Effects of physical therapy-based rehabilitation on recovery of upper limb motor function after stroke in adults: a systematic review and meta-analysis of randomized controlled trials.

ABSTRACT

BACKGROUND: Limb hemiplegia is one of the common sequelae of stroke. Physical therapy-based rehabilitation training can rapidly improve limb functioning and muscle strength. This study investigated the effect of physical therapy on the recovery of upper limb motor function by employing a literature search and meta-analysis. METHODS: We searched Embase, The Cochrane Central Register of Controlled Trials library, Wiley online library, PubMed, Ovid, and Clinicaltrials.org for randomized controlled trial (RCT) studies and performed an electronic search with the keyword combinations 'physical therapy/rehabilitation' & 'stroke/post-stroke' & 'upper extremity/upper limb'. After screening the literature for inclusion criteria and assessing the risk of bias, Revman 5.4 software was used for the analysis and to obtain forest and funnel plots. RESULTS: A total of 15 RCTs with 1,081 patients were included in the quantitative analysis for this study. The meta-analysis results showed that compared with conventional therapy, physical therapy improved the upper limb Fugl-Meyer Assessment for Upper Extremity (FMA) scores in convalescent stroke patients (MD =7.27, 95% CI 4.23-10.32, Z=4.68, P<0.00001), and increased the Functional Independence Measure (FIM) scores (MD =18.82, 95% CI 6.34-31.30, Z=2.96, P=0.003), the Action Research Arm Test (ARAT) scores (MD =8.84, 95% CI 6.53-11.15, Z=7.50, P<0.00001), and the Box and Block Test (BBT) scores (MD =6.11, 95% CI 1.18-11.04, Z=2.43, P=0.02) of patients during the rehabilitation period. DISCUSSION: The use of physical therapy-based rehabilitation training in the recovery period for stroke patients with hemiplegia can improve upper limb movement ability, increase muscle strength, reduce limb pain, and improve the quality of life.