A SYSTEMATIC REVIEW OF PHYSIOTHERAPY INTERVENTIONS IN THE MANAGEMENT OF SICKLE CELL DISEASE

ABSTRACT

Background/Aim: Sickle cell disease is a hereditary blood disorder impacting millions of individuals worldwide. While pharmacological treatments are common, non-pharmacological interventions like physiotherapy have not been sufficiently explored and no cumulative evidence exists on effectiveness of physiotherapy interventions in the management of SCD. Thus, this study systematically reviewed the literature on the effectiveness of physiotherapy interventions in SCD management. Methods: Eight electronic databases were systematically searched for studies on the use of physiotherapy interventions in the management of SCD patients. The reference lists of included studies were further searched for eligible studies. Inclusion criteria comprised RCTs, pre-post studies, quasi experimental studies, cluster studies and only articles published in English Language were used. The search was conducted from inception to 31st January, 2024. Quality appraisal was conducted using Physiotherapy Evidence Database (PEDro) for RCTs and the Downs and Black checklist for the assessment of non-RCTs. Narrative synthesis was used to present the findings of the included studies. Results: Out of 154 citations identified from databases, 9 reports were included after screening for title, abstracts and full texts. Of these reports 5 RCTs and 4 non-RCTs were included. Out of the 5 RCTs, 4 were rated good with PEDro scores ranging from 6-8 and one rated fair with a score of 4. The non RCTs had scores ranging from 21-23 on Downs and Black. From the narrative synthesis identified physiotherapy interventions for SCD management included exercise, massage, TENS and incentive spirometry. Exercise had significant effects on pain, cardiorespiratory and functional outcomes. Conclusion: In sum, exercise, massage, transcutaneous electrical nerve stimulation (TENS), and incentive spirometry were the physiotherapy interventions identified in this systematic review. Exercise was the most commonly used intervention in the management of SCD. There is a potential beneficial effect of exercise on pain, cardiorespiratory parameters and functional outcome among patients with SCD. Registration: A review protocol was developed and registered with the PROSPERO database (ID-CRD42024512613) Keywords: Sickle cell disease, SCD, Physiotherapy intervention.