Article

PURPOSE: To determine the evidence for bilateral therapy interventions aimed at
improving upper limb (UL) function in adults with a range of UL activity
limitations due to a first time chronic stroke. METHOD:
Seven databases were
searched prior to 2008 for articles reporting experimental studies investigating
bilateral UL interventions on functional outcome in participants with a first
stroke, 6 or more months prior. Included articles were evaluated with the quality
index, a tool which evaluates the quality of both randomised and non-randomised
studies. Data relating to study design and functional outcome were extracted.
RESULTS: Nine articles were included; three reported on randomised controlled
trials (RCT) and six on cohort studies. Eight studies incorporated a mechanical
device as their bilateral intervention. Bilateral arm training with rhythmic
auditory cueing (BATRAC) was the most commonly used mechanically based
intervention, and three of the four uncontrolled BATRAC studies reported
significant improvements in UL function post-intervention, however these results
were not substantiated by a RCT study of the BATRAC intervention. One study
demonstrated significant functional improvements after 6 days of training with a
non-mechanical bilateral task. Of the four studies that performed a follow-up
assessment, three reported significant improvement in UL function. Quality index
ratings of the included studies ranged from 18 to 25 out of 27. CONCLUSION: There
is some evidence that bilateral therapy improves function in adults with chronic
stroke, however more quality RCTs are required to strengthen this evidence.

Langue : ANGLAIS