[Evidence-based arm rehabilitation--a systematic review of the literature].
Based on a systematic MEDLINE search and informal sources, 40 references were identified that evaluate training therapy or neuromuscular electric stimulation for arm paresis after stroke and describe either a systematic review, meta-analysis, randomised controlled trial, or controlled cohort study. The evidence was grouped into three areas of interest: comparison of physiotherapy schools, effects of intensity of training, and efficacy of specific arm rehabilitation techniques. The only physiotherapy school with evidence of superior efficacy was the task-oriented 'motor relearning programme'. Higher intensities of motor rehabilitation can accelerate motor recovery. Various training techniques with demonstrated efficacy are available for specific patient subgroups: arm ability training for mildly affected patients with reduced efficiency of motor control, constrained-induced movement therapy for patients with partial functional deficits and learned nonuse of the affected arm, and repetitive sensorimotor training techniques, EMG-biofeedback, functional electrical stimulation, and robot-assisted training for patients with severe arm paresis.
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Abteilung für Neurologische Rehabilitation am UKBF der FU Berlin, Klinik Berlin.
D001132:Arm / Q000294:innervation*; D001676:Biofeedback, Psychology; D019317:Evidence-Based Medicine; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D015201:Meta-Analysis as Topic; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012371:Robotics; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted