Article

OBJECTIVE: To determine if repetitive task training after stroke improves
functional activity. DESIGN: Systematic review and meta-analysis of trials
comparing repetitive task training with attention control or usual care. DATA SOURCES:
The Cochrane Stroke Trials Register, electronic databases of published,
unpublished and non-English language papers; conference proceedings, reference
lists, and trial authors.
METHODS : studies were
randomized / quasi-randomized trials in adults after stroke where an active motor
sequence aiming to improve functional activity was performed repetitively within
a single training session. We used Cochrane Collaboration methods, resources, and
software. RESULTS: We included 14 trials with 17 intervention-control pairs and
659 participants. Results were statistically significant for walking distance
(mean difference 54.6, 95% confidence interval (95% CI) 17.5, 91.7); walking
speed (standardized mean difference (SMD) 0.29, 95% CI 0.04, 0.53); sit-to-stand
(standard effect estimate 0.35, 95% CI 0.13, 0.56), and activities of daily
living: SMD 0.29, 95% CI 0.07, 0.51; and of borderline statistical significance
for measures of walking ability (SMD 0.25, 95% CI 0.00, 0.51), and global motor
function (SMD 0.32, 95% CI -0.01, 0.66). There were no statistically significant
differences for hand/arm functional activity, lower limb functional activity
scales, or sitting/standing balance/reach. CONCLUSION: Repetitive task training
resulted in modest improvement across a range of lower limb outcome measures, but
not upper limb outcome measures. Training may be sufficient to have a small
impact on activities of daily living. Interventions involving elements of repetition and task training are diverse and difficult to classify : the results
presented are specific to trials where both elements are clearly present in the
intervention, without major confounding by other potential mechanisms of action.

Langue : ANGLAIS