Hansen Ricky J, Joy Anna, Lockwood Kylee J
Occupational Therapy, Eastern Health, Box Hill, Victoria, Australia.
Occupational Therapy, School of Primary and Allied Health Care, Monash University, Australia.
Disabil Rehabil. 2025 May 2:1-9. doi: 10.1080/09638288.2025.2496361.
To synthesise evidence on the effectiveness of modified constraint-induced movement therapy on upper limb function in stroke survivors within inpatient hospital settings.
A systematic review was pre-registered in PROSPERO (CRD42023421715b) and searched six databases (EMBASE, AMED, MEDLINE, CINAHL, Cochrane Library, OTseeker) up to November 2024.
Articles included adults with stroke undergoing modified constraint-induced movement therapy in inpatient hospital settings. Article quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Homogenous data was synthesised in a meta-analysis and assessed using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Remaining data was synthesised descriptively.
Ten randomised controlled trials (364 participants) were included. Four (191 participants) were analysed in a meta-analysis, showing modified constraint-induced movement therapy improved upper limb function (standardised mean difference (SMD) 0.94, 95% confidence interval (CI) 0.40 to 1.48), based on low-quality evidence. Five articles included follow-up, with two (90 participants) reporting sustained improvements. Five articles assessed activities of daily living, with two (136 participants) reporting positive effects.
Modified constraint-induced movement therapy improves upper limb function in the acute and sub-acute stages of stroke recovery within inpatient hospital settings. Sustainability of improvements and the impact on activities of daily living remains uncertain.
综合关于改良强制性运动疗法对住院脑卒中幸存者上肢功能有效性的证据。
一项系统评价在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023421715b）进行了预注册，并检索了截至2024年11月的六个数据库（EMBASE、AMED、MEDLINE、CINAHL、Cochrane图书馆、OTseeker）。
纳入的文章涉及在住院环境中接受改良强制性运动疗法的成年脑卒中患者。使用物理治疗证据数据库（PEDro）量表评估文章质量。同质数据在荟萃分析中进行综合，并使用推荐分级、评估、制定与评价（GRADE）方法进行评估。其余数据进行描述性综合。
纳入了10项随机对照试验（364名参与者）。其中4项试验（191名参与者）进行了荟萃分析，结果显示基于低质量证据，改良强制性运动疗法改善了上肢功能（标准化均数差（SMD）为0.94，95%置信区间（CI）为0.40至1.48）。5篇文章包含随访内容，其中2篇（90名参与者）报告了持续改善情况。5篇文章评估了日常生活活动，其中2篇（136名参与者）报告了积极效果。
改良强制性运动疗法可改善住院脑卒中恢复急性期和亚急性期患者的上肢功能。改善的可持续性以及对日常生活活动的影响仍不确定。
