Time Post-Stroke and Upper Extremity Stroke Motor Recovery Rehabilitation: A Meta-Analysis.
Sarvenaz Mehrabi, Cecilia Flores-Sandoval, Jamie L Fleet and 3 others
PMID 40698597WHAT IT FOUND
Upper extremity rehabilitation interventions improved motor function scores in both early and late stroke phases, but gains were larger in the acute/subacute phase.
High-frequency brain stimulation and constraint-induced therapy showed the biggest early benefits. Chronic-phase trials may underestimate treatment effects.
Key findings
01Interventions in the acute/subacute phase produced a mean difference of 5.04 points on the Fugl-Meyer Assessment Upper Extremity, compared to 2.14 points in the chronic phase.
02High-frequency repetitive transcranial magnetic stimulation, theta-burst stimulation, and modified constraint-induced movement therapy showed the largest early treatment effects, with mean differences exceeding 9 points.
03Of the interventions studied in both phases, only bilateral arm training showed a greater benefit in the chronic phase than in the acute/subacute phase.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study did not register a protocol beforehand. Only English-language studies were included, potentially missing relevant trials. Most trials had a high or unclear risk of bias, particularly regarding blinding of therapists and participants. The analysis used total FMA-UE scores, so it cannot determine which specific motor functions (e.g., hand vs. shoulder) improved. It is unclear if patients with more severe initial deficits benefited equally from the interventions.
Declared interests
The authors declared no conflicts of interest. Funding was provided by the Heart and Stroke Foundation of Canada, the St. Joseph’s Health Care (London) Foundation, and the CanStroke Recovery Trials Platform.
The easy way to misread this
Do not assume that a lack of significant improvement in chronic-phase trials means an intervention is ineffective. The study suggests that chronic-phase research may underestimate treatment benefits compared to trials conducted in the acute/subacute phase.
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 →