Article

PURPOSE: To investigate the effect of interventions that promote upper limb (UL)
recovery in stroke survivors with severe paresis. METHODS:
A systematic search of
the scientific literature from January 1970 to March 2009 was conducted using
CINAHL, Cochrane, PEDro, Pubmed and Web of Science. keywords used included
stroke, severe, hemiplegia, UL, task-oriented, robot, non-robot and electrical
stimulation. Methodological quality of the studies was assessed using the PEDro
rating scale. Studies were grouped into one of three intervention categories:
robotic therapy, electrical stimulation or 'other' therapy. RESULTS: Seventeen
randomised controlled trials met the inclusion criteria. A 'best evidence
synthesis' indicated strong evidence that robotic therapy provides a large
beneficial effect and limited evidence that electrical stimulation and 'other'
interventions provide a large beneficial effect on function. There is no evidence
that these interventions influence use of the arm in everyday tasks. CONCLUSION:
There are a number of newly developed interventions that enable stroke survivors
with severe paresis to actively participate in task-oriented practice to promote
UL recovery. While these interventions offer some promise for stroke survivors
with severe paresis, ultimately, the effectiveness of these interventions will be
dependent on whether they lead to restoration of function to the point at which
the stroke survivor can practice everyday tasks.

Langue : ANGLAIS