Davide G de Sousa1, Lisa A Harvey2, Simone Dorsch3, Joanne V Glinsky2. 1. Graythwaite Rehabilitation Centre, Ryde Hospital; John Walsh Centre for Rehabilitation Research, Kolling Institute; Sydney Medical School Northern, University of Sydney. 2. John Walsh Centre for Rehabilitation Research, Kolling Institute; Sydney Medical School Northern, University of Sydney. 3. Faculty of Health Sciences, Australian Catholic University, Sydney, Australia.
Abstract
QUESTIONS: Do interventions involving repetitive practice improve strength after stroke? Are any improvements in strength accompanied by improvements in activity? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Adults who have had a stroke. INTERVENTION: Any intervention involving repetitive practice compared with no intervention or a sham intervention. OUTCOME MEASURES: The primary outcome was voluntary strength in muscles trained as part of the intervention. The secondary outcomes were measures of lower limb and upper limb activity. RESULTS: Fifty-two studies were included. The overall SMD of repetitive practice on strength was examined by pooling post-intervention scores from 46 studies involving 1928 participants. The SMD of repetitive practice on strength when the upper and lower limb studies were combined was 0.25 (95% CI 0.16 to 0.34, I2=44%) in favour of repetitive practice. Twenty-four studies with a total of 912 participants investigated the effects of repetitive practice on upper limb activity after stroke. The SMD was 0.15 (95% CI 0.02 to 0.29, I2=50%) in favour of repetitive practice on upper limb activity. Twenty studies with a total of 952 participants investigated the effects of repetitive practice on lower limb activity after stroke. The SMD was 0.25 (95% CI 0.12 to 0.38, I2=36%) in favour of repetitive practice on lower limb activity. CONCLUSION: Interventions involving repetitive practice improve strength after stroke, and these improvements are accompanied by improvements in activity. REVIEW REGISTRATION: PROSPERO CRD42017068658. [de Sousa DG, Harvey LA, Dorsch S, Glinsky JV (2018) Interventions involving repetitive practice improve strength after stroke: a systematic review. Journal of Physiotherapy 64: 210-221].
QUESTIONS: Do interventions involving repetitive practice improve strength after stroke? Are any improvements in strength accompanied by improvements in activity? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Adults who have had a stroke. INTERVENTION: Any intervention involving repetitive practice compared with no intervention or a sham intervention. OUTCOME MEASURES: The primary outcome was voluntary strength in muscles trained as part of the intervention. The secondary outcomes were measures of lower limb and upper limb activity. RESULTS: Fifty-two studies were included. The overall SMD of repetitive practice on strength was examined by pooling post-intervention scores from 46 studies involving 1928 participants. The SMD of repetitive practice on strength when the upper and lower limb studies were combined was 0.25 (95% CI 0.16 to 0.34, I2=44%) in favour of repetitive practice. Twenty-four studies with a total of 912 participants investigated the effects of repetitive practice on upper limb activity after stroke. The SMD was 0.15 (95% CI 0.02 to 0.29, I2=50%) in favour of repetitive practice on upper limb activity. Twenty studies with a total of 952 participants investigated the effects of repetitive practice on lower limb activity after stroke. The SMD was 0.25 (95% CI 0.12 to 0.38, I2=36%) in favour of repetitive practice on lower limb activity. CONCLUSION: Interventions involving repetitive practice improve strength after stroke, and these improvements are accompanied by improvements in activity. REVIEW REGISTRATION: PROSPERO CRD42017068658. [de Sousa DG, Harvey LA, Dorsch S, Glinsky JV (2018) Interventions involving repetitive practice improve strength after stroke: a systematic review. Journal of Physiotherapy 64: 210-221].
Authors: Helen Bosomworth; Helen Rodgers; Lisa Shaw; Leanne Smith; Lydia Aird; Denise Howel; Nina Wilson; Natasha Alvarado; Sreeman Andole; David L Cohen; Jesse Dawson; Cristina Fernandez-Garcia; Tracy Finch; Gary A Ford; Richard Francis; Steven Hogg; Niall Hughes; Christopher I Price; Laura Ternent; Duncan L Turner; Luke Vale; Scott Wilkes; Hermano I Krebs; Frederike van Wijck Journal: Clin Rehabil Date: 2020-09-11 Impact factor: 3.477