Does more rehabilitation lead to better upper limb outcomes after stroke? A systematic review.
Manush Patel, Ines Serrada, Brenton Hordacre
PMID 41847569WHAT IT FOUND
Increasing upper-limb therapy dose showed a positive effect on Fugl-Meyer scores but not on Action Research Arm Test scores overall.
Significant gains on the arm test only appeared when therapy time was more than doubled, suggesting a high dose is needed for functional change.
Key findings
01Pooled analysis of Fugl-Meyer Assessment scores showed a significant mean difference of 6.73 points favouring higher therapy doses.
02Pooled analysis of Action Research Arm Test scores showed no statistically significant difference between low and high therapy doses.
03Subgroup analysis revealed that a therapy dose increase of 200% or more resulted in a significant mean difference of 13.86 points on the Action Research Arm Test.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included only four studies with a small total sample size of 151 participants, leading to imprecise estimates. All included studies had some concerns regarding risk of bias, particularly due to lack of blinding and allocation concealment issues. Only one study provided data for the Fugl-Meyer Assessment meta-analysis, limiting the generalisability of that finding. The definition of 'high dose' varied across studies, and the specific therapy protocols differed, making direct comparison difficult. Most participants were in the chronic phase of stroke, so results may not apply to acute or early subacute patients.
Declared interests
The authors declared that no financial support was received for this work or its publication.
The easy way to misread this
Do not assume that any increase in therapy duration will improve function. The overall analysis of functional outcomes was not significant, and benefits on the Action Research Arm Test were only seen when therapy time was increased by 200% or more.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →