Dembele Justine, Triccas Lisa Tedesco, Amanzonwé Lisa Elogni Renaud, Kossi Oyéné, Spooren Annemie
REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
Department of Rehabilitation, National Reference Centre of Physical Medicine and Rehabilitation, Ouagadougou, Burkina Faso.
S Afr J Physiother. 2024 Jan 23;80(1):1985. doi: 10.4102/sajp.v80i1.1985. eCollection 2024.
Integrating high dosage bilateral movements to improve upper limb (UL) recovery after stroke is a rehabilitation strategy that could potentially improve bimanual activities.
This study aims to compare the effects of bilateral with unilateral UL training on upper limb impairments and functional independence in (sub)acute stroke.
Five electronic databases (PubMed, Scopus, PEDro, ScienceDirect, Web of Science) were systematically searched from inception to June 2023. Randomised controlled trials comparing the effect of bilateral training to unilateral training in stroke survivors (< 6 months poststroke) were included. The treatment effect was computed by the standard mean differences (SMDs).
The review included 14 studies involving 706 participants. Bilateral training yielded a significant improvement on UL impairments measured by FMA-UE compared to unilateral training (SMD = 0.48; 95% CI: 0.08 to 0.88; = 0.02). In addition, subgroup analysis based on the severity of UL impairments reported significant results in favour of bilateral UL training in improving UL impairments compared to unilateral training in "no motor capacity" patients (SMD = 0.66; 95% CI: 0.16 to 1.15; = 0.009). Furthermore, a significant difference was observed in favour of bilateral UL training compared to unilateral UL training on daily activities measured by Functional Independence Measure (SMD = 0.45; 0.13 to 0.78; = 0.006).
Bilateral UL training was superior to unilateral training in improving impairments measured by FMA-UE and functional independence in daily activities measured by Functional Independence Measure in (sub)acute stroke.
Bilateral upper limb training promotes recovery of impairments and daily activities in (sub)acute phase of stroke.
整合高剂量双侧运动以改善中风后上肢（UL）恢复是一种康复策略，可能会改善双手活动能力。
本研究旨在比较双侧与单侧上肢训练对（亚）急性中风患者上肢损伤和功能独立性的影响。
系统检索了五个电子数据库（PubMed、Scopus、PEDro、ScienceDirect、Web of Science），检索时间从建库至2023年6月。纳入比较双侧训练与单侧训练对中风幸存者（中风后<6个月）影响的随机对照试验。治疗效果通过标准平均差（SMD）计算。
该综述纳入了14项研究，涉及706名参与者。与单侧训练相比，双侧训练在通过FMA-UE测量的上肢损伤方面有显著改善（SMD = 0.48；95%CI：0.08至0.88；P = 0.02）。此外，基于上肢损伤严重程度的亚组分析报告了显著结果，表明与“无运动能力”患者的单侧训练相比，双侧上肢训练在改善上肢损伤方面更具优势（SMD = 0.66；95%CI：0.16至1.15；P = 0.009）。此外，在通过功能独立性测量评估的日常活动方面，与单侧上肢训练相比，双侧上肢训练也有显著差异（SMD = 0.45；0.13至0.78；P = 0.006）。
在（亚）急性中风中，双侧上肢训练在改善通过FMA-UE测量的损伤以及通过功能独立性测量评估的日常活动功能独立性方面优于单侧训练。
双侧上肢训练可促进中风（亚）急性期损伤的恢复和日常活动能力。
