Physical rehabilitation approaches for the recovery of function and mobility following stroke

• Published in: Cochrane database of systematic reviews 2014-04, Vol.2014 (4), p.CD001920-CD001920
• Main Authors: Pollock, Alex, Baer, Gillian, Campbell, Pauline, Choo, Pei Ling, Forster, Anne, Morris, Jacqui, Pomeroy, Valerie M, Langhorne, Peter
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Biofeedback, Psychology - methods; Heart & circulation; Humans; Leg - physiology; Motor Skills; Neurology; Physical Therapy Modalities; Posture; PREVENTION AND TREATMENT OF COMPLICATIONS FOLLOWING STROKE; Proprioception - physiology; Randomized Controlled Trials as Topic; Recovery of Function; Stroke Rehabilitation
• ISSN: 1469-493X
• DOI: 10.1002/14651858.cd001920.pub3

Various approaches to physical rehabilitation may be used after stroke, and considerable controversy and debate surround the effectiveness of relative approaches. Some physiotherapists base their treatments on a single approach; others use a mixture of components from several different approaches. To determine whether physical rehabilitation approaches are effective in recovery of function and mobility in people with stroke, and to assess if any one physical rehabilitation approach is more effective than any other approach.For the previous versions of this review, the objective was to explore the effect of 'physiotherapy treatment approaches' based on historical classifications of orthopaedic, neurophysiological or motor learning principles, or on a mixture of these treatment principles. For this update of the review, the objective was to explore the effects of approaches that incorporate individual treatment components, categorised as functional task training, musculoskeletal intervention (active), musculoskeletal intervention (passive), neurophysiological intervention, cardiopulmonary intervention, assistive device or modality.In addition, we sought to explore the impact of time after stroke, geographical location of the study, dose of the intervention, provider of the intervention and treatment components included within an intervention. We searched the Cochrane Stroke Group Trials Register (last searched December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 12, 2012), MEDLINE (1966 to December 2012), EMBASE (1980 to December 2012), AMED (1985 to December 2012) and CINAHL (1982 to December 2012). We searched reference lists and contacted experts and researchers who have an interest in stroke rehabilitation. Randomised controlled trials (RCTs) of physical rehabilitation approaches aimed at promoting the recovery of function or mobility in adult participants with a clinical diagnosis of stroke. Outcomes included measures of independence in activities of daily living (ADL), motor function, balance, gait velocity and length of stay. We included trials comparing physical rehabilitation approaches versus no treatment, usual care or attention control and those comparing different physical rehabilitation approaches. Two review authors independently categorised identified trials according to the selection criteria, documented their methodological quality and extracted the data. We included a total of 96 studies