In this Cochrane review, the authors included 33 randomised controlled trials, involving 1,853 adults who have suffered a stroke. Trials of repetitive task training were considered eligible if the RRT intervention comprised an active motor sequence performed repetitively within a single training session, and where the practice was aimed towards a clear functional goal (eg, picking up a cup, sit-to-stand). Eligible control interventions were usual care or placebo. In many studies risk of bias was unclear due to poor reporting of study details. The quality of evidence was limited by inconsistency of results across studies, small sample sizes, and poor reporting. Therefore, the available evidence was only of ’moderate’ or ’low’ quality according to the GRADE system.
The review concluded that there was low-quality evidence that repetitive task training improves arm function (standardised mean difference (SMD) 0.25, 95% confidence interval (CI) 0.01 to 0.49; 11 studies, n=749), hand function (SMD 0.25, 95% CI 0.00 to 0.51; 8 studies, n=619), and lower limb functional measures (SMD 0.29, 95% CI 0.10 to 0.48; 5 trials, n=419). There was moderate-quality evidence that repetitive task training improves walking distance (mean difference (MD) 34.80, 95% CI 18.19 to 51.41; 9 studies, n=610) and functional ambulation (SMD 0.35, 95% CI 0.04 to 0.66; 8 studies, n=525). Improvements for both upper and lower limb function were sustained up to six months post treatment. The effect estimates were not altered by intervention type, dosage of task practice or time since stroke.
French B, et al. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev 2016;Issue 11
