What is current practice for upper limb rehabilitation in the acute hospital setting following stroke? A systematic review

So no one in the world seems to know anything about arm stroke rehabilitation. At least not enough to put it out there publicly and freely. Have your therapists paid for these latest research articles? Just another failure point of our fucking failures of stroke associations. If they did know of this shortcoming and did nothing, that is fucking appalling. If they didn't even know of this shortcoming, that is even worse and deserves keel-hauling. On your own once again. This research should have never been required. A fully functioning stroke protocol database would have all the relevant research and would have updated the protocols as research came in. God, this is so simple to do and understand. Why the fuck can't our stroke teams get this done?
http://content.iospress.com/articles/neurorehabilitation/nre1374

Article type: Research Article

Authors: Serrada, Ines | McDonnell, Michelle N.^* | Hillier, Susan L.

Affiliations: [a] Stroke in Rehabilitation Research Group, International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, Australia

Correspondence: [*] Address for correspondence: Dr Michelle McDonnell, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Tel.: +61 8 8302 1684; E-mail: michelle.mcdonnell@unisa.edu.au.

Abstract:  

OBJECTIVE: To investigate the amount of time and types of interventions used during therapy sessions in the acute setting following stroke. 

METHODS: A systematic search of relevant databases was conducted. Studies were eligible if they were observational studies of adults with a confirmed diagnosis and within 4 weeks post-stroke; receiving Physiotherapy (PT) and/or Occupational Therapy (OT); and the outcome included amount of therapy time devoted to UL and/or types of interventions. Two authors independently selected studies for inclusion, assessed methodological quality and extracted data. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. 

RESULTS: From the 94 studies reviewed, seven studies involving 3236 participants met the inclusion criteria. Pooled results indicated that 7.9 min/day (21.4%) of a total 36.7 min/day combined PT and OT session was devoted to UL therapy. Two of the seven studies reported types of interventions, predominantly upper limb activity and control. 

CONCLUSIONS: A small proportion of total PT and OT time is directed to the involved UL during acute rehabilitation. Given the evidence for early and intense rehabilitation, there is a need to explore the reasons for this low intensity of UL therapy in the acute stage post-stroke.

Keywords: Stroke, systematic review, rehabilitation, behavioural mapping, upper limb

DOI: 10.3233/NRE-161374

Journal: NeuroRehabilitation, vol. Preprint, no. Preprint, pp. 1-8, 2016

Published 15 July 2016

Price: EUR 27.50