Stewart Claire, McCluskey Annie, Ada Louise, Kuys Suzanne
Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia.
Aust Occup Ther J. 2017 Jun;64(3):204-217. doi: 10.1111/1440-1630.12351. Epub 2017 Jan 10.
BACKGROUND/AIM: Improved motor performance is related to the amount of practice completed after a stroke. Australian guidelines recommend that at least one hour of active practice should be completed per day. Yet active practice levels remain low. The aims of this scoping review were to describe how extra practice at the activity level is structured for stroke survivors, and explore the feasibility of participants completing extra practice.
A systematic search was conducted of five electronic databases up to August 2015. Trials were included when the intended dose of the control intervention was less than the experimental intervention. The structure of extra practice was classified by the level of supervision, type of personnel, and whether equipment was used. Feasibility of practice was explored by comparing the intended and actual dose of practice completed.
Thirty-five trials, comprising 40 comparisons were included. Multiple configurations of personnel, supervision and equipment were used to structure extra practice. The structure most often used was full supervision by staff without equipment (30 comparisons), typically involving a therapist (17 comparisons), with equipment being used occasionally (12 comparisons). Sixteen comparisons reported both the intended and the actual dose of extra practice completed. The mean percentage of actual extra practice completed was 80% (SD 18) of the intended dose.
Extra practice during rehabilitation after stroke is most often structured using full supervision by a therapist, and appears feasible for stroke survivors to complete. Less often, extra practice is structured using equipment, non-therapists and/or group classes.
背景/目的：运动功能的改善与中风后完成的练习量有关。澳大利亚指南建议每天至少完成一小时的主动练习。然而，主动练习水平仍然较低。本范围综述的目的是描述中风幸存者在活动层面的额外练习是如何组织的，并探讨参与者完成额外练习的可行性。
截至2015年8月，对五个电子数据库进行了系统检索。当对照干预的预期剂量低于实验干预时，纳入试验。额外练习的组织方式根据监督水平、人员类型以及是否使用设备进行分类。通过比较预期和实际完成的练习剂量来探讨练习的可行性。
纳入了35项试验，包括40项比较。人员、监督和设备的多种配置被用于组织额外练习。最常用的组织方式是由工作人员进行全程监督且不使用设备（30项比较），通常涉及治疗师（17项比较），偶尔使用设备（12项比较）。16项比较报告了额外练习的预期剂量和实际完成剂量。实际完成的额外练习的平均百分比为预期剂量的80%（标准差18）。
中风后康复期间的额外练习最常采用由治疗师全程监督的方式组织，对中风幸存者来说似乎可行。较少采用的方式是使用设备、非治疗师和/或团体课程来组织额外练习。
