Article

OBJECTIVE: To compare the effects of unilateral and bilateral training on upper
limb function after stroke with regard to two key factors: severity of upper limb
paresis and time of intervention post-stroke. DESIGN: Systematic review and
meta-analysis of randomized controlled trials. METHODS:
Two authors independently
selected trials for inclusion, assessed the methodological quality and extracted
data. Study outcomes were pooled by calculating the (standardized) mean
difference ((S)MD). Sensitivity analyses for severity and time of intervention
post-stroke were applied when possible. RESULTS: All 9 studies involving 452
patients showed homogeneity. In chronic patients with a mild upper limb paresis
after stroke a marginally significant SMD for upper limb activity performance
(SMD 0.34; 95% confidence interval): 0.04-0.63), and marginally significant MDs
for perceived upper limb activity performance (amount of use: MD 0.42; 95%
confidence interval: 0.09-0.76, and quality of movement: MD 0.45; 95% confidence
interval: 0.12-0.78) were found in favour of unilateral training.
All other MDs
and SMDs were non-significant. CONCLUSION: Unilateral and bilateral training are
similarly effective. However, intervention success may depend on severity of
upper limb paresis and time of intervention post-stroke.

Langue : ANGLAIS