Deans' stroke musings: The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, September 8, 2023

The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review

It's only 13 years old. What did your incompetent doctor use as an excuse not to get this implemented for your recovery? Yeah, it's for chronic but I bet it would work even better for acute.

The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review

Disability and Rehabilitation, 2010; 32(15): 1221–1231

Centre for Physiotherapy Research, University of Otago, Dunedin, New Zealand
Accepted November 2009

Abstract

Purpose.

To determine the evidence for bilateral therapy interventions aimed at improving upper limb (UL) function inadults with a range of UL activity limitations due to a ﬁrst time chronic stroke.

Method.

Seven databases were searched prior to 2008 for articles reporting experimental studies investigating bilateral UL interventions on functional outcome in participants with a ﬁrst stroke, 6 or more months prior. Included articles were evaluated with the quality index, a tool which evaluates the quality of both randomised and non-randomised studies. Data relating to study design and functional outcome were extracted.

Results.

Nine articles were included; three reported on randomised controlled trials (RCT) and six on cohort studies. Eight studies incorporated a mechanical device as their bilateral intervention. Bilateral arm training with rhythmic auditory cueing(BATRAC) was the most commonly used mechanically based intervention, and three of the four uncontrolled BATRAC studies reported signiﬁcant improvements in UL function post-intervention, however these results were not substantiated by a RCT study of the BATRAC intervention. One study demonstrated signiﬁcant functional improvements after 6 days of training with a non-mechanical bilateral task. Of the four studies that performed a follow-up assessment, three reported signiﬁcant improvement in UL function. Quality index ratings of the included studies ranged from 18 to 25 out of 27.

Conclusion.

There is some evidence that bilateral therapy improves function in adults with chronic stroke, however more quality RCTs are required to strengthen this evidence.