Valenzuela-López L, Moreno-Verdú M, Cuenca-Zaldívar JN, Romero JP. Effects of Hand Motor Interventions on Cognitive Outcomes Post-stroke: A Systematic Review and Bayesian Network Meta-analysis.
Arch Phys Med Rehabil 2024:S0003-9993(24)00029-7. [PMID:
38211761 DOI:
10.1016/j.apmr.2023.12.013]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE
To synthetize the evidence on the effects of hand rehabilitation (RHB) interventions on cognition post-stroke and compare their efficacy.
DATA SOURCES
PubMed, Embase, Cochrane, Scopus, Web of Science, and CINAHL were searched from inception to November 2022.
DATA SELECTION
Randomized controlled trials conducted in adults with stroke where the effects of hand motor interventions on any cognitive domains were assessed.
DATA EXTRACTION
Data were extracted by 2 independent reviewers. A Bayesian Network Meta-analysis (NMA) was applied for measures with enough studies and comparisons. Risk of bias was assessed with the Cochrane Risk of Bias tool.
DATA SYNTHESIS
Fifteen studies were included in qualitative synthesis, and 11 in NMA. Virtual reality (VR) (n=7), robot-assisted (n=5), or handgrip strength (n=3) training were the experimental interventions and conventional RHB (n=14) control intervention. Two separate NMA were performed with MoCA (n=480 participants) and MMSE (n=350 participants) as outcome measures. Both coincided that the most probable best interventions were robot-assisted and strength training, according to SUCRA and rankogram, followed by conventional RHB and VR training. No significant differences between any of the treatments were found in the MoCA network, but in the MMSE, robot-assisted and strength training were significantly better than conventional RHB and VR. No significant differences between robot-assisted and strength training were found nor between conventional RHB and VR.
CONCLUSIONS
Motor interventions can improve MoCA/MMSE scores post-stroke. Most probable best interventions were robot-assisted and strength training. Limited literature assessing domain-specific cognitive effects was found.
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