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||Wattchow, K. A., McDonnell, 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), 367-382.
||Acute care, biofeedback, body movement, devices, electrical stimulation, intervention, limbs, literature reviews, outcomes, physical therapy, therapeutic training
||Study investigated the therapeutic interventions reported in the research literature and determined their effectiveness in improving upper-limb (UL) function in the first 4 weeks after a stroke. Electronic databases and trial registries were searched from inception until June 2016, in addition to searching systematic reviews by hand, to identify relevant randomized controlled trials (RCTs), controlled trials, and interventional studies with a pre/posttest design. A total of 104 trials (83 RCTs and 21 nonrandomized studies) involving 5,225 participants were included. Two reviewers independently assessed eligibility of full texts, and methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool. Meta-analyses of RCTs only (20 comparisons) and narrative syntheses were completed. Participants all received an intervention of any physiotherapeutic or occupational therapeutic technique designed to address impairment or activity of the affected UL, which could be compared with usual care, sham, or another technique. Key findings included significant positive effects for modified constraint-induced movement therapy and task-specific training. Evidence was also found to support supplementary use of biofeedback and electrical stimulation. Use of Bobath therapy was not supported. Further high-quality studies are needed to determine therapies for targeted functional UL outcomes within the acute phase following a stroke.
|Full-Text Availability Options:||https://www.ncbi.nlm.nih.gov/pubmed/28734936|