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[Evidence-based arm rehabilitation--a systematic review of the literature]

Nervenarzt. 2003 Oct;74(10):841-9. doi: 10.1007/s00115-003-1549-7.
[Article in German]

Abstract

Based on a systematic MEDLINE search and informal sources, 40 references were identified that evaluate training therapy or neuromuscular electric stimulation for arm paresis after stroke and describe either a systematic review, meta-analysis, randomised controlled trial, or controlled cohort study. The evidence was grouped into three areas of interest: comparison of physiotherapy schools, effects of intensity of training, and efficacy of specific arm rehabilitation techniques. The only physiotherapy school with evidence of superior efficacy was the task-oriented 'motor relearning programme'. Higher intensities of motor rehabilitation can accelerate motor recovery. Various training techniques with demonstrated efficacy are available for specific patient subgroups: arm ability training for mildly affected patients with reduced efficiency of motor control, constrained-induced movement therapy for patients with partial functional deficits and learned nonuse of the affected arm, and repetitive sensorimotor training techniques, EMG-biofeedback, functional electrical stimulation, and robot-assisted training for patients with severe arm paresis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Arm / innervation*
  • Biofeedback, Psychology
  • Evidence-Based Medicine*
  • Hemiplegia / rehabilitation*
  • Humans
  • Meta-Analysis as Topic
  • Physical Therapy Modalities
  • Randomized Controlled Trials as Topic
  • Robotics
  • Stroke Rehabilitation*
  • Therapy, Computer-Assisted