Home‐based therapy programmes for upper limb functional recovery following stroke

Cochrane Database of Systematic Reviews, 2012

Home‐based therapy programmes for upper limb functional recovery following stroke - The Cochrane Library - Coupar - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content Home‐based therapy programmes for upper limb functional recovery following stroke Fiona Coupar 1,* , Alex Pollock 2 , Lynn A Legg 3 , Catherine Sackley 4 , Paulette van Vliet 5 Editorial Group: Published Online: 16 MAY 2012 Assessed as up-to-date: 31 MAY 2011 DOI: 10.1002/14651858.CD006755.pub2 Copyright © 2012 The Cochrane Collaboration.
Publication History Publication Status: New Published Online: 16 MAY 2012 SEARCH ARTICLE TOOLS Abstract Abstract Background With an increased focus on home-based stroke services and the undertaking of programmes, targeted at upper limb recovery within clinical practice, a systematic review of home-based therapy programmes for individuals with upper limb impairment following stroke was required.
Objectives To determine the effects of home-based therapy programmes for upper limb recovery in patients with upper limb impairment following stroke.
Search methods We searched the Cochrane Stroke Group's Specialised Trials Register (May 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2011, Issue 2), MEDLINE (1950 to May 2011), EMBASE (1980 to May 2011), AMED (1985 to May 2011) and six additional databases.
Selection criteria Randomised controlled trials (RCTs) in adults after stroke, where the intervention was a home-based therapy programme targeted at the upper limb, compared with placebo, or no intervention or usual care.
Primary outcomes were performance in activities of daily living (ADL) and functional movement of the upper limb.
Data collection and analysis Two review authors independently screened abstracts, extracted data and appraised trials.
We undertook assessment of risk of bias in terms of method of randomisation and allocation concealment (selection bias), blinding of outcome assessment (detection bias), whether all the randomised patients were accounted for in the analysis (attrition bias) and the presence of selective outcome reporting.
No studies compared the effects of home-based upper limb therapy programmes with placebo or no intervention.
Primary outcomes: we found no statistically significant result for performance of ADL (mean difference (MD) 2.85; 95% confidence interval (CI) -1.43 to 7.14) or functional movement of the upper limb (MD 2.25; 95% CI -0.24 to 4.73)).
Secondary outcomes: no statistically significant results for extended ADL (MD 0.83; 95% CI -0.51 to 2.17)) or upper limb motor impairment (MD 1.46; 95% CI -0.58 to 3.51).