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Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review

OBJECTIVE: The objectives of this systematic review were to describe the current dose and content of usual care upper limb motor intervention for inpatients following stroke and examine if context factors alter dose and content. DATA SOURCES: A systematic search (EMBASE, MEDLINE) was completed from...

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Autores principales: Newton, Sarah P, Dalton, Emily J, Ang, Jia Y, Klaic, Marlena, Thijs, Vincent, Hayward, Kathryn S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492439/
https://www.ncbi.nlm.nih.gov/pubmed/37151039
http://dx.doi.org/10.1177/02692155231172295
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author Newton, Sarah P
Dalton, Emily J
Ang, Jia Y
Klaic, Marlena
Thijs, Vincent
Hayward, Kathryn S
author_facet Newton, Sarah P
Dalton, Emily J
Ang, Jia Y
Klaic, Marlena
Thijs, Vincent
Hayward, Kathryn S
author_sort Newton, Sarah P
collection PubMed
description OBJECTIVE: The objectives of this systematic review were to describe the current dose and content of usual care upper limb motor intervention for inpatients following stroke and examine if context factors alter dose and content. DATA SOURCES: A systematic search (EMBASE, MEDLINE) was completed from January 2015 to February 2023 (PROSPERO CRD42021281986). METHODS: Studies were eligible if they reported non-protocolised usual care upper limb motor intervention dose data for stroke inpatients. Studies were rated using the Johanna Briggs Institute critical appraisal tool. Data were descriptively reported for dose dimensions of time (on task or, in therapy) and intensity (repetitions, repetition/minute), content (intervention type/mode), and context (e.g., severity strata). RESULTS: Eight studies were included from four countries, largely reflecting inpatient rehabilitation. Time in therapy ranged from 23 to 121 min/day. Time on task ranged from 8 to 44 min/day. Repetitions ranged from 36 to 57/session, and 15 to 282/day. Time on task was lowest in the stratum of people with severe upper limb impairment (8 min/day), the upper limit for this stratum was 41.5 min/day. There was minimal reporting of usual care content across all studies. CONCLUSION: Upper limb motor intervention dose appears to be increasing in usual care compared to prior reports (e.g., average 21 min/day and 23 to 32 repetitions/session). Context variability suggests that doses are lowest in the stratum of patients with a severely impaired upper limb. Consistent reporting of the multiple dimensions of dose and content is necessary to better understand usual care offered during inpatient rehabilitation.
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spelling pubmed-104924392023-09-10 Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review Newton, Sarah P Dalton, Emily J Ang, Jia Y Klaic, Marlena Thijs, Vincent Hayward, Kathryn S Clin Rehabil Evaluative Studies OBJECTIVE: The objectives of this systematic review were to describe the current dose and content of usual care upper limb motor intervention for inpatients following stroke and examine if context factors alter dose and content. DATA SOURCES: A systematic search (EMBASE, MEDLINE) was completed from January 2015 to February 2023 (PROSPERO CRD42021281986). METHODS: Studies were eligible if they reported non-protocolised usual care upper limb motor intervention dose data for stroke inpatients. Studies were rated using the Johanna Briggs Institute critical appraisal tool. Data were descriptively reported for dose dimensions of time (on task or, in therapy) and intensity (repetitions, repetition/minute), content (intervention type/mode), and context (e.g., severity strata). RESULTS: Eight studies were included from four countries, largely reflecting inpatient rehabilitation. Time in therapy ranged from 23 to 121 min/day. Time on task ranged from 8 to 44 min/day. Repetitions ranged from 36 to 57/session, and 15 to 282/day. Time on task was lowest in the stratum of people with severe upper limb impairment (8 min/day), the upper limit for this stratum was 41.5 min/day. There was minimal reporting of usual care content across all studies. CONCLUSION: Upper limb motor intervention dose appears to be increasing in usual care compared to prior reports (e.g., average 21 min/day and 23 to 32 repetitions/session). Context variability suggests that doses are lowest in the stratum of patients with a severely impaired upper limb. Consistent reporting of the multiple dimensions of dose and content is necessary to better understand usual care offered during inpatient rehabilitation. SAGE Publications 2023-05-07 2023-11 /pmc/articles/PMC10492439/ /pubmed/37151039 http://dx.doi.org/10.1177/02692155231172295 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Evaluative Studies
Newton, Sarah P
Dalton, Emily J
Ang, Jia Y
Klaic, Marlena
Thijs, Vincent
Hayward, Kathryn S
Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title_full Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title_fullStr Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title_full_unstemmed Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title_short Dose, Content, and Context of Usual Care in Stroke Upper Limb Motor Interventions: A Systematic Review
title_sort dose, content, and context of usual care in stroke upper limb motor interventions: a systematic review
topic Evaluative Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492439/
https://www.ncbi.nlm.nih.gov/pubmed/37151039
http://dx.doi.org/10.1177/02692155231172295
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