What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis

J.M. Veerbeek, E.E.H. van Wegen, R. van Peppen, P.J. van der Wees, E. Hendriks, M.B. Rietberg, G. Kwakkel

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Abstract

Background: Physical therapy (PT) is one of the key disciplines in interdisciplinary stroke rehabilitation. The aim of this systematic review was to provide an update of the evidence for stroke rehabilitation interventions in the domain of PT. Methods and Findings: Randomized controlled trials (RCTs) regarding PT in stroke rehabilitation were retrieved through a systematic search. Outcomes were classified according to the ICF. RCTs with a low risk of bias were quantitatively analyzed. Differences between phases poststroke were explored in subgroup analyses. A best evidence synthesis was performed for neurological treatment approaches. The search yielded 467 RCTs (N = 25373; median PEDro score 6 [IQR 5-7]), identifying 53 interventions. No adverse events were reported. Strong evidence was found for significant positive effects of 13 interventions related to gait, 11 interventions related to arm-hand activities, 1 intervention for ADL, and 3 interventions for physical fitness. Summary Effect Sizes (SESs) ranged from 0.17 (95%CI 0.03-0.70; I
Original languageEnglish
Article numbere87987
JournalPLOS ONE
Volume9
Issue number2
DOIs
Publication statusPublished - 2014

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