Article

OBJECTIVE: To investigate whether allied health therapy provided by caregivers
improves patient outcomes. DATA SOURCES: Electronic databases MEDLINE, CINAHL,
Embase, Allied Health Evidence, and Cochrane Central Register of Controlled
Trials were searched from the earliest available date until July 2011. STUDY SELECTION:
The search strategy included synonyms for allied health disciplines,
caregivers, and randomized controlled trials. Of 1761 potentially relevant
articles evaluated by 2 reviewers independently, 29 trials met inclusion
criteria. DATA EXTRACTION: After data were extracted, 2 reviewers independently
assessed the quality of trials using the Physiotherapy Evidence Database Scale.
The Grading of Recommendations Assessment, Development and Evaluation approach
was used to assess quality of evidence across studies. DATA SYNTHESIS: The 29
trials included 1196 participants and investigated speech and language therapy
(n=19), physical therapy (n=2), social work (n=1), psychology (n=1), and
combinations of 2 or more disciplines (n=6). Meta-analysis provided high-quality
evidence that when compared with no intervention, caregiver-administered speech
and language therapy improved language outcomes in children. Meta-analysis
provided moderate-quality evidence that therapy provided by speech and language
therapists was not superior to caregiver-administered therapy for children with
speech impairments. The smaller number of physical therapy, psychology, and
social work trials could not be combined in meta-analyses but provided examples
of caregiver-administered therapy being more effective than no intervention and
as effective as clinician-administered therapy. CONCLUSIONS: There is
moderate-quality evidence that caregivers can be trained to provide effective
speech and language therapy interventions. This approach needs more evaluation,
but may be applicable in the disciplines of physical therapy, occupational
therapy, social work, psychology, dietetics, and podiatry.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS