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Evaluation of stroke rehabilitation by randomized controlled studies: a review
Author(s) -
PedroCuesta J.,
WidénHolmqvist L.,
BachyRita P.
Publication year - 1992
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1992.tb05119.x
Subject(s) - rehabilitation , randomized controlled trial , stroke (engine) , physical medicine and rehabilitation , physical therapy , medicine , surgery , engineering , mechanical engineering
In all, 22 reports of 20 randomized, controlled rehabilitation studies were evaluated. In 18 of these, the design of the trial was parallel, with a cross‐over format being employed in the remaining 2 instances. Seven studies related to intensive rehabilitation during the early post‐acute period. In six others, specific techniques ‐ sometimes associated with traditional physiotherapy procedures ‐ were compared: biofeedback, perceptual retraining, and amphetamine treatment. Eight experiments evaluated speech therapy in aphasia. Frequently, methodological considerations limited the interpretation of the results. The review showed that: 1) as regards activities of daily life and motor function, differences as between rehabilitation in stroke units on the one hand and non‐rehabilitation or rehabilitation in medical wards on the other, were detected in relatively few quality studies and remained particularly inconclusive insofar as life in the home environment was concerned; 2) rehabilitation for aphasia and perceptual dysfunction proved effective for at least several months after acute stroke; 3) in general, examination of the reports cited revealed no differences in the effects of biofeedback and perceptual retraining vs conventional physiotherapy; 4) rehabilitation, whether administered by specialists or amateur caregivers purpose‐trained by specialists, proved equally effective for aphasia. These conclusions constitute a valuable basis for the development and evaluation of modern rehabilitation programs for stroke patients.