Abstract
Background. Stroke commonly affects upper extremity motor abilities, yet there has been very limited success in developing effective rehabilitation interventions to remediate motor impairments, particularly for the upper extremity. Objective. To determine if task-oriented practice administered soon after stroke is more effective than usual care in improving poststroke upper extremity motor recovery and to explore the optimal amount of practice. Methods. A systematic review of the literature was performed from 1950 to November 2012, to identify randomized controlled trials of task-oriented practice compared to usual care, or to different amounts of task-oriented practice to improve motor impairment and activity. Studies were excluded if specific types of interventions were used as comparators or if they were of poor methodological quality. Results. Six studies met the review criteria. Three of the six studies demonstrated a statistically significant effect of task-oriented practice. Study results could not be pooled because of a lack of homogeneity in populations and intervention. Conclusions. The results demonstrate that an increase in the amount of task-oriented practice after stroke may result in less upper extremity impairment; further research on both effect and required dosage is needed as results are inconsistent.
Highlights
Stroke is the fifth leading cause of disability internationally [1] and it is likely that this is an underestimate of the absolute level of functioning that is lost, especially in lowincome countries [2]
Motor impairments are a principal target of rehabilitation interventions, and many novel therapeutic approaches for motor recovery have emerged in recent decades [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18]
Research has focused on lower limb motor impairment more than upper limb partly because lower limb interventions are more described, outcomes are more quantified, and mobility is considered a key functional consideration after stroke
Summary
Stroke is the fifth leading cause of disability internationally [1] and it is likely that this is an underestimate of the absolute level of functioning that is lost, especially in lowincome countries [2]. Research has focused on lower limb motor impairment more than upper limb partly because lower limb interventions are more described, outcomes are more quantified, and mobility is considered a key functional consideration after stroke. Among those who have had a stroke, upper limb recovery is considered important because it is integral to independence in many activities of daily living [19]. The results demonstrate that an increase in the amount of task-oriented practice after stroke may result in less upper extremity impairment; further research on both effect and required dosage is needed as results are inconsistent
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