Effect Of Early Intensive Physiotherapy For Upper Limb After Stroke: A Mata-Analysis

OBJECTIVES: To review systematically whether there was enough existing evidence that early Enhanced physical therapy is effective and safe in treatment hemiplegia upper limb of patients with accute cerebrovascular accident.METHODS: A Cochrane systematic review of randomized or quasi-randomized controlled trials of Enhanced physical therapy for upper limb function of early stroke patients was performed. Enhanced physical therapy compared with normal physical therapy in patients with ischaemic and / or haemorrhagic stroke.Trials were searched from Cochrane Stroke group Trial Register Issue 4, 2006, Cochrane Controlled trials Register Issue 4, 2006, Embase (1974-2006),Pubmed(1966-2006), the Chinese Biological Medicine Database (1978-2006), CNKI journal full text Database(1994-2006), VP journal of science and technology(1989-2006), the Chinese stroke trials Register and reference of all included trials. The reviewer independently assessed trials quality and extracted the data. The following outcomes were assessed: movement function of upper limb(ARAT ),ADL, death or dependency,changes of quality of life at the end of follow-up, and changes of neurological deficits score.RESULTS: Six trials involving 667 patients met the inclusion criteria. Three trials using blinding measured outcome was of relatively high quality. Impairment of upper limb in early intensive physiotherapy group at the end of follow-up as compared with normal physiotherapy group was not founded statistically significant. The results of the Meta-analysis suggest that early intensive physiotherapy may do not reduce mortality and disability for stoke patients , which can not improve ADL. Global neurologic impairment may not be improved at the end treatment and follow-up, Early intensive physiotherapy may improve quality of life of stoke patient but that this effect is transient and of limited scale.CONCLUSIONS : There was insufficient evidence to draw definitive conclusions about the effectiveness of early intensive physiotherapy on arm function in stroke patients. Larger trials with high quality methodology are required in future.