Journal of Physiotherapy

Journal of Physiotherapy

Volume 64, Issue 4, October 2018, Pages 210-221
Journal of Physiotherapy

Research
Interventions involving repetitive practice improve strength after stroke: a systematic review

https://doi.org/10.1016/j.jphys.2018.08.004Get rights and content
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Abstract

Questions

Do interventions involving repetitive practice improve strength after stroke? Are any improvements in strength accompanied by improvements in activity?

Design

Systematic review of randomised trials with meta-analysis.

Participants

Adults who have had a stroke.

Intervention

Any intervention involving repetitive practice compared with no intervention or a sham intervention.

Outcome measures

The primary outcome was voluntary strength in muscles trained as part of the intervention. The secondary outcomes were measures of lower limb and upper limb activity.

Results

Fifty-two studies were included. The overall SMD of repetitive practice on strength was examined by pooling post-intervention scores from 46 studies involving 1928 participants. The SMD of repetitive practice on strength when the upper and lower limb studies were combined was 0.25 (95% CI 0.16 to 0.34, I2 = 44%) in favour of repetitive practice. Twenty-four studies with a total of 912 participants investigated the effects of repetitive practice on upper limb activity after stroke. The SMD was 0.15 (95% CI 0.02 to 0.29, I2 = 50%) in favour of repetitive practice on upper limb activity. Twenty studies with a total of 952 participants investigated the effects of repetitive practice on lower limb activity after stroke. The SMD was 0.25 (95% CI 0.12 to 0.38, I2 = 36%) in favour of repetitive practice on lower limb activity.

Conclusion

Interventions involving repetitive practice improve strength after stroke, and these improvements are accompanied by improvements in activity.

Review registration

PROSPERO CRD42017068658. [de Sousa DG, Harvey LA, Dorsch S, Glinsky JV (2018) Interventions involving repetitive practice improve strength after stroke: a systematic review. Journal of Physiotherapy 64: 210–221]

Key words

Stroke
Strength
Repetitive practice
Systematic review
Meta-analysis

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