Therapeutic effect of adjuvant therapy added to constraint-induced movement therapy in patients with subacute to chronic stroke: a systematic review and meta-analysis.

Autor:	Kaneko T; Department of Rehabilitation, Yamagata Prefectural Central Hospital, Yamagata, Japan., Maeda M; Department of Occupational Therapy, JA Nagano Koseiren Kakeyu-Misayama Rehabilitation Center Kakeyu Hospital, Ueda, Japan., Yokoyama H; Department of Rehabilitation, Kansai Medical University Kuzuha Hospital, Hirakata, Japan., Kai S; Department of Rehabilitation, Fukuoka Wajiro Hospital, Fukuoka, Japan., Obuchi K; Department of Rehabilitation, Nagano Matsushiro General Hospital, Nagano, Japan., Takase S; Department of Rehabilitation, Kawasaki Kyodo Hospital, Kawasaki, Japan., Horimoto T; Department of Rehabilitation, Osaka General Hospital of West Japan Railway Company, Osaka, Japan., Shimada R; Department of Occupational Therapy, Faculty of Health Sciences, Iryo Sosei University, Iwaki, Japan., Moriya T; Department of Rehabilitation, Kosei Hospital, Medical Corporation Rokushinkai, Japan., Ohmae H; Department of Rehabilitation, Tokushima University Hospital, Tokushima, Japan., Amanai M; Department of Rehabilitation, Kujira Hospital, Koto City, Japan., Okita Y; Soaring Health Sports, Wellness & Community Centre, Melbourne, Australia., Takebayashi T; Department of Occupational Therapy, School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Japan.
Jazyk:	angličtina
Zdroj:	Disability and rehabilitation [Disabil Rehabil] 2024 Sep; Vol. 46 (18), pp. 4098-4112. Date of Electronic Publication: 2023 Oct 19.
DOI:	10.1080/09638288.2023.2269843
Abstrakt:	Purpose: This review investigated the effectiveness of adjuvant therapy combined with constraint-induced movement therapy (CIMT) in improving the paretic upper limb functionality in adults with stroke sequelae during the subacute to chronic rehabilitation phase. Materials and Methods: In this systematic review and meta-analysis of randomized controlled trials (RCT), electronic databases, including PubMed, Web of Science, CINAHL, and MEDLINE, were searched. We included RCTs that investigated the outcomes of adjuvant therapy (i.e. other therapies) added to CIMT compared with CIMT alone. Key trial findings were qualitatively synthesized and analyzed. This meta-analysis examined variables, such as mean scores and standard deviations, using the following outcome measures: Fugl-Meyer Assessment (FMA) upper limb items, Action Research Arm Test (ARAT), Amount of Use (AOU) of Motor Activity Log (MAL), and Quality of Movement (QOM) of MAL. Results: Eighteen eligible RCTs were included in the analysis. Adding CIMT to adjunctive therapy significantly improved FMA compared with CIMT alone (mean difference [MD] 4.02, 95% confidence interval [CI] 2.60-5.44; I 2 = 85%; 15 studies; 330 participants). Similarly, the ARAT and MAL-AOU scores improved significantly. Conclusions: CIMT combined with several adjunctive therapies effectively improved upper limb function.
Databáze:	MEDLINE
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