Home-based interactive therapy for improving upper limb function in stroke patients: Systematic review and meta-analysis

ABSTRACT

Background: stroke is one of most common causes of motor impairment, and most of stroke patients remain their life with residual upper limb function which needs long-term of rehabilitation at hospitals or rehab centres. Spread of COVID19 around the world prevent hospital admission for long period,so many patients continue their treatment at home Objective: to detect the role of home-based interactive therapy in improving upper limb function post stroke. Data sources Electronic databases of PubMed, Cochrane library and Google scholar were searched up to May 2021, in addition to manual search of reference lists of relevant studies and reviews. Methods: Randomized controlled trials were included if they involved any form of home-based interactive therapy. Two authors independently screened articles, extracted data, and assessed the methodological quality using the PEDro scale, with any conflict resolved by the third author. Modified Sackett's Scale was used to determine the level of evidence for each outcome. Because of the clinical heterogeneity between the included studies;only 2 studies were appropriate for meta-analysis. Results: Out of 583 records screened, 3studies with 286 participants met the inclusion criteria. The duration of treatment ranged from 30 to 60 min, 5-6 times a week and for 5–8weeks. The quality of studies was good for the 3 studies, with a mean PEDro score of 6.3out of 10. All included studies showed positive effects in the measured outcomes. The results showed level1a evidence for the effectiveness of home-based interactive therapy in improving upper extremity function post stroke. Meta-analysis of 2 included trials used the action research arm score test showed no significant difference (P=0.28) in the overall effect of (SMD= -0.14;95% CI) between intervention and control groups Conclusion: Findings of this review found a strong evidence that home-based interactive therapy for stroke patients can improve their upper limb function but its effect is not superior to conventional therapy. This evidence is based on a limited number of RCTs and more high-quality RCTs are needed to support this evidence.