Article

Many stroke patients exhibit excessive compensatory trunk movements
during reaching. Compensatory movement behaviors may improve upper extremity
function in the short-term but be detrimental to long-term recovery. OBJECTIVE:
To evaluate the evidence that trunk restraint limits compensatory trunk movement
and/or promotes better upper extremity recovery in stroke patients. METHODS: A
search was conducted through electronic databases from January 1980 to June 2013.
Only randomized controlled trials (RCTs) comparing upper extremity training with
and without trunk restraint were selected for review. Three review authors
independently assessed the methodological quality and extracted data from the
studies. Meta-analysis was conducted when there was sufficient homogenous data.
RESULTS: Six RCTs involving 187 chronic stroke patients were identified.
Meta-analysis of key outcome measures showed that trunk restraint has a moderate
statistically significant effect on improving Fugl-Meyer Upper Extremity (FMA-UE)
score, active shoulder flexion, and reduction in trunk displacement during
reaching. There was a small, nonsignificant effect of trunk restraint on upper
extremity function. CONCLUSION: Trunk restraint has a moderate effect on
reduction of upper extremity impairment in chronic stroke patients, in terms of
FMA-UE score, increased shoulder flexion, and reduction in excessive trunk
movement during reaching. There is insufficient evidence to demonstrate that
trunk restraint improves upper extremity function and reaching trajectory
smoothness and straightness in chronic stroke patients. Future research on stroke
patients at different phases of recovery and with different levels of upper
extremity impairment is recommended.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS