The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. Implications for chronic traumatic encephalopathy symptom management.

Abstract

ObjectiveThis review sought to address an evidence gap and lay a foundation for future Chronic Traumatic Encephalopathy (CTE) management studies by evaluating and appraising the literature which reports the effect that active rehabilitation has on other tauopathies, a group of conditions with hyperphosphorylation and aggregation of tau protein that can lead to neurodegeneration.DesignUmbrella review.Data sourceMeta-analyses and systematic reviews were identified using CINAHL, Medline, Cochrane, Web of Science, PubMed, and SPORTDiscus.EligibilitySystematic review or meta-analyses that examine the effect active rehabilitation has on outcome measures of symptoms associated with CTE. Studies with men and women diagnosed with Alzheimer's disease, Parkinson's disease, Lewy Body dementia, Frontotemporal degeneration/dementia or Corticobasal degeneration. All types of active rehabilitation were included. Control group was usual care, no intervention, or light-intensity physical activity.ResultsTwelve reviews were included. A large pooled standardized mean difference (SMD) was observed for balance (SMD = 0.88, PConclusionsA positive effect of active rehabilitation was observed in patients with tau pathologies suffering from motor, vestibular and cognitive impairments supporting the use of active rehabilitation for CTE management; however, the findings need to be considered with caution given the limited research in some of the tau pathologies, large between-study heterogeneity and wide 95% prediction intervals.