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

Laziness is bolded in the abstract. We'll never get decent stroke protocols until we eliminate all the dead wood in stroke.  As far as I can tell this information is completely useless for anyone who has any knowledge of stroke rehab at all. They acknowledge failure by suggesting followup.

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

• Susan Hamady Lin¹, ScD, OTR ; 
• Timothy P Dionne², MS, OTR 

¹Institute of Health Professions, Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, United States
²Department of Rehabilitation Sciences, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, United States

Corresponding Author:

Susan Hamady Lin, ScD, OTR
Institute of Health Professions
Department of Occupational Therapy
Massachusetts General Hospital Institute of Health Professions
School of Health and Rehabilitation Sciences, Charlestown Navy Yard
36 First Avenue
Boston, MA, 02129
United States
Phone: 1 540 338 9352
Email: susanlinot [at] gmail.com

ABSTRACT

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.

J Participat Med 2018;10(1):e3

doi:10.2196/jopm.8929