Deans' stroke musings: Bilateral arm training in the chronic phase of stroke rehabilitation: a systematic review and meta-analysis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, March 10, 2015

Bilateral arm training in the chronic phase of stroke rehabilitation: a systematic review and meta-analysis

I hate these studies that never explain what the therapy protocols were that were used.
https://ojs.library.dal.ca/DMJ/article/view/5439
The full 9 pages are available by clicking on the Full Text PDF link.

Rachel Mays, Amanda McIntyre, Cecilia Kwok, Robert Teasell

Abstract

Objective: Bilateral arm training (BAT) is an intervention utilized in rehabilitating upper-extremity paresis. The objective of this study was to conduct a systematic review and meta-analysis on the evidence for BAT on upperlimb paresis in the chronic phase of stroke.
Methods: A literature search of multiple databases (MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, OT Seeker ) was conducted for relevant randomized controlled trials (RCTs) published in the English language that met inclusion criteria. Studies must have included BAT as part of treatment and participants must have been ≥6 months post stroke. Methodological quality of each study was assessed using the PEDro scale (maximum score=10).
Results: Eight RCTs satisfied the inclusion criteria (PEDro scores 1-7) for a total pooled sample size of 131 subjects (88 males and 43 females). The mean age of subjects was 57.6±4.1 years (range 50.7-64.8 years) and the mean time since stroke was 43.8±34.8 months (range 13.9-114.0 months). Among study endpoints, only the Fugl-Meyer Assessment tool showed significant improvement in motor impairment whereby the BAT groups improved, on average, 3.77 points whereas the control group improved just 1.23 points (Difference of Means = 1.46±0.662; p=0.028).
Conclusion: Overall, BAT showed a general trend in improvement over standard therapy, although it was not statistically significant. Future studies with improved methodological quality (e.g., strict inclusion criteria, protocol standardization) and larger sample sizes are needed to appropriately assess the benefit of BAT in stroke patients.