Effectiveness of physical therapy for locomotive syndrome: Study protocol for a systematic review and meta-analysis

Locomotive syndrome, characterized by impaired mobility due to musculoskeletal disorders, poses a significant public health challenge, especially in the aging population. Locomotive syndrome limits physical activity, increases fall risk, leads to dependency, and diminishes quality of life. Effective interventions are urgently required. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical therapy in improving the symptoms of locomotive syndrome. A systematic evaluation of its effectiveness compared with other interventions is crucial for informing clinical practice and policy decisions. This systematic review and meta-analysis follows the PRISMA-P guidelines. Studies involving individuals diagnosed with locomotive syndrome, without restrictions on age, sex, or location, were included. The interventions that are reviewed encompass exercise programs, manual therapy, neuromuscular stimulation, and balance training, which are be compared with no intervention or alternative therapies. The primary outcomes include improvements in functional mobility and physical performance, a reduction in symptoms, and the progression of locomotive syndrome. Secondary outcomes include adherence to therapy, safety, quality of life, patient satisfaction, and psychological well-being. Randomized controlled and non-randomized controlled trials published in English were searched from PubMed, CENTRAL, CINAHL, PEDro, Ichushi Web, and the Thai-Journal Citation Index Center. Independent reviewers performed data extraction and assess the risk of bias. A meta-analyses was conducted using RevMan 5.4 software, with subgroup analyses to address heterogeneity. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. This review aims to provide robust evidence on the effectiveness of physical therapy in managing locomotive syndrome and to guide clinical practice and healthcare policy decisions.