Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies.

Saba Anwer,Syed Omer Gilani,Imran Khan Niazi,Javaid Iqbal,Amit N Pujari,Nusratnaaz Shaikh,Asim Waris

doi:10.3390/healthcare10020190

Abstract

Stroke has been one of the leading causes of disability worldwide and is still a social health issue. Keeping in view the importance of physical rehabilitation of stroke patients, an analytical review has been compiled in which different therapies have been reviewed for their effectiveness, such as functional electric stimulation (FES), noninvasive brain stimulation (NIBS) including transcranial direct current stimulation (t-DCS) and transcranial magnetic stimulation (t-MS), invasive epidural cortical stimulation, virtual reality (VR) rehabilitation, task-oriented therapy, robot-assisted training, tele rehabilitation, and cerebral plasticity for the rehabilitation of upper extremity motor impairment. New therapeutic rehabilitation techniques are also being investigated, such as VR. This literature review mainly focuses on the randomized controlled studies, reviews, and statistical meta-analyses associated with motor rehabilitation after stroke. Moreover, with the increasing prevalence rate and the adverse socio-economic consequences of stroke, a statistical analysis covering its economic factors such as treatment, medication and post-stroke care services, and risk factors (modifiable and non-modifiable) have also been discussed. This review suggests that if the prevalence rate of the disease remains persistent, a considerable increase in the stroke population is expected by 2025, causing a substantial economic burden on society, as the survival rate of stroke is high compared to other diseases. Compared to all the other therapies, VR has now emerged as the modern approach towards rehabilitation motor activity of impaired limbs. A range of randomized controlled studies and experimental trials were reviewed to analyse the effectiveness of VR as a rehabilitative treatment with considerable satisfactory results. However, more clinical controlled trials are required to establish a strong evidence base for VR to be widely accepted as a preferred rehabilitation therapy for stroke.

Highlights

Stroke is categorized as one of the most concerning global health issues as it is a serious and common disabling factor worldwide
We have focused on the importance of stroke rehabilitation while explaining the socio-economic burden of this disease and related risk factors narratively
Results indicated that virtual reality (VR) effectively improves UL function and daily life activities when used as a complement to usual care

Summary

Introduction

Stroke is categorized as one of the most concerning global health issues as it is a serious and common disabling factor worldwide. Recent figures suggest that around 650 million people are of 60 years or above age globally, and this number is expected to increase up to 2 billion by 2050 [1]. A recent report by the World Health Organization (WHO) [3] states that stroke is the primary cause of disability and deaths among the senior population after heart disease. Post-stroke care programs impose a substantial economic burden on society. Recent years have seen noticeable improvements in the management of stroke rehabilitation [5]. Modern developments in the medical world are playing a pivotal role in rehabilitating and managing the stroke population and related economic burden [5]. The promise of technological developments has renewed the interest of researchers and clinical experts in rehabilitation interventions for post-stroke treatments

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