{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T22:15:07Z","timestamp":1764713707643,"version":"3.40.5"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This review sought to address an evidence gap and lay a foundation for future Chronic Traumatic Encephalopathy (CTE) management studies by evaluating and appraising the literature which reports the effect that active rehabilitation has on other tauopathies, a group of conditions with hyperphosphorylation and aggregation of tau protein that can lead to neurodegeneration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>Umbrella review.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Data source<\/jats:title>\n<jats:p>Meta-analyses and systematic reviews were identified using CINAHL, Medline, Cochrane, Web of Science, PubMed, and SPORTDiscus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Eligibility<\/jats:title>\n<jats:p>Systematic review or meta-analyses that examine the effect active rehabilitation has on outcome measures of symptoms associated with CTE. Studies with men and women diagnosed with Alzheimer\u2019s disease, Parkinson\u2019s disease, Lewy Body dementia, Frontotemporal degeneration\/dementia or Corticobasal degeneration. All types of active rehabilitation were included. Control group was usual care, no intervention, or light-intensity physical activity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Results<\/jats:title>\n<jats:p>Twelve reviews were included. A large pooled standardized mean difference (SMD) was observed for balance (SMD = 0.88, P&lt;0.001) and motor function (SMD = 0.83, <jats:italic>P<\/jats:italic>&lt;0.001). A moderate pooled SMD was observed for cognitive function (SMD = 0.66, <jats:italic>P&lt;<\/jats:italic>0.116). A small pooled SMD was observed for mobility (SMD = 0.45, <jats:italic>P<\/jats:italic> = 0.002). A trivial pooled SMD was observed for gait speed\/velocity (SMD = 0.11, <jats:italic>P<\/jats:italic> = 0.372). No findings for mood\/behavioral symptoms. All pooled effects demonstrated substantial to considerable heterogeneity (74.3% to 91.9%, P&lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>A positive effect of active rehabilitation was observed in patients with tau pathologies suffering from motor, vestibular and cognitive impairments supporting the use of active rehabilitation for CTE management; however, the findings need to be considered with caution given the limited research in some of the tau pathologies, large between-study heterogeneity and wide 95% prediction intervals.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0271213","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T17:47:38Z","timestamp":1658425658000},"page":"e0271213","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. Implications for chronic traumatic encephalopathy symptom management"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2417-6938","authenticated-orcid":true,"given":"Rachael","family":"Hearn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Selfe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0692-8064","authenticated-orcid":true,"given":"Maria I.","family":"Cordero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-1683","authenticated-orcid":true,"given":"Nick","family":"Dobbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"issue":"7","key":"pone.0271213.ref001","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.tips.2017.03.011","article-title":"A Brief Overview of Tauopathy: Causes, Consequences, and Therapeutic Strategies","volume":"38","author":"ME Orr","year":"2017","journal-title":"Trends Pharmacol Sci"},{"key":"pone.0271213.ref002","article-title":"Tau interactome maps synaptic and mitochondrial processes associated with neurodegeneration","author":"TE Tracy","year":"2022","journal-title":"Cell"},{"key":"pone.0271213.ref003","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3389\/fnins.2017.00572","article-title":"Axonal Degeneration in Tauopathies: Disease Relevance and Underlying Mechanisms","volume":"11","author":"A Kneynsberg","year":"2017","journal-title":"Front Neurosci"},{"key":"pone.0271213.ref004","article-title":"A critical appraisal of tau-targeting therapies for primary and secondary tauopathies [published online ahead of print, 2021 Sep 17","author":"BP Imbimbo","year":"2021","journal-title":"Alzheimers Dement"},{"issue":"10","key":"pone.0271213.ref005","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1080\/14737175.2019.1633916","article-title":"Management of chronic traumatic encephalopathy","volume":"19","author":"R Cantu","year":"2019","journal-title":"Expert Rev Neurother"},{"key":"pone.0271213.ref006","doi-asserted-by":"crossref","first-page":"n168","DOI":"10.1136\/bmj.n168","article-title":"Sport associated dementia","volume":"372","author":"W. Stewart","year":"2021","journal-title":"BMJ"},{"issue":"1","key":"pone.0271213.ref007","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s00401-015-1515-z","article-title":"The first NINDS\/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy","volume":"131","author":"AC McKee","year":"2016","journal-title":"Acta Neuropathol"},{"issue":"3","key":"pone.0271213.ref008","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/bpa.12248","article-title":"The neuropathology of chronic traumatic encephalopathy","volume":"25","author":"AC McKee","year":"2015","journal-title":"Brain Pathol"},{"issue":"2","key":"pone.0271213.ref009","doi-asserted-by":"crossref","first-page":"a024059","DOI":"10.1101\/cshperspect.a024059","article-title":"Chronic traumatic encephalopathy: is latency in symptom onset explained by tau propagation?","volume":"8","author":"J Kriegel","year":"2018","journal-title":"Cold Spring Harbor perspectives in medicine"},{"issue":"11","key":"pone.0271213.ref010","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1136\/jnnp-2017-317557","article-title":"Understanding neurodegeneration after traumatic brain injury: from mechanisms to clinical trials in dementia","volume":"90","author":"NS Graham","year":"2019","journal-title":"Journal of Neurology, Neurosurgery & Psychiatry"},{"issue":"3","key":"pone.0271213.ref011","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1038\/s41582-018-0114-8","article-title":"Chronic traumatic encephalopathy\u2014confusion and controversies","volume":"15","author":"DH Smith","year":"2019","journal-title":"Nat Rev Neurol"},{"key":"pone.0271213.ref012","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/s41582-020-0382-y","article-title":"\u2018Concussion\u2019 is not a true diagnosis","volume":"16","author":"D.H. Smith","year":"2020","journal-title":"Nat Rev Neurol"},{"issue":"2","key":"pone.0271213.ref013","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/YCO.0000000000000580","article-title":"Chronic traumatic encephalopathy: understanding the facts and debate","volume":"33","author":"C LoBue","year":"2020","journal-title":"Current opinion in psychiatry"},{"issue":"2","key":"pone.0271213.ref014","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/arclin\/acz074","article-title":"Point\/Counter-Point\u2014Beyond the headlines: the actual evidence that traumatic brain injury is a risk factor for later-in-life dementia","volume":"35","author":"C LoBue","year":"2020","journal-title":"Archives of clinical neuropsychology"},{"key":"pone.0271213.ref015","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1056\/NEJMoa1908483","article-title":"Neurodegenerative disease mortality among former professional soccer players","volume":"381","author":"DF Mackay","year":"2019","journal-title":"N Engl J Med"},{"issue":"19","key":"pone.0271213.ref016","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1212\/WNL.0b013e31826daf50","article-title":"Neurodegenerative causes of death among retired National Football League players","volume":"79","author":"EJ Lehman","year":"2012","journal-title":"Neurology"},{"issue":"4","key":"pone.0271213.ref017","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3390\/jfmk5040094","article-title":"Beneficial Effects of Physical Activity on Subjects with Neurodegenerative Disease","volume":"5","author":"L Vizzi","year":"2020","journal-title":"J Funct Morphol Kinesiol"},{"issue":"13","key":"pone.0271213.ref018","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1113\/JP275021","article-title":"HIITing the brain with exercise: mechanisms, consequences and practical recommendations","volume":"598","author":"TA Calverley","year":"2020","journal-title":"The Journal of Physiology"},{"issue":"4","key":"pone.0271213.ref019","doi-asserted-by":"crossref","first-page":"914","DOI":"10.3390\/jcm9040914","article-title":"The effect of exercise training on brain structure and function in older adults: a systematic review based on evidence from randomized control trials","volume":"9","author":"FT Chen","year":"2020","journal-title":"Journal of clinical medicine"},{"journal-title":"Neural Plast","article-title":"Effects of Physical Exercise on Neuroplasticity and Brain Function: A Systematic Review in Human and Animal Studies","author":"MS de Sousa Fernandes","key":"pone.0271213.ref020"},{"key":"pone.0271213.ref021","first-page":"536","article-title":"Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials","volume":"79","author":"C Vorkapic","year":"2021","journal-title":"Arquivos de Neuro-Psiquiatria"},{"issue":"3","key":"pone.0271213.ref022","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/XEB.0000000000000055","article-title":"Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach","volume":"13","author":"E Aromataris","year":"2015","journal-title":"Int J Evid Based Health"},{"key":"pone.0271213.ref023","doi-asserted-by":"crossref","DOI":"10.46658\/JBIMES-20-01","volume-title":"JBI Manual for Evidence Synthesis","author":"E Aromataris","year":"2020"},{"issue":"3","key":"pone.0271213.ref024","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1136\/ebmental-2018-300014","article-title":"Ten simple rules for conducting umbrella reviews","volume":"21","author":"P Fusar-Poli","year":"2018","journal-title":"Evid Based Ment Health"},{"issue":"24","key":"pone.0271213.ref025","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"FC Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"pone.0271213.ref026","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s13195-014-0068-z","article-title":"Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome","volume":"6","author":"P.H. Montenigro","year":"2014","journal-title":"Alz Res Therapy"},{"key":"pone.0271213.ref027","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"J. Cohen","year":"1988","edition":"2"},{"key":"pone.0271213.ref028","article-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021)","author":"JJ Deeks","year":"2021","journal-title":"Cochrane"},{"issue":"6","key":"pone.0271213.ref029","first-page":"693","article-title":"Complementary physical therapies for movement disorders in Parkinson\u2019s disease: a systematic review","volume":"51","author":"P Alves Da Rocha","year":"2015","journal-title":"Eur J Phys Rehabil Med"},{"key":"pone.0271213.ref030","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2147\/CIA.S135700","article-title":"Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials","volume":"12","author":"H Cai","year":"2017","journal-title":"Clin Interv Aging"},{"issue":"4","key":"pone.0271213.ref031","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jphys.2019.08.003","article-title":"Home-based prescribed exercise improves balance-related activities in people with Parkinson\u2019s disease and has benefits similar to centre-based exercise: a systematic review","volume":"65","author":"A Flynn","year":"2019","journal-title":"J Physiother"},{"key":"pone.0271213.ref032","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ctim.2016.09.016","article-title":"Effects of mind-body exercises on the physiological and psychosocial well-being of individuals with Parkinson\u2019s disease: A systematic review and meta-analysis","volume":"29","author":"JY Kwok","year":"2016","journal-title":"Complement Ther Med"},{"issue":"7","key":"pone.0271213.ref033","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s40520-017-0836-2","article-title":"Effects of dance practice on functional mobility, motor symptoms and quality of life in people with Parkinson\u2019s disease: a systematic review with meta-analysis","volume":"30","author":"M Dos Santos Delabary","year":"2018","journal-title":"Aging Clin Exp Res"},{"key":"pone.0271213.ref034","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.neubiorev.2014.09.009","article-title":"Dance as an intervention for people with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"47","author":"K Sharp","year":"2014","journal-title":"Neurosci Biobehav Rev"},{"issue":"12","key":"pone.0271213.ref035","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.jagp.2015.07.007","article-title":"Drug and Exercise Treatment of Alzheimer Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Effects on Cognition in Randomized Controlled Trials","volume":"23","author":"A Str\u00f6hle","year":"2015","journal-title":"Am J Geriatr Psychiatry"},{"key":"pone.0271213.ref036","doi-asserted-by":"crossref","first-page":"e5004","DOI":"10.1136\/bmj.e5004","article-title":"Physiotherapy intervention in Parkinson\u2019s disease: systematic review and meta-analysis","volume":"345","author":"C L Tomlinson","year":"2012","journal-title":"BMJ"},{"issue":"9","key":"pone.0271213.ref037","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1177\/0269215518773442","article-title":"Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis","volume":"32","author":"SJ Winser","year":"2018","journal-title":"Clin Rehabil"},{"issue":"7","key":"pone.0271213.ref038","doi-asserted-by":"crossref","first-page":"e102942","DOI":"10.1371\/journal.pone.0102942","article-title":"Tai Chi for improvement of motor function, balance and gait in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"9","author":"Y Yang","year":"2014","journal-title":"PLoS One"},{"issue":"9","key":"pone.0271213.ref039","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/mds.23790","article-title":"Balance and falls in Parkinson\u2019s disease: a meta-analysis of the effect of exercise and motor training","volume":"26","author":"NE Allen","year":"2011","journal-title":"Mov Disord"},{"issue":"1","key":"pone.0271213.ref040","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1017\/S1041610213001385","article-title":"The effect of exercise interventions on cognitive outcome in Alzheimer\u2019s disease: a systematic review","volume":"26","author":"N Farina","year":"2014","journal-title":"Int Psychogeriatr"},{"issue":"8","key":"pone.0271213.ref041","first-page":"1","article-title":"New NINDS Consensus Criteria for Traumatic Encephalopathy Syndrome: Not Yet Ready for the Clinic Just Yet, but Useful for Research","volume":"21","author":"D. Hurley","year":"2021","journal-title":"NeuroToday"},{"issue":"14","key":"pone.0271213.ref042","doi-asserted-by":"crossref","first-page":"4977","DOI":"10.3390\/ijms21144977","article-title":"Modulation of MicroRNAs as a Potential Molecular Mechanism Involved in the Beneficial Actions of Physical Exercise in Alzheimer Disease","volume":"21","author":"AC Improta-Caria","year":"2020","journal-title":"Int J Mol Sci"},{"issue":"3","key":"pone.0271213.ref043","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3934\/Neuroscience.2021020","article-title":"Molecular mechanisms in Alzheimer\u2019s disease and the impact of physical exercise with advancements in therapeutic approaches","volume":"8","author":"KK Siddappaji","year":"2021","journal-title":"AIMS Neurosci"},{"key":"pone.0271213.ref044","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.4100\/jhse.2012.8.Proc2.06","article-title":"Resistance training program on functional independence of a elderly man with frontotemporal dementia: A case report","volume":"8","author":"C Borba-Pinheiro","year":"2013","journal-title":"Journal of Human Sport and Exercise"},{"issue":"8","key":"pone.0271213.ref045","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.2522\/ptj.20060166","article-title":"Long-term locomotor training for gait and balance in a patient with mixed progressive supranuclear palsy and corticobasal degeneration","volume":"87","author":"TM Steffen","year":"2007","journal-title":"Phys Ther"},{"issue":"2","key":"pone.0271213.ref046","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2522\/ptj.20130052","article-title":"Long-term exercise training for an individual with mixed corticobasal degeneration and progressive supranuclear palsy features: 10-year case report follow-up","volume":"94","author":"TM Steffen","year":"2014","journal-title":"Phys Ther"},{"key":"pone.0271213.ref047","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.prdoa.2019.08.005","article-title":"Corticobasal degeneration and corticobasal syndrome: a review","volume":"1","author":"VC Constantinides","year":"2019","journal-title":"Parkinsonism Relat Disord"},{"issue":"Pt 9","key":"pone.0271213.ref048","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1093\/brain\/awr179","article-title":"Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia","volume":"134","author":"K Rascovsky","year":"2011","journal-title":"Brain"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271213","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T17:48:36Z","timestamp":1658425716000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271213"}},"subtitle":[],"editor":[{"given":"Firas H","family":"Kobeissy","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,7,21]]},"references-count":48,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0271213","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,7,21]]}}}