Effectiveness of external cues to facilitate task performance in people with neurological disorders: a systematic review and meta-analysis
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Purpose: To examine in people with neurological disorders, which method/s of providing external cues to improve task performance are most effective. Methods: Medline, EMBASE and PsycINFO were systematically searched. Two reviewers independently screened, extracted data and assessed the quality of the evidence using GRADE. Results: 26 studies were included. Studies examined a wide-range of cues including visual, tactile, auditory, verbal and multi-component cues. Cueing (any type) improved walking speed when comparing cues to no cues (Mean difference (95% Confidence Interval): 0.08m/s (0.06 to 0.10), I²=68%, low quality of evidence). Remaining evidence was analysed narratively; evidence that cueing improves activity-related outcomes was inconsistent and rated as very low quality. It was not possible to determine which form of cueing may be more effective than others. Conclusions: Providing cues to encourage successful task performance is a core component of rehabilitation, however there is limited evidence on the type of cueing or which tasks benefit most from external cueing. Low-quality evidence suggests there may be a beneficial effect of cueing (any type) on walking speed. Sufficiently powered randomised controlled trials are needed to inform therapists of the most effective cueing strategies to improve activity performance in populations with a neurological disorder.
“This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 9 March 2018, available online: http://www.tandfonline.com/10.1080/09638288.2018.1448465” © 2018 Informa UK Limited, trading as Taylor & Francis Group This author accepted manuscript is made available following 12 month embargo from date of publication (March 2018) in accordance with the publisher’s archiving policy