The effectiveness of the motor relearning program on upper limb function post-stroke: a systematized review

Abstract

Background Upper limb (UL) impairment-related functional limitation is a frequent post-stroke consequence, potentially negatively impacting health-related quality of life (HRQoL). Significant debate surrounds optimal approach to UL stroke rehabilitation. Task-oriented rehabilitation is recommended to improve UL performance, however despite the motor relearning program (MRP) being a task-oriented approach widely utilized in stroke rehabilitation, there has been insufficient appraisal on its specific effectiveness. This review therefore aimed to review evidence pertaining to the effectiveness of MRP on UL function post-stroke. Objective A systematized review on MRP effectiveness on post-stroke UL function in adults aged 18 years and above, also considering UL impairment and HRQoL. Methods A search of AMED, CINAHL, MEDLINE, CENTRAL and PEDro was conducted, accompanied by examination of individual study citations. Only full text English language randomized controlled trials (RCTs) were included. The methodological quality of each included study was rated using PEDro. Results Of 721 articles identified, 10 met analysis criteria. There was moderate evidence that MRP, as an individual approach, improved UL function post-stroke. Limited evidence was obtained for positive effect of MRP combined with adjunctive therapies on UL function and impairment. Evidence was lacking regarding the relationship of MRP and HRQoL. Conclusion There is inadequate evidence on the supremacy of the MRP in comparison to other interventions in improving UL function post-stroke. The inclusion of the MRP into rehabilitation shows some evidence for UL function and impairment improvements. Methodological flaws have been identified within the RCTs reviewed, warranting further high-quality RCTs.