Effectiveness of technology-based stroke interventions to improve upper limb functioning in low- and middle-income countries: a systematic review and meta-analysis.

IF 2.2 4区医学 Q1 REHABILITATION Topics in Stroke Rehabilitation Pub Date : 2025-03-10 DOI:10.1080/10749357.2025.2469473

Meiling Carbajal Galarza, Nathaly Olga Chinchihualpa Paredes, Sergio Alejandro Abanto Perez, Gustavo Saposnik, Maria Lazo-Porras

{"title":"Effectiveness of technology-based stroke interventions to improve upper limb functioning in low- and middle-income countries: a systematic review and meta-analysis.","authors":"Meiling Carbajal Galarza, Nathaly Olga Chinchihualpa Paredes, Sergio Alejandro Abanto Perez, Gustavo Saposnik, Maria Lazo-Porras","doi":"10.1080/10749357.2025.2469473","DOIUrl":null,"url":null,"abstract":"Background: Stroke is one of the leading causes of disability worldwide, with low- and middle- income countries (LMICs) representing 69% of stroke incidence. Technology-based interventions offer potential for improving motor function and rehabilitation adherence; however, their impact in LMICs remains unknown.Objective: To measure the efficacy of technological interventions compared to conventional physical rehabilitation in improving post- stroke upper limb motor function in LMICs.Methods: We conducted a systematic review (PROSPERO registration: CRD42020213333) of randomized clinical trials (RCTs) from PubMed, Global Index Medicus, and Physiotherapy Evidence Databases. Studies included stroke survivors receiving technological interventions for upper limb rehabilitation. Effectiveness outcomes included upper limb motor function, performance for activities of daily living, and quality of life. A meta-analysis was performed using mean differences (MD) and 95% confidence intervals (95% CI). Risk of bias was assessed using the Cochrane Collaboration tool for RCTs.Results: Fifty studies were included after the screening phase, comprising a total of 2646 participants. Nine technological interventions were evaluated, including: virtual reality (40%), robotics (22%), telerehabilitation (10%), among others. Meta-analysis showed significant effect of immersive virtual reality on upper limb function using the Fugl-Meyer Scale (MD 5.65; 95% CI 4.88 to 6.43) and on daily activity performance using the Functional Independence Measure (MD 4,82; 95% CI 2,45-7,19). A significant difference was also found between telerehabilitation and conventional therapy using the modified Barthel index (MD of 3.28; 95% CI 0.86 to 5.70).Conclusions: Immersive virtual reality and telerehabilitation are effective interventions compared to conventional rehabilitation in LMICs.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-21"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Stroke Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10749357.2025.2469473","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Stroke is one of the leading causes of disability worldwide, with low- and middle- income countries (LMICs) representing 69% of stroke incidence. Technology-based interventions offer potential for improving motor function and rehabilitation adherence; however, their impact in LMICs remains unknown.

Objective: To measure the efficacy of technological interventions compared to conventional physical rehabilitation in improving post- stroke upper limb motor function in LMICs.

Methods: We conducted a systematic review (PROSPERO registration: CRD42020213333) of randomized clinical trials (RCTs) from PubMed, Global Index Medicus, and Physiotherapy Evidence Databases. Studies included stroke survivors receiving technological interventions for upper limb rehabilitation. Effectiveness outcomes included upper limb motor function, performance for activities of daily living, and quality of life. A meta-analysis was performed using mean differences (MD) and 95% confidence intervals (95% CI). Risk of bias was assessed using the Cochrane Collaboration tool for RCTs.

Results: Fifty studies were included after the screening phase, comprising a total of 2646 participants. Nine technological interventions were evaluated, including: virtual reality (40%), robotics (22%), telerehabilitation (10%), among others. Meta-analysis showed significant effect of immersive virtual reality on upper limb function using the Fugl-Meyer Scale (MD 5.65; 95% CI 4.88 to 6.43) and on daily activity performance using the Functional Independence Measure (MD 4,82; 95% CI 2,45-7,19). A significant difference was also found between telerehabilitation and conventional therapy using the modified Barthel index (MD of 3.28; 95% CI 0.86 to 5.70).

Conclusions: Immersive virtual reality and telerehabilitation are effective interventions compared to conventional rehabilitation in LMICs.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

Topics in Stroke Rehabilitation 医学-康复医学

CiteScore

5.10

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.