a Department of Rehabilitation Services , Northwestern Memorial Hospital , Chicago , USA.
b Department of Rehabilitation Services , Barnes Jewish Hospital , St. Louis , MO.
Top Stroke Rehabil. 2019 Jul;26(5):389-398. doi: 10.1080/10749357.2019.1599172. Epub 2019 Apr 7.
: Orthoses for individuals with stroke is considered an integral part of the neurorehabilitation process. However, there are no universal guidelines to determine the initiation period, duration, or type of orthosis for stroke patients. : For this study, we systematically reviewed the evidence surrounding the use of orthoses for stroke-related upper extremity deficits. : Medical librarians searched MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Health Technology Assessment Database, Physiotherapy Evidence Database, and OTSeeker using subject headings and keywords related to upper extremities, orthoses, and stroke. The resulting articles were evaluated for inclusion by the systematic review team. Articles that met the inclusion criteria were appraised for content and quality using the "Evaluation Guidelines for Rating the Quality of an Intervention Study (EQIS). : 14 studies were included, with the mean score of 31.29 (out of 48) for the EQIS using an ordinal scale with a range of 23-43.6 studies produced significant outcomes with effect sizes ranging from d = .52 (wrist flexion PROM) to d = 9.02 (patient satisfaction with orthosis). : Future studies should aim to utilize homogenous outcome measures while exploring variability in dosage and level of upper extremity impairment upon initiation. Additionally, universal guidelines for initiation period, duration, and type of orthosis for patients post-stroke need to be established.
矫形器用于中风患者被认为是神经康复过程的一个组成部分。然而,目前没有确定中风患者开始使用矫形器的时间、持续时间或类型的通用指南。
在这项研究中,我们系统地回顾了与中风相关上肢功能障碍使用矫形器的证据。医学图书馆员使用与上肢、矫形器和中风相关的主题词和关键词,在 MEDLINE、EMBASE、CINAHL、Cochrane 系统评价数据库、Cochrane 对照试验登记处、卫生技术评估数据库、物理治疗证据数据库和 OTSeeker 中进行了搜索。系统评价团队对检索到的文章进行了评估,以确定是否符合纳入标准。符合纳入标准的文章使用等级量表(范围为 23-43),EQIS 评分为 31.29 分(满分 48 分),对内容和质量进行了评估。14 项研究符合纳入标准,其中 10 项研究报告了上肢运动范围(ROM)的结果,4 项研究报告了握力的结果,而 14 项研究报告了患者满意度的结果。
未来的研究应该旨在使用同质的结果测量方法,同时探索起始时上肢损伤程度和剂量的变异性。此外,需要为中风后患者制定开始使用矫形器的时间、持续时间和类型的通用指南。