The dosage dependent effects of upper limb rehabilitation in chronic neurological patients

Abstract

The aim of this systematic review is to investigate the dose-dependent effects of upper limb rehabilitation in chronic neurological patients. Web Of Science and PubMed were used to search for RCTs. Eleven articles were found which investigated the dose-dependent effects of upper limb rehabilitation in stroke patients. Five articles found significant differences in favor of the high dose intervention group(s). Five articles concluded there were no significant between-group differences. One article found significant differences in disadvantage of the high dose intervention group. The results of this review did not allow an unambiguous conclusion as to whether a higher dose of a rehabilitation strategy has more beneficial effects. Several explanations were found: The first one is the differences in baseline characteristics such as age, time post stroke,... They may all have an influence. Thereby the different types and amounts of dose that are used may affect the results as well. Finally, the most influential factor may be the differences in the intervention strategies that are used. Aim of the research protocol: To compare modified constraint induced movement therapy (mCimt) with a dose matched standard care program in subacute stroke patients. A sample is randomized in two groups: one group receiving mCIMT and the other group dose matched standard care. Upper limb capacity measures will be taken before, after two weeks of training and one month post-intervention.