Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis.
OBJECTIVE
To determine if repetitive task training after stroke improves functional activity.


METHODS
Systematic review and meta-analysis of trials comparing repetitive task training with attention control or usual care.


METHODS
The Cochrane Stroke Trials Register, electronic databases of published, unpublished and non-English language papers; conference proceedings, reference lists, and trial authors.


METHODS
Included studies were randomized/quasi-randomized trials in adults after stroke where an active motor sequence aiming to improve functional activity was performed repetitively within a single training session. We used Cochrane Collaboration methods, resources, and software.


RESULTS
We included 14 trials with 17 intervention-control pairs and 659 participants. Results were statistically significant for walking distance (mean difference 54.6, 95% confidence interval (95% CI) 17.5, 91.7); walking speed (standardized mean difference (SMD) 0.29, 95% CI 0.04, 0.53); sit-to-stand (standard effect estimate 0.35, 95% CI 0.13, 0.56), and activities of daily living: SMD 0.29, 95% CI 0.07, 0.51; and of borderline statistical significance for measures of walking ability (SMD 0.25, 95% CI 0.00, 0.51), and global motor function (SMD 0.32, 95% CI -0.01, 0.66). There were no statistically significant differences for hand/arm functional activity, lower limb functional activity scales, or sitting/standing balance/reach.


CONCLUSIONS
Repetitive task training resulted in modest improvement across a range of lower limb outcome measures, but not upper limb outcome measures. Training may be sufficient to have a small impact on activities of daily living. Interventions involving elements of repetition and task training are diverse and difficult to classify: the results presented are specific to trials where both elements are clearly present in the intervention, without major confounding by other potential mechanisms of action.
French
Beverley
B
School of Nursing and Caring Sciences, University of Central Lancashire, Preston, PR1 2HE, UK. bfrench1@uclan.ac.uk
Thomas
Lois
L
Leathley
Michael
M
Sutton
Christopher
C
McAdam
Joanna
J
Forster
Anne
A
Langhorne
Peter
P
Price
Christopher
C
Walker
Andrew
A
Watkins
Caroline
C
D000203:Activities of Daily Living; D000328:Adult; D001132:Arm / Q000503:physiopathology; D006801:Humans; D007866:Leg / Q000503:physiopathology; D009043:Motor Activity / Q000502:physiology; D009068:Movement / Q000502:physiology; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology