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

Did your fucking failures of stroke associations  incompetently do nothing with this? I would expect that an EXACT PROTOCOL would have been created and distributed within a month of this research being published. At least by competent persons or groups. But I guess that there are NO competent persons among our stroke medical 'professionals'!

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

 CHRISTOPHER PAUL LATIMER, JUSTINE KEELING, BRODERICK LIN,MEREDITH HENDERSON & LEIGH ANNE HALE
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 morequality RCTs are required to strengthen this evidence.