Effect of task-oriented training for people with stroke: a meta-analysis focused on repetitive or circuit training

Jeon, Byoung‐Jin; Kim, Won‐Ho; Park, Eun‐Young

doi:10.1179/1074935714z.0000000035

Cited by 53 publications

(29 citation statements)

References 52 publications

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“…Spontaneous recovery usually occurs within the first 3 months after the onset of stroke; however, there exists a great deal of variability in recovery across patients, particularly patients with severe deficits, who tend to recover less and more slowly [2]. With regard to the importance of motor training in facilitating motor recovery after stroke, various rehabilitation training protocols, such as taskspecific training and constrained-induced motor training have been applied in regard to stroke [3,4]. However, these protocols are limited in patients with severe motor function deficit, due to the voluntary participation of hemiparetic hands.…”

Section: Introductionmentioning

confidence: 99%

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis

Bai

Fong

Zhang

et al. 2020

J NeuroEngineering Rehabil

139

148

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Background: A substantial number of clinical studies have demonstrated the functional recovery induced by the use of brain-computer interface (BCI) technology in patients after stroke. The objective of this review is to evaluate the effect sizes of clinical studies investigating the use of BCIs in restoring upper extremity function after stroke and the potentiating effect of transcranial direct current stimulation (tDCS) on BCI training for motor recovery. Methods: The databases (PubMed, Medline, EMBASE, CINAHL, CENTRAL, PsycINFO, and PEDro) were systematically searched for eligible single-group or clinical controlled studies regarding the effects of BCIs in hemiparetic upper extremity recovery after stroke. Single-group studies were qualitatively described, but only controlled-trial studies were included in the meta-analysis. The PEDro scale was used to assess the methodological quality of the controlled studies. A meta-analysis of upper extremity function was performed by pooling the standardized mean difference (SMD). Subgroup meta-analyses regarding the use of external devices in combination with the application of BCIs were also carried out. We summarized the neural mechanism of the use of BCIs on stroke. Results: A total of 1015 records were screened. Eighteen single-group studies and 15 controlled studies were included. The studies showed that BCIs seem to be safe for patients with stroke. The single-group studies consistently showed a trend that suggested BCIs were effective in improving upper extremity function. The meta-analysis (of 12 studies) showed a medium effect size favoring BCIs for improving upper extremity function after intervention (SMD = 0.42; 95% CI = 0.18-0.66; I 2 = 48%; P < 0.001; fixed-effects model), while the long-term effect (five studies) was not significant (SMD = 0.12; 95% CI = − 0.28-0.52; I 2 = 0%; P = 0.540; fixed-effects model). A subgroup meta-analysis indicated that using functional electrical stimulation as the external device in BCI training was more effective than using other devices (P = 0.010). Using movement attempts as the trigger task in BCI training appears to be more effective than using motor imagery (P = 0.070). The use of tDCS (two studies) could not further facilitate the effects of BCI training to restore upper extremity motor function (SMD = − 0.30; 95% CI = − 0.96-0.36; I 2 = 0%; P = 0.370; fixed-effects model).

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Section: Introductionmentioning

confidence: 99%

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis

Bai

Fong

Zhang

et al. 2020

J NeuroEngineering Rehabil

139

148

View full text Add to dashboard Cite

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“…Task-oriented training can improve gait, and can benefit people with chronic stroke [ 30 , 46 ]. Despite States and colleagues’ review concluding insufficient evidence for overground gait training [ 47 ], several systematic reviews support intensive repetitive task training’s effects on gait and gait-related activities [ 22 , 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

Interventions to Improve Movement and Functional Outcomes in Adult Stroke Rehabilitation: Review and Evidence Summary

Lin¹,

Dionne²

2018

J Participat Med

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Background Patients who have had a stroke may not be familiar with the terminology nor have the resources to efficiently search for evidence-based rehabilitation therapies to restore movement and functional outcomes. Recognizing that a thorough systematic review on this topic is beyond the scope of this article, we conducted a rapid review evidence summary to determine the level of evidence for common rehabilitation interventions to improve movement/motor and functional outcomes in adults who have had a stroke. Objective The objective of this study was to find evidence for common rehabilitation interventions to improve movement/motor and functional outcomes in adults who have had a stroke. Methods Medline Complete, PubMed, CINAHL Complete, Cochrane Database, Rehabilitation and Sports Medicine Source, Dissertation Abstracts International, and National Guideline Clearinghouse, from 1996 to April of 2016, were searched. From 348 articles, 173 met the following inclusion criteria: (1) published systematic reviews or meta-analyses, (2) outcomes target functional movement or motor skills of the upper and lower limbs, (3) non-pharmacological interventions that are commonly delivered to post-stroke population (acute and chronic), (4) human studies, and (5) English. Evidence tables were created to analyze the findings of systematic reviews and meta-analyses by category of interventions and outcomes. Results This rapid review found that the following interventions possess credible evidence to improve functional movement of persons with stroke: cardiorespiratory training, therapeutic exercise (ie, strengthening), task-oriented training (task-specific training), constraint-induced movement therapy (CIMT), mental practice, and mirror therapy. Neuromuscular electrical stimulation (NMES) (ie, functional electrical stimulation) shows promise as an intervention for stroke survivors. Conclusions Most commonly delivered therapeutic interventions to improve motor recovery after a stroke possess moderate quality evidence and are effective. Future research recommendations, such as optimal timing and dosage, would help rehabilitation professionals tailor interventions to achieve the best outcomes for stroke survivors.

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“…Impaired posture control ( 19 , 23 ), neuromuscular coordination ( 14 ), coordination between nerve segments; hyperreflexia or spasticity; unilateral weakness and impaired proprioception ( 28 ); motor and sensory changes (presence of abnormal sensation); and lack of synchronization in movement ( 29 ) are responsible for imbalance. Improvement in motor and communication skills (via plasticity); intense, targeted treatments (active and repetitive daily exercise of paralyzed limbs) ( 14 ); quick reorganization of injured nerves ( 14 ); activation of brain changes in sensory and motor systems ( 30 ); earlier initiation of movements and exercises at the affected side and use of healthy limbs (to stimulate the affected side) ( 31 ); early, intense physical activity (increased tolerance of patients to postural alterations and decreased alterations) ( 32 ); and progressive long-term exercises (improved muscle power, positive effect on perception and muscle contractures and function of walking) ( 17 , 18 ) are methods to improve impaired balance in these patients. Improving the motor function and balance enhances the functional activities and independence of these patients.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Neuroanatomy of the Human Mirror Neuron System: Impact on Functional Recovery of Ischemic Hemiparetic Patients

Motaqhey¹,

Ghanjal²,

Farahani³

et al. 2015

Iran Red Crescent Med J

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Background:Considering the higher activity of mirror neuron system in females, they frequently have better performance in empathy, interpersonal sensitivity, and emotional recognition compared to males.Objectives:The purpose of this study was to assess whether gender difference in neuroanatomy of the human mirror neuron system has any impact on functional recovery of ischemic hemiparetic patients.Patients and Methods:This single-blind clinical trial was conducted on 24 patients with cerebrovascular accident (CVA) in the age range of 45 - 60 years, referring at a rehabilitation center in Tehran, Iran, during 2013 - 2014. Sampling method was stratified random sampling. The subjects were assigned to 2 groups of 12 males and 12 females. Then, each group was randomly divided into 2 groups (totally 4 groups, n = 6 for each group): women watching functional movies, control women, men watching functional movies, and control men. Movies were shown to patients and then, they were evaluated by Timed Up and Go (TUG), Six-minute walk test (SMW), Barthel index (BI), and Berg balance scale (BBS).Results:Comparison of all variables related to functional activities of all groups before and after watching movies revealed significant differences. The highest percentage of change and improvement was observed in groups 1 and 3 watching the functional movies (P = 0.0001). Percentage of improvement in women of groups 1 and 2 was higher than men in groups 3 and 4 (P = 0.0003). The changes in group of females watching the functional movies (group 1) were significantly greater than in other groups (P < 0.0001).Conclusions:The Sex differences in the neuroanatomy of the human mirror neuron system affect functional recovery of patients with hemiparesis. The improvement in studied women was found to be significantly greater than studied men. The results indicate a higher chance of recovery among hemiparetic women, especially those watching functional movies.

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Effect of task-oriented training for people with stroke: a meta-analysis focused on repetitive or circuit training

Cited by 53 publications

References 52 publications

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis

Interventions to Improve Movement and Functional Outcomes in Adult Stroke Rehabilitation: Review and Evidence Summary

Sex Differences in Neuroanatomy of the Human Mirror Neuron System: Impact on Functional Recovery of Ischemic Hemiparetic Patients

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