Does rehabilitation enhance effects of cell therapy on motor functional recovery after cerebral infarction?

-Understanding the current situation by systematic review-

抄録

【Background/Purpose】

 Cerebral infarction is known as a top cause of indispensable nursing care in Japan because of its severe motor dysfunction, as a common complication. Cell therapy strategy is a noted approach for neural repair, and the rehabilitation is known as a conventional strategy for functional recovery after cerebral injury, however it is unclear whether rehabilitation enhance effects of cell therapy. The aim of this study is to systematically and comprehensively collect papers reporting effects on motor functional recovery under the combined therapy in the brain ischemic animal model, and clarify the current situation.

 

【Methods or Cases】

 The research design was systematic review and was carried out according to the PRISMA statement. The electronic data bases of PubMed, Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials were used, using search expression; stroke or brain ischemia, and stem cell or cell transplantation, and rehabilitation or environment or recovery of function. All papers were published in English by May 2018, and medical diseases and genetic diseases were excluded.

【Results】

 The nine studies referring to the combined therapy were extracted, and most of studies indicate that rehabilitation enhance the effect of cell therapy, however there were no consistent results or unified views.

 

【Discussion/Conclusion】

The combined therapy may enhance these independent effects of each single therapy, but the evidence for the benefits are lacking, and mechanisms are unclear. The number of studies with respect to the combined therapy is few, and their interventions are not sufficiently verified. Further evidences of rehabilitation effects in the cell therapy are expected. We consider that these evidences demonstrated by physiotherapists themselves, who can explain the importance of physical therapy intervention in regenerative medicine even better, is much more potent.

 

【Ethical consideration, Informed consent】

Since this research design was systematic review, description of ethical consideration and informed consent was not required.