Meta-Analysis
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World J Meta-Anal. May 26, 2013; 1(1): 27-46
Published online May 26, 2013. doi: 10.13105/wjma.v1.i1.27
Effectiveness of rehabilitation based on recreational activities: A systematic review
Hiroharu Kamioka, Kiichiro Tsutani, Minoru Yamada, Hyuntae Park, Hiroyasu Okuizumi, Takuya Honda, Shinpei Okada, Sang-Jun Park, Jun Kitayuguchi, Shuichi Handa, Yoshiteru Mutoh
Hiroharu Kamioka, Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo 156-8502, Japan
Kiichiro Tsutani, Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo 113-0033, Japan
Minoru Yamada, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
Hyuntae Park, Department of Functioning Activation, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
Hiroyasu Okuizumi, Shuichi Handa, Mimaki Onsen (Spa) Clinic, Nagano 389-0402, Japan
Takuya Honda, Japan Society for Promotion of Science, Kyoto 619-0288, Japan
Shinpei Okada, Sang-Jun Park, Physical Education and Medicine Research Foundation, Nagano 389-0402, Japan
Jun Kitayuguchi, Physical Education and Medicine Research Center Unnan, Shimane 690-2404, Japan
Yoshiteru Mutoh, Research Institute of Nippon Sport Science University, Tokyo 158-0081, Japan
Author contributions: Kamioka H, Okuizumi H, Okada S, Park SJ, Honda T, Handa S, and Mutoh Y conceived the study and take responsibility for the quality assessment and summary of included studies and data extraction; Tsutani K and Mutoh Y are the guarantors; Kamioka H, Okada S, Okuizumi H and Handa S designed the study; Honda T conducted the statistical analyses; Park SJ, Honda H and Kamioka H assessed the quality of articles; all authors critically revised the manuscript for important intellectual content.
Supported by Grant-in-Aid for Scientific Research (C) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan, No. 23500817
Correspondence to: Hiroharu Kamioka, PhD, Professor, Faculty of Regional Environment Science, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan. h1kamiok@nodai.ac.jp
Telephone: +81-3-54772587 Fax: +81-3-54772587
Received: March 1, 2013
Revised: April 16, 2013
Accepted: May 9, 2013
Published online: May 26, 2013
Abstract

AIM: To summarize the evidence from randomized controlled trials (RCTs) on the rehabilitation effects of recreational activities.

METHODS: Studies were eligible if they were RCTs. Studies included one treatment group in which recreational activity was applied. We searched the following databases from 1990 to May 31, 2012: MEDLINE via PubMed, CINAHL, Web of Science, and Ichushi-Web. We also searched all Cochrane Databases and Campbell Systematic Reviews up to May 31, 2012.

RESULTS: Eleven RCTs were identified, which included many kinds of target diseases and/or symptoms such as stroke, dementia, Parkinson’s disease, acquired brain injury, chronic non-malignant pain, adolescent obesity, high-risk pregnancy, and the frail elderly. Various intervention methods included gaming technology, music, dance, easy rider wheelchair biking, leisure education programs, and leisure tasks. The RCTs conducted have been of relatively low quality. A meta-analysis (pooled sample; n = 44, two RCTs) for balance ability using tests such as “Berg Balance Scale” and “Timed Up and Go Test” based on game intervention revealed no significant difference between interventions and controls. In all other interventions, there were one or more effects on psychological status, balance or motor function, and adherence as primary or secondary outcomes.

CONCLUSION: There is a potential for recreational activities to improve rehabilitation-related outcomes, particularly in psychological status, balance or motor function, and adherence.

Keywords: Recreation activities, Randomized controlled trial, Rehabilitation effect

Core tip: This is the first systematic review of the effectiveness of rehabilitation based on recreational activities. There is a potential for recreational activities to improve rehabilitation-related outcomes, particularly in psychological status (depression, mood, emotion, and power), balance or motor function, and adherence (feasibility and attendance). To most effectively assess the potential benefits of recreational activities for rehabilitation, it will be important for further research to utilize (1) randomized controlled trials methodology (person unit or cluster unit) when appropriate; (2) an intervention dose; (3) a description of adverse effects and withdrawals; and (4) the cost of recreational activities.