Wednesday, October 9, 2019

Occupational Therapy for Stroke Patients: A Systematic Review * Occupational Therapy for Stroke Patients: When, Where, and How?

Very importantly you will notice they don't point to any rehab protocols.  My takeaway from this is that you are still a one person guinea pig in an uncontrolled clinical study.  Hope you are ok with that.  How long before your hospital discontinues splinting, 7 years after research came out ? 

Hand splinting for poststroke spasticity: A randomized controlled trial

November 2012

The latest here:

Occupational Therapy for Stroke Patients: A Systematic Review * Occupational Therapy for Stroke Patients: When, Where, and How?

 Esther M.J. Steultjens, MA; Joost Dekker, PhD; Lex M. Bouter, PhD; Jos C.M. van de Nes, MD;Edith H.C. Cup, MSc; Cornelia H.M. van den Ende, PhD
 Background and Purpose
—Occupational therapy (OT) is an important aspect of stroke rehabilitation. The objective of thisstudy was to determine from the available literature whether OT interventions improve outcome for stroke patients.
 Methods
—An extensive search in MEDLINE, CINAHL, EMBASE, AMED, and SCISEARCH was performed. Studieswith controlled and uncontrolled designs were included. Seven intervention categories were distinguished and separatelyanalyzed. If a quantitative approach (meta-analysis) of data analysis was not appropriate, a qualitative approach(best-evidence synthesis), based on the type of design, methodological quality, and significant findings of outcomeand/or process measures, was performed.
 Results
—Thirty-two studies were included in this review, of which 18 were randomized controlled trials. Ten randomized controlled trials had a high methodological quality. For the comprehensive OT intervention, the pooled standardized mean difference for primary activities of daily living (ADL) (0.46; CI, 0.04 to 0.88), extended ADL (0.32; CI, 0.00 to0.64), and social participation (0.33; CI, 0.03 to 0.62) favored treatment. For the training of skills intervention, some evidence for improvement in primary ADL was found. Insufficient evidence was found to indicate that the provision of splints is effective in decreasing muscle tone.
Conclusions
—This review identified small but significant effect sizes for the efficacy of comprehensive OT on primaryADL, extended ADL, and social participation. These results correspond to the outcome of a systematic review of intensified rehabilitation for stroke patients. The amount of evidence with respect to specific interventions, however, islimited. More research is needed to enable evidence-based OT for stroke patients.
 (Stroke. 2003;34:676-687.)

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