J Rehabil Med. 2020 Oct 29;52(10):jrm00118. doi: 10.2340/16501977-2738.
To investigate the effectiveness of self-administered, home-based, upper limb practice in improving upper limb activity after stroke. To compare structured home-based practice vs non-structured home-based practice.
Databases were searched for randomized or quasi-randomized controlled trials using a pre-defined search strategy. Data were extracted from 15 studies involving 788 participants. The quality of included studies was assessed using the PEDro scale. The studies included an experimental group that received self-administered, home-based practice for upper limb activity limitations of any level of severity and any time after stroke, and a control group that received no intervention, or received non-structured home-based practice. Only measures of upper limb activity were investigated.
Self-administered, home-based practice did not improve activity compared with no intervention (standardized mean difference 0.00, 95% confidence interval; -0.47 to 0.48). There was no difference between structured and non-structured home-based practice in terms of upper limb activity (SMD -0.05, 95% CI -0.22 to 0.13).
Existing self-administered, home-based practice is not more effective than no intervention in improving upper limb activity in chronic, severely disabled stroke survivors. Structured home-based practice is no more effective than non-structured home-based practice.
探究自我管理的家庭上肢练习对改善脑卒中后上肢活动的有效性。比较结构化家庭实践与非结构化家庭实践。
使用预先确定的搜索策略，在数据库中搜索随机或半随机对照试验。从涉及 788 名参与者的 15 项研究中提取数据。使用 PEDro 量表评估纳入研究的质量。研究包括实验组，接受自我管理的家庭上肢活动练习，针对任何严重程度和任何脑卒中后时间的上肢活动限制，对照组未接受干预，或接受非结构化家庭实践。仅调查上肢活动的措施。
与无干预相比，自我管理的家庭实践并未改善活动（标准化均数差 0.00，95%置信区间；-0.47 至 0.48）。结构化家庭实践与非结构化家庭实践在改善上肢活动方面没有差异（SMD-0.05，95%CI-0.22 至 0.13）。
现有的自我管理的家庭实践在改善慢性、严重残疾的脑卒中幸存者上肢活动方面并不优于无干预。结构化家庭实践并不优于非结构化家庭实践。
