Hands-on physiotherapy interventions and stroke and International Classification of
Functionality, Disability and Health outcomes: A systematic review
Sammanfattning
The effectiveness of "hands-on" physiotherapy for stroke is unclear. The objective here is to
analyze the effectiveness of such
interventions on movement-related International Classifi cation of Functionality, Disability and Health
(ICF) categories.
A systematic review was undertaken of randomized controlled trials published since 1980, using the
following criteria: stroke,
humans, 18 years, outcomes related to ICF movement-related categories, physiotherapeutic
handling techniques, control group
as placebo or no intervention, including experiments where both groups have the same intervention
and the experimental group
has one extra intervention. Nine studies were included and a best evidence synthesis is presented.
Recommendations with limited
evidence favor slow-stroke back massage for shoulder pain, range-of-motion exercises for upper-limb
and lower-limb structures
and functions of muscles and joints, proprioceptive neuromuscular facilitation (PNF) for gait step,
walking backwards with hip
facilitation for gait parameters and performance, and conventional physiotherapy with facilitation
techniques for gait parameters.
Recommendations with indicative fi ndings favor PNF with trunk rhythmic stabilizations for function
and mobility of upper limbs.
Recommendations with limited evidence show the non-effi cacy of Bobath therapy for upper-limb
function and activity and
facilitation of the step on body weight support treadmill training for gait parameters and performance.
In conclusion, some
hands-on interventions have limited evidence in stroke rehabilitation.