Unilateral versus bilateral upper limb exercise therapy after stroke: A systematic review.
Summary of "Unilateral versus bilateral upper limb exercise therapy after stroke: A systematic review."
Objective: To compare the effects of unilateral and bilateral training on upper limb function after stroke with regard to two key factors: severity of upper limb paresis and time of intervention post-stroke. Design: Systematic review and meta-analysis of randomized controlled trials. Methods: Two authors independently selected trials for inclusion, assessed the methodological quality and extracted data. Study outcomes were pooled by calculating the (standardized) mean difference ((S)MD). Sensitivity analyses for severity and time of intervention post-stroke were applied when possible. Results: All 9 studies involving 452 patients showed homogeneity. In chronic patients with a mild upper limb paresis after stroke a marginally significant SMD for upper limb activity performance (SMD 0.34; 95% confidence interval): 0.04-0.63), and marginally significant MDs for perceived upper limb activity performance (amount of use: MD 0.42; 95% confidence interval: 0.09-0.76, and quality of movement: MD 0.45; 95% confidence interval: 0.12-0.78) were found in favour of unilateral training. All other MDs and SMDs were non-significant. Conclusion: Unilateral and bilateral training are similarly effective. However, intervention success may depend on severity of upper limb paresis and time of intervention post-stroke. Key words: rehabilitation; stroke; upper limb; systematic review; CIMT; bilateral arm training.
Affiliation
Faculty of Human Movement Sciences, Research Institute MOVE, VU University Amsterdam, Amsterdam, The Netherlands. E-mail: l.van.delden@vu.nl.
Journal Details
This article was published in the following journal.
Name: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine
ISSN: 1651-2081
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22266762
- DOI: http://dx.doi.org/10.2340/16501977-0928
Medical and Biotech [MESH] Definitions
Hearing Loss, Central
Hearing loss due to disease of the AUDITORY PATHWAYS (in the CENTRAL NERVOUS SYSTEM) which originate in the COCHLEAR NUCLEI of the PONS and then ascend bilaterally to the MIDBRAIN, the THALAMUS, and then the AUDITORY CORTEX in the TEMPORAL LOBE. Bilateral lesions of the auditory pathways are usually required to cause central hearing loss. Cortical deafness refers to loss of hearing due to bilateral auditory cortex lesions. Unilateral BRAIN STEM lesions involving the cochlear nuclei may result in unilateral hearing loss.
Upper Extremity
The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER.
Exercise Tolerance
The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an EXERCISE TEST.
Choanal Atresia
A congenital abnormality that is characterized by a blocked CHOANAE, the opening between the nose and the NASOPHARYNX. Blockage can be unilateral or bilateral; bony or membranous.
Macrostomia
Greatly exaggerated width of the mouth, resulting from failure of union of the maxillary and mandibular processes, with extension of the oral orifice toward the ear. The defect may be unilateral or bilateral. (Dorland, 27th ed)
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