Psychological Interventions to Improve Upper Limb Motor Dysfunction Post-stroke: A Scoping Review.

Cognitive strategies in post-stroke patients significantly influence upper limb motor function recovery. Integrating upper extremity and psychological interventions may enhance rehabilitation outcomes. This scoping review aimed to summarize studies evaluating the effectiveness of combining these approaches to improve upper extremity motor dysfunction in patients with post-stroke syndrome. Randomized controlled trials (RCTs) comparing combined upper extremity and psychological interventions versus upper extremity interventions alone were included. Studies published between November 25, 2024, and the study's conclusion were retrieved from PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Cumulative Index to Nursing and Allied Health Literature. Only English-language studies were reviewed. Three RCTs met the inclusion criteria. Two studies utilized cognitive orientation to daily occupational performance (CO-OP), while one employed cognitive-oriented strategy training augmented rehabilitation (COSTAR). The CO-OP studies demonstrated that combined psychological and physical interventions significantly improved motor function compared to physical interventions alone. However, the COSTAR-based study reported greater efficacy for upper extremity interventions alone. This review highlighted the mixed efficacy of combined interventions. While CO-OP showed potential benefits, the COSTAR findings suggest variability in the effectiveness of different cognitive strategies. Both approaches prioritized activity and goal setting rather than directly targeting motor recovery. Although the findings are inconclusive, this is the first review to explore the role of combined psychological and upper extremity interventions for post-stroke motor dysfunction, providing a foundation for further research.