Wednesday, 16 May 2018

Evidence for your Practice: Improving Upper Limb Function Poststroke

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Article for review:
Wattchow, K.A., McDopnnell, M.N., & Hillier, S.L. (2018). Rehabilitation interventions for upper limb function in the first four weeks following stroke: A systematic review and meta-analysis of the evidence. Archives of Physical Medicine and Rehabilitation, 99(2), 367-82. doi: 10.1016/j.apmr.2017.06.014

This systematic review investigates the evidence for a range of interventions for upper limb (UL) function in adults within 4 weeks poststroke.  The review included “any physical therapy (PT) or occupational therapy (OT) technique designed to address impairment and/or activity of the affected UL after stroke,” but did not distinguish between interventions in evaluating efficacy for intervention.

Meta-analyses revealed support for modified constraint-induced movement therapy (mCIMT) and task-specific training in improving UL functional outcomes.  The review also suggests biofeedback and electrical stimulation are useful as supplementary therapies to support UL rehabilitation poststroke.  On the other hand, the review discourages using Bobath therapy.  Insufficient evidence was found to either support or refute other OT/PT interventions (air splints, bilateral arm training, circuit class therapy, somatosensory interventions, Kinesio Tape, mechanical arm trainer, medication, mirror box therapy, music therapy passive movement, reflex inhibiting/immobilization, robotics, shoulder strapping/orthosis, static positional strength training, and virtual reality training/video gaming). 

Read the abstract

Post by Alana Marshall, fieldwork student with CAOT-BC


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