BACKGROUND: Many stroke patients exhibit excessive compensatory trunk movements during reaching. Compensatory movement behaviors may improve upper extremity function in the short-term but be detrimental to long-term recovery. OBJECTIVE: To evaluate the evidence that trunk restraint limits compensatory trunk movement and/or promotes better upper extremity recovery in stroke patients. METHODS: A search was conducted through electronic databases from January 1980 to June 2013. Only randomized controlled trials (RCTs) comparing upper extremity training with and without trunk restraint were selected for review. Three review authors independently assessed the methodological quality and extracted data from the studies. Meta-analysis was conducted when there was sufficient homogenous data. RESULTS: Six RCTs involving 187 chronic stroke patients were identified. Meta-analysis of key outcome measures showed that trunk restraint has a moderate statistically significant effect on improving Fugl-Meyer Upper Extremity (FMA-UE) score, active shoulder flexion, and reduction in trunk displacement during reaching. There was a small, nonsignificant effect of trunk restraint on upper extremity function. CONCLUSION: Trunk restraint has a moderate effect on reduction of upper extremity impairment in chronic stroke patients, in terms of FMA-UE score, increased shoulder flexion, and reduction in excessive trunk movement during reaching. There is insufficient evidence to demonstrate that trunk restraint improves upper extremity function and reaching trajectory smoothness and straightness in chronic stroke patients. Future research on stroke patients at different phases of recovery and with different levels of upper extremity impairment is recommended.
BACKGROUND: Many strokepatients exhibit excessive compensatory trunk movements during reaching. Compensatory movement behaviors may improve upper extremity function in the short-term but be detrimental to long-term recovery. OBJECTIVE: To evaluate the evidence that trunk restraint limits compensatory trunk movement and/or promotes better upper extremity recovery in strokepatients. METHODS: A search was conducted through electronic databases from January 1980 to June 2013. Only randomized controlled trials (RCTs) comparing upper extremity training with and without trunk restraint were selected for review. Three review authors independently assessed the methodological quality and extracted data from the studies. Meta-analysis was conducted when there was sufficient homogenous data. RESULTS: Six RCTs involving 187 chronic strokepatients were identified. Meta-analysis of key outcome measures showed that trunk restraint has a moderate statistically significant effect on improving Fugl-Meyer Upper Extremity (FMA-UE) score, active shoulder flexion, and reduction in trunk displacement during reaching. There was a small, nonsignificant effect of trunk restraint on upper extremity function. CONCLUSION: Trunk restraint has a moderate effect on reduction of upper extremity impairment in chronic strokepatients, in terms of FMA-UE score, increased shoulder flexion, and reduction in excessive trunk movement during reaching. There is insufficient evidence to demonstrate that trunk restraint improves upper extremity function and reaching trajectory smoothness and straightness in chronic strokepatients. Future research on strokepatients at different phases of recovery and with different levels of upper extremity impairment is recommended.
Authors: Asif Hussain; Sivakumar Balasubramanian; Nick Roach; Julius Klein; Nathanael Jarrassé; Michael Mace; Ann David; Sarah Guy; Etienne Burdet Journal: J Rehabil Assist Technol Eng Date: 2017-09-18
Authors: Matthew J Major; Rebecca L Stine; Craig W Heckathorne; Stefania Fatone; Steven A Gard Journal: J Neuroeng Rehabil Date: 2014-09-06 Impact factor: 4.262