelle, il n'existe que peu de preuves émergentes concernant les interventions non comportementales ou non cognitives pour les programmes ciblant les enfants âgés de 4 à 9 ans et dont l'objectif est d'offrir un programme fondé sur des preuves pour améliorer le fonctionnement social, émotionnel et/ou comportemental de l'enfant. 

Compte tenu de l'augmentation récente des besoins en matière de santé mentale chez les enfants, les interventions ciblées basées sur la thérapie comportementale et/ou cognitive devraient être largement accessibles aux enfants (et à leurs familles) qui présentent des symptômes élevés.

Abstract

To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.

Keywords: Behavioral problems; Childhood; Emotional problems; Intervention; Mental health; Social problems.

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