Rehabilitation Interventions for Poststroke Hand Oedema: A Systematic Review

Abstract

Objective/BackgroundTo review the evidence of rehabilitation interventions for the management of poststroke hand oedema.MethodsWe conducted a systematic review of research articles in electronic databases published in English between 1999 and 2015. Two investigators working independently retrieved articles from the Cochrane Central Register of Controlled Trials, SCOPUS, Taylor & Francis Online, Wiley Online Library, CINAHL, Springer (MetaPress), ScienceDirect, PubMed, SAGE Journals Online, EBSCO, and Web of Science. Only controlled trials with outcome measures and interventions for poststroke hand oedema were included. Three investigators critically appraised the selected studies using the Physiotherapy Evidence Database Scale.ResultsOf the 189 articles identified, nine (5 randomized controlled trials, 3 nonrandomized controlled trials, and 1 crossover controlled trial) were selected. These studies are heterogeneous in terms of design and types of intervention for poststroke hand oedema. The interventions reducing hand oedema are Lycra pressure garments with glove splints, bilateral passive motion upper-limb exercises, laser therapy, and acupressure. However, due to these studies’ short intervention periods and the fact that hand oedema is not their primary outcome measure, it is not possible to draw a firm conclusion on their clinical significance for managing poststroke hand oedema.ConclusionFurther study needs to focus solely on interventions for poststroke hand oedema and their long-term effects. No conclusion can be made on the most effective management of poststroke hand oedema until much more evidence is available.

Grip Exercise of Non-Paretic Hand Can Improve Venous Return in the Paretic Arm in Stroke Patients: An Experimental Study in the Supine and Sitting Positions

“…Although rehabilitation is carried out to alleviate poststroke hand edema, drawing any firm conclusions about its clinical significance in the management of poststroke hand edema is not yet possible. 3) As there is little evidence to guide clinical decision-making, 1) it has become apparent that novel, more effective interventions are required to address poststroke hand edema. It has been suggested that the etiology of poststroke hand edema is impaired functioning of venous return due to immobility.…”

“…It has been suggested that the etiology of poststroke hand edema is impaired functioning of venous return due to immobility. 2,3) In a review article, Geurts et al 4) reported that immobility of the paretic upper extremity, repeated minor trauma, elevated filtration pressure, and altered capillary permeability due to autonomic vasomotor dysregulation may be associated with the development of hand edema. Although the etiology of poststroke hand edema remains unclear, the most widely accepted hypothesis regarding poststroke upper extremity edema is that the decreased venous return is related to the loss of the muscle-pumping function in the paretic extremity.…”

Current practice trends of oedema management in the hands of people with tetraplegia in Australia

“…The most commonly applied and effective method for the treatment of lymphoedema is compression therapy, including bandages and garments [12]. A systematic review of stroke-specific literature found the most effective treatment methods were compression garments, bilateral passive ROM and contemporary therapies [13]. A treatment method that appears to be unique to SCI is the 'boxing glove' splint [14].…”

Effects of Repetitive Peripheral Magnetic Stimulation through Hand Splint Materials on Induced Movement and Corticospinal Excitability in Healthy Participants

“…Hand splint materials, which are thermoplastics, are used to immobilize, protect, and support the fingers, hands, and forearms during surgery and therapy. They are also used to maintain a fixed functional position in neurorehabilitation [ 16 , 17 , 18 , 19 , 20 ]. In this study, we investigated the effects of rPMS applied over hand splint materials on induced movement and corticospinal excitability in healthy participants.…”