Objective

Upper limb recovery is a crucial component of stroke rehabilitation aimed to maximize functional activities and reduce disability. Using both arms post stroke is essential to carry out many functional activities but the evidence on bilateral arm training (BAT) is understudied. To investigate the evidence for efficacy of task-based BAT on upper limb recovery, function, and participation post stroke.

Methods

We included 13 randomized controlled trials, and methodological quality was assessed using Cochrane risk of bias tool and the PEDro scale. The outcome measures such as Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), Box and Block Test (BBT), Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Stroke Impact Scale (SIS) were synthesized and analysed based on ICF.

Results

When comparing BAT with control group, BAT showed improvement in the pooled standard mean difference (SMD) of FMA-UE (SMD= 0.62, 95% confidence interval (CI), 0.12 to 1.12, p = 0.01; I²=83%). The control group showed significant improvement in MAL-QOM (SMD= -0.10, 95%CI, -0.77 to 0.58, p = 0.78; I²=89%). Compared to conventional group, BAT showed a significant improvement in BBT (SMD= 0.52, 95%CI, 0.04 to 1.00, p = 0.03; I²=0%). When compared with BAT, unimanual training yielded a significant improvement (SMD= -0.60, 95%CI, -0.98 to -0.22, p = 0.002; I²=0%) in MAL-QOM. In real-life participation, the control group showed improvement in SIS (SMD= -0.17, 95% (CI), -0.70 to 0.37, p = 0.54; I²=48%) over BAT.

Conclusions

Task-based BAT appears to improve upper limb motor function post stroke. The benefits of task-based BAT on activity performance and participation in real life are not statistically significant.

中文翻译：

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基于任务的双臂训练对中风后上肢恢复的影响：系统评价和荟萃分析

客观的

上肢康复是中风康复的重要组成部分，旨在最大限度地提高功能活动和减少残疾。中风后使用双臂对于进行许多功能性活动至关重要，但双臂训练 (BAT) 的证据尚未得到充分研究。调查基于任务的 BAT 对中风后上肢恢复、功能和参与的有效性的证据。

方法

我们纳入了 13 项随机对照试验，并使用 Cochrane 偏倚风险工具和 PEDro 量表评估了方法学质量。结果测量，如 Fugl-Meyer 评估-上肢 (FMA-UE)、行动研究手臂测试 (ARAT)、Wolf 运动功能测试 (WMFT)、运动活动日志 (MAL)、盒和块测试 (BBT)、修改Barthel 指数 (MBI)、功能独立性测量 (FIM) 和卒中影响量表 (SIS) 基于 ICF 进行综合和分析。

结果

将 BAT 与对照组进行比较时，BAT 显示 FMA-UE 的合并标准均值差 (SMD) 有所改善（SMD= 0.62，95% 置信区间 (CI)，0.12 至 1.12，p = 0.01；I 2 =  83 ^%） . 对照组在 MAL-QOM 方面表现出显着改善（SMD= -0.10，95%CI，-0.77 至 0.58，p  = 0.78；I ² =89%）。与常规组相比，BAT 显示 BBT 有显着改善（SMD= 0.52，95%CI，0.04 至 1.00，p  = 0.03；I ² =0%）。与 BAT 相比，单手训练产生了显着改善 (SMD= -0.60, 95%CI, -0.98 to -0.22, p  = 0.002; I ²=0%) 在 MAL-QOM 中。在现实生活中，与BAT 相比，对照组在 SIS 方面有所改善（SMD= -0.17，95% (CI)，-0.70 至 0.37， p  = 0.54；I ^{2 =48%）。}

结论

基于任务的 BAT 似乎可以改善中风后的上肢运动功能。基于任务的 BAT 对活动表现和参与现实生活的好处在统计上并不显着。