Neural correlates of bilateral upper limb task training after stroke:a systematic review

Introduction: A quarter of care home residents in the USA and UK have had a stroke and stroke is the second most common cause of disability in the care home population. It is not known whether the benefits of occupational therapy found amongst community-dwelling stroke survivors, would be seen in the care home population. This systematic review aimed to measure the effects of occupational therapy interventions targeted at improving, restoring and maintaining independence in activities of daily living (ADL) among care home residents with stroke.Method: We searched the Cochrane Stroke Group Trials Register, MEDLINE, EMBASE, and eleven other databases; seven trials registers; and hand searched seven journals. Randomised trials of occupational therapy interventions for care home residents with stroke versus standard care were selected for inclusion. Two reviewers independently assessed all titles and abstracts, selected trials for inclusion, and extracted data, to ensure reliability. A third reviewer resolved discrepancies. The primary outcomes were performance in ADL at the end of scheduled follow-up, and death or a poor outcome.Results: The search returned 1436 unduplicated records. Of these, nine studies were reviewed in full. One study, involving 118 participants met the inclusion criteria for the review. One ongoing study also met the criteria but had no data available. There was insufficient data to determine the efficacy of occupational therapy interventions for improving, restoring or maintaining independence in ADL for care home residents with stroke.Conclusion: The effectiveness of occupational therapy for care home residents with stroke remains unclear. Further research is needed