A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke

Systematic Reviews

Sharon F. Kramer¹  Julie Bernhardt¹  Tina Kaffenberger¹  Julie Ratcliffe²  Laura Jolliffe³  Dale Corbett⁴  Geoffrey Cloud⁵  Amy Brodtmann⁶  Kathryn S. Hayward⁷  Leonid Churilov⁸  Natasha A. Lannin⁹  Vincent Thijs^1,10  Nick S. Ward^1,11 

[1] AVERT Early Rehabilitation Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health;College of Nursing and Health Sciences, Flinders University;College of Science, Health and Engineering, La Trobe University;Department of Cellular and Molecular Medicine, University of Ottawa and Canadian Partnership for Stroke Recovery;Department of Neurology, Alfred Health;Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health;Melbourne School of Health Sciences, University of Melbourne;NHMRC CRE in Stroke Rehabilitation and Brain Recovery, University of Melbourne;Occupational Therapy Department, Alfred Health;Stroke Theme, Florey Institute of Neuroscience and Mental Health and Neurology Department, Austin Health;UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery;

关键词: Stroke;    Upper limb;    Systematic review;    Protocol;    Therapy;    Rehabilitation;   

DOI  :  10.1186/s13643-019-1093-6

来源: DOAJ

【 摘 要 】

Abstract Background Improving upper limb (UL) motor recovery after stroke represents a major clinical and scientific goal. We aim to complete three systematic reviews to estimate the (1) association between time to start of UL therapy and motor recovery, (2) relative efficacy of different UL therapy approaches post-stroke and (3) cost-effectiveness of UL therapy interventions. Methods We have designed a systematic review protocol to address three systematic review questions that were each registered with PROSPERO. The search will be conducted in MEDLINE, EMBASE, and Cochrane Controlled Register of Trials. We will include randomised controlled trials, non-randomised clinical trials, before-after studies and observational studies of adult stroke survivors with an average stroke onset < 6 months, undergoing hospital-based therapy to improve UL function. Eligible interventions will aim to promote UL functional recovery. Two reviewers will independently screen, select and extract data. Study risk of bias will be appraised using appropriate tools. Clinical measures of motor recovery will be investigated (primary measure Fugl Meyer UL assessment), as well as measures of health-related quality of life (primary measure EQ-5D) and all cost-effectiveness analyses completed. Secondary outcomes include therapy dose (minutes, weeks, repetitions as available) and safety (i.e. adverse events, serious adverse events). A narrative synthesis will describe quality and content of the evidence. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion We anticipate the findings of this review will increase our understanding of UL therapy and inform the generation of novel, data-driven hypotheses for future UL therapy research post-stroke. Systematic review registration PROSPERO, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018019367, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018111629, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018111628.

【 授权许可】

Unknown