Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis

French, B., Thomas, L., Leathley, M., Sutton, C., McAdam, J., Forster, A., Langhorne, P. , Price, C., Walker, A. and Watkins, C. (2010) Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. Journal of Rehabilitation Medicine, 42(1), pp. 9-15. (doi:10.2340/16501977-0473)

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Abstract

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 Data sources: The Cochrane Stroke Trials Register, electronic databases of published, unpublished and non-English language papers; conference proceedings, reference lists, and trial authors.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/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 he 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

Item Type:Articles
Keywords:activities of daily living ARM FUNCTION DESIGN EXERCISE THERAPY IMPACT INTERVAL INTERVENTION MOBILITY motor activity outcome OUTCOMES PERFORMANCE physical therapy modalities RANDOMIZED CONTROLLED-TRIAL RECOVERY recovery of function REHABILITATION stroke task performance and analysis TRIAL UPPER-LIMB
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Langhorne, Professor Peter and Walker, Dr Andrew
Authors: French, B., Thomas, L., Leathley, M., Sutton, C., McAdam, J., Forster, A., Langhorne, P., Price, C., Walker, A., and Watkins, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
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Journal Name:Journal of Rehabilitation Medicine
ISSN:1650-1977

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