Arm Rehabilitation

Excerpt

A systematic review of the literature and its critical appraisal shows that there is ample evidence for benefits gained by dedicated arm rehabilitation therapy in terms of improvement of active motor control (impairment) and activities among stroke victims. Self-perceived usefulness of the affected arm as well as disability has been shown to improve with some interventions. Overall, the immediate benefits from various interventions are moderate and long-term effects were less systematically assessed. If applied appropriately, the interventions show little risk to harm and are by and large very acceptable to stroke survivors. The question of feasibility to deliver evidence-based arm rehabilitation therapy rests largely on access to and the availability of skilled human therapeutic resources. The use of technical devices requires additional resources and therapeutic skills.

This chapter gives insight into the current evidence for therapy to improve (sensori)motor control and function of the affected arm and hand. Early after stroke, recovery of function is often the main goal, while in the chronic stage therapeutic goals more often focus on activities. Further, therapy, and therefore choice of interventions, for patients with severe arm paresis is quite different from those with mild-to-moderate arm paresis. Hence, separate evidence-based recommendations are provided for the acute and subacute and the chronic phase and for patients with severe or mild-to-moderate paresis.