TY - JOUR
T1 - Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis
AU - French, Beverley
AU - Thomas, Lois
AU - Leathley, Michael
AU - Sutton, Christopher
AU - McAdam, Joanna
AU - Forster, Anne
AU - Langhorne, Peter
AU - Price, Christopher
AU - Walker, Andrew
AU - Watkins, Caroline
PY - 2010/1/1
Y1 - 2010/1/1
N2 - 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 Data sources: The Cochrane Stroke Trials Register, electronic databases of published, unpublished and non-English language papers; conference proceedings, reference lists, and trial authors. Review methods: Included studies were randomized/quasirandomized 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, 5% 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. Journal Compilation
AB - 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. Review methods: Included studies were randomized/quasirandomized 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, 5% 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. Journal Compilation
KW - Activities of daily living
KW - Motor activity
KW - Physical therapy modalities
KW - Recovery of function
KW - Stroke
KW - Task performance and analysis
UR - http://www.scopus.com/inward/record.url?scp=75649087364&partnerID=8YFLogxK
U2 - 10.2340/16501977-0473
DO - 10.2340/16501977-0473
M3 - Review article
C2 - 20111838
AN - SCOPUS:75649087364
SN - 1650-1977
VL - 42
SP - 9
EP - 15
JO - Journal of Rehabilitation Medicine
JF - Journal of Rehabilitation Medicine
IS - 1
ER -
