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Effectiveness of Activity-Based Task-Oriented Training on Upper Extremity Recovery for Adults With Stroke: A Systematic Review

奇纳 康复 冲程(发动机) 心理干预 日常生活活动 物理医学与康复 物理疗法 作业疗法 医学 系统回顾 梅德林 包裹体(矿物) 心理学 精神科 机械工程 工程类 社会心理学 政治学 法学
作者
Cheng-Yu Lee,Tsu‐Hsin Howe
出处
期刊:American Journal of Occupational Therapy [American Occupational Therapy Association]
卷期号:78 (2) 被引量:17
标识
DOI:10.5014/ajot.2024.050391
摘要

Abstract Importance: Interventions for improving upper extremity (UE) recovery have become a priority in stroke rehabilitation because UE disability can undermine a person’s capacity to perform daily activities after stroke. A better understanding of the use of activity-based task-oriented training (TOT) will inform the development of more effective UE interventions in stroke rehabilitation. Objective: To examine the effectiveness of activity-based TOT in improving the UE recovery of adults with stroke. Data Sources: CINAHL Plus, MEDLINE, and PubMed. Study Selection and Data Collection: Inclusion criteria included quantitative studies published between June 2012 and December 2022 that reported UE recovery as an outcome, including measurements of motor function, motor performance, and performance of activities of daily living (ADLs); a sample age ≥18 yr, with stroke in all phases; and interventions that incorporated real-world daily activities. We assessed articles for inclusion, quality, and risk of bias following Cochrane methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Findings: Sixteen studies (692 participants, Level 1–4 evidence) were included. Strong to moderate evidence supported the effectiveness of activity-based TOT in UE motor function, motor performance, and ADL performance for adults with stroke. Strong evidence supported the effectiveness of hospital-based TOT, and moderate evidence supported the effectiveness of home-based TOT. Conclusions and Relevance: The results not only showed the value of activity-based TOT as an effective UE intervention in stroke rehabilitation but also supported the occupational therapy philosophy of using functional and meaningful activities in practice. Further research on home-based TOT is needed. Plain-Language Summary: This systematic review shows the effectiveness and value of using real-life activities in task-oriented training approaches for adult survivors of stroke. The authors found strong evidence for hospital-based task-oriented training interventions and moderate evidence for home-based interventions for improving upper extremity recovery. This review shows the value of upper extremity task-oriented training as an effective intervention in stroke rehabilitation. The review also supports the occupational therapy philosophy of using functional and meaningful activities in practice as well as the profession’s use of evidence-based practice in stroke rehabilitation.

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