What is current practice for upper limb rehabilitation in the acute hospital setting following stroke? A systematic review

OBJECTIVE: To investigate the amount of time and types of interventions used during therapy sessions in the acute setting following stroke. METHODS: A systematic search of relevant databases was conducted. Studies were eligible if they were observational studies of adults with a confirmed diagnosis and within 4 weeks post-stroke; receiving Physiotherapy (PT) and/or Occupational Therapy (OT); and the outcome included amount of therapy time devoted to UL and/or types of interventions. Two authors independently selected studies for inclusion, assessed methodological quality and extracted data. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: From the 94 studies reviewed, seven studies involving 3236 participants met the inclusion criteria. Pooled results indicated that 7.9 min/day (21.4%) of a total 36.7 min/day combined PT and OT session was devoted to UL therapy. Two of the seven studies reported types of interventions, predominantly upper limb activity and control. CONCLUSIONS: A small proportion of total PT and OT time is directed to the involved UL during acute rehabilitation. Given the evidence for early and intense rehabilitation, there is a need to explore the reasons for this low intensity of UL therapy in the acute stage post-stroke.