Article

OBJECTIVE: To systematically identify, review, and explore the evidence for use
of assistive technologies (ATs) in poststroke upper limb rehabilitation. DATA
SOURCES: AMED, CINAHL, Cochrane Library, Compendex, CSA Illumina, EMBASE,
MEDLINE, PEDro, PyscINFO, and Web of Science were last searched in September
2011. STUDY SELECTION: Two independent researchers screened for inclusion
criteria (adult poststroke subjects, upper limb rehabilitation with an AT). The
risk of bias was assessed. Randomized controlled trials of poststroke subjects
with baseline equivalence as assessed by blinded assessors were selected for data
extraction. DATA EXTRACTION: Details of subjects, experimental and control
treatments, and all outcomes were recorded in a spreadsheet. DATA SYNTHESIS:
These data were used to calculate effect sizes for all outcome measures.
Impairment measures ranged from -.39 (95% confidence interval [CI], -1.14 to .62)
to 1.46 (95% CI, .72-2.20). Measures of activity effect sizes were from .04 (95%
CI, -.35 to .44) to .93 (95% CI, -.39 to 2.25); for Motor Activity Log, from .07
(95% CI, -.66 to .80) to 1.24 (95% CI, .47-2.01); and for participation, from
-3.32 (95% CI, -4.52 to 2.11) to 1.78 (95% CI, 0-3.56). CONCLUSIONS: AT
treatments appear to give modest additional benefit when compared with usual care
or in addition to usual care. This is most apparent for subjects early poststroke
with 2 caveats: high-intensity constraint-induced movement therapy and electrical
stimulation exclusively to the shoulder appear detrimental. The heterogeneity of
treatment parameters and population characteristics precludes specific
recommendations. Research would benefit from modeling studies to explicitly
define criteria of population, intervention, comparator, and outcomes for
effective treatments before the development of efficiently integrated care
pathways.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS