Last Updated: 2007-11-02 17:46:21 -0400 (Reuters Health)
NEW YORK (Reuters Health) – Repetitive task training that simulates everyday leg function can improve mobility after stroke, according to a new review of studies published in the latest issue of the Cochrane Library.
"Stroke is still the major cause of long-term neurological disability in adults," note Dr. Beverley French, of the University of Central Lancashire, England, and colleagues. "In the acute stage of stroke approximately half of all stroke survivors are left with severe functional problems."
To see if repetitive task training can ameliorate these problems, the investigators conducted a systematic review of studies in which adult stroke survivors repeatedly practiced everyday tasks or movements associated with these tasks, such as buttoning clothes, walking up steps, reaching for items, or standing from a sitting position.
A total of 14 trials with 659 patients were included in the analysis. The interventions usually consisted of 1-hour sessions, three to five times a week for 6 to 8 weeks.
Results were significant for walking distance in 6 minutes (mean difference 54.6 meters), walking speed (standardized mean difference 0.29), and sit-to-stand time (standard effect estimate 0.35).
Results were of borderline significance for functional ambulation and global motor function. No significant differences were found for hand/arm function, or sitting balance/reach.
The investigators report that results were significant for activities of daily living, but not for quality of life or impairment measures. No evidence of adverse effects was found.
The authors note that it is unclear whether the gains in leg mobility were permanent.
The findings "provide sufficient evidence to validate the general principle that repetitive, task-specific training for lower limbs can result in functional gain when compared against other forms of usual care or attention control," Dr. French’s team concludes.
Cochrane Database Syst Rev 2007.
