The effect of adding trunk restraint to task-oriented training in improving function in stroke patients: A systematic review and meta-analysis

Article type: Review Article

Authors: Zhang, Qing^{a; b; 1} | Fu, Chenying^{b; c; 1} | Liang, Zejun^{a; b} | Peng, Lihong^{a; b} | Xiong, Feng^{a; b} | Chen, Li^{a; b} | He, Chengqi^{a; b} | Wei, Quan^{a; b; *}

Affiliations: [a] Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China | [b] Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China | [c] State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China

Correspondence: [*] Address for correspondence: Dr. Quan Wei, Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. E-mail: weiquan@scu.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: BACKGROUND:The effectiveness of trunk restraint on post-stroke arm motor function and daily function remain controversial. OBJECTIVE:To evaluate the effect of adding trunk restraint to task-oriented rehabilitation of arm motor function and functional ability after stroke. METHODS:Nine databases were systematically searched for randomized controlled trials studying the effects of trunk restraint in post-stroke task-oriented training. Researchers assessed methodological qualities using the Physiotherapy Evidence Database scale, and extracted data related to study participants, intervention, and outcomes. The overall effectiveness was calculated using a meta-analytic method. RESULTS:In total, ten articles met the inclusion criteria and nine trails (n = 255 subjects) were included in quantitative analyses. Meta-analysis revealed that trunk restraint exhibited a significant improvement on the Motor Activity Log-amount of use, 0.39 (95% CI: 0.25– 0.54), the Motor Activity Log-quality of movement, 0.45 (95% CI: 0.27– 0.63), the Fugl-Meyer Assessment (upper extremity), 1.09 (95% CI: 0.67– 1.51), Action Research Arm test, 4.51 (95% CI: 2.49– 6.54) and performance of Activities of daily living, 1.70 (95% CI: 0.19– 3.21) in trunk restraint group in patients at subacute stage, compared to the non-trunk restraint group, but no significant difference was found in patients with chronic stroke. CONCLUSIONS:Adding trunk restraint to task-oriented training may improve function in patients with subacute stroke.

Keywords: Stroke, trunk restraint, task-oriented training, upper extremity, functional performance

DOI: 10.3233/NRE-192964

Journal: NeuroRehabilitation, vol. 46, no. 1, pp. 95-108, 2020