Eficacia de la fisioterapia neurológica en la rehabilitación de pacientes con ictus isquémico: revisión sistemática ampliada

• Autores: Ignacio Conde Arias, Patricia Costa Rodriguez, Ana María Lascorz Goicoechea, Andrea Fumanal Escartín, Teresa Sierra Pascual, Raquel Magaz Montaner
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 6, Nº. 9, 2025
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    Objetivo: Evaluar la eficacia de la fisioterapia neurológica en la rehabilitación de pacientes con ictus isquémico, analizando su impacto sobre la recuperación motora, la funcionalidad, la independencia en las actividades de la vida diaria y la calidad de vida.

    Metodología: Se realizó una revisión sistemática ampliada en PubMed, Scopus, Cochrane Library y PEDro hasta junio de 2025. Se incluyeron ensayos clínicos aleatorizados y estudios controlados que comparaban intervenciones fisioterapéuticas (método Bobath⁸, constraint-induced movement therapy [CIMT], ejercicios orientados a tareas, terapia robótica y fisioterapia convencional) con cuidados habituales o intervenciones educativas. Las variables principales fueron la función motora (Escala Fugl-Meyer, Motricity Index), la independencia funcional (Barthel Index, Functional Independence Measure), la marcha (10MWT, 6MWT, TUG) y la calidad de vida (SF-36, EQ-5D).

    Resultados: Se analizaron 42 estudios con 5.800 pacientes. La fisioterapia neurológica mostró mejoras significativas en recuperación motora (↑15 puntos en Fugl-Meyer), marcha (↑65 m en 6MWT), independencia funcional (↑20 puntos Barthel) y calidad de vida (mejoras en SF-36). La CIMT y el entrenamiento orientado a tareas resultaron especialmente efectivos en la recuperación de extremidad superior, mientras que la robótica potenció la rehabilitación de la marcha en fases subagudas.

    Conclusiones: La fisioterapia neurológica es una intervención esencial y eficaz en la rehabilitación post-ictus, con beneficios clínicamente relevantes en la recuperación funcional y la calidad de vida.

  • English

    Objective: To evaluate the effectiveness of neurological physiotherapy in the rehabilitation of ischemic stroke patients, analyzing its impact on motor recovery, functionality, independence in daily living activities, and quality of life.

    Methods: An extended systematic review was conducted in PubMed, Scopus, Cochrane Library and PEDro until June 2025. Randomized controlled trials and controlled studies comparing physiotherapy interventions (Bobath⁸ concept, constraint-induced movement therapy [CIMT], task-oriented training, robotic therapy, and conventional physiotherapy) with usual care or educational interventions were included. Outcomes were motor function (Fugl-Meyer, Motricity Index), functional independence (Barthel Index, FIM), gait (10MWT, 6MWT, TUG), and quality of life (SF-36, EQ-5D).

    Results: Forty-two studies with 5,800 patients were analyzed. Neurological physiotherapy showed significant improvements in motor recovery (+15 Fugl-Meyer points), gait (+65 m 6MWT), functional independence (+20 Barthel points) and quality of life (improvements in SF-36). CIMT and task-oriented training were particularly effective in upper limb recovery, while robotics enhanced gait rehabilitation in subacute phases.

    Conclusions: Neurological physiotherapy is an essential and effective intervention in post-stroke rehabilitation, with clinically relevant benefits in functional recovery and quality of life.

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