The Effect of Priming on Outcomes of Task-Oriented Training for the Upper Extremity in Chronic Stroke: A Systematic Review and Meta-analysis

Autor(es)

da Silva, Erika Shirley Moreira ^[1] ; Ocamoto, Gabriela Nagai ^[1] ; Santos-Maia, Gabriela Lopes dos ^{[1, 2]} ; de Fatima Carreira Moreira Padovez, Roberta ^[1] ; Trevisan, Claudia ^[1] ; de Noronha, Marcos Amaral ^[3] ; Pereira, Natalia Duarte ^[1] ; Borstad, Alexandra ^[4] ; Russo, Thiago Luiz ^[1]

Afiliação do(s) autor(es)

^[1] Fed Univ Sao Carlos UFSCar, Sao Carlos, SP - Brazil

^[2] Alfredo Nasser Coll, Aparecida De Goiania, Go - Brazil

^[3] La Trobe Univ, Bendigo, Vic - Australia

^[4] Coll St Scholast, Duluth, MN - USA

• Tipo de documento: Artigo de Revisão
• Fonte: NEUROREHABILITATION AND NEURAL REPAIR; v. 34, n. 6 MAY 2020.
• Citações Web of Science: 0

Resumo

Background. Priming results in a type of implicit memory that prepares the brain for a more plastic response, thereby changing behavior. New evidence in neurorehabilitation points to the use of priming interventions to optimize functional gains of the upper extremity in poststroke individuals. Objective. To determine the effects of priming on task-oriented training on upper extremity outcomes (body function and activity) in chronic stroke. Methods. The PubMed, CINAHL, Web of Science, EMBASE, and PEDro databases were searched in October 2019. Outcome data were pooled into categories of measures considering the International Classification Functional (ICF) classifications of body function and activity. Means and standard deviations for each group were used to determine group effect sizes by calculating mean differences (MDs) and 95% confidence intervals via a fixed effects model. Heterogeneity among the included studies for each factor evaluated was measured using the I-2 statistic. Results. Thirty-six studies with 814 patients undergoing various types of task-oriented training were included in the analysis. Of these studies, 17 were associated with stimulation priming, 12 with sensory priming, 4 with movement priming, and 3 with action observation priming. Stimulation priming showed moderate-quality evidence of body function. Only the Wolf Motor Function Test (time) in the activity domain showed low-quality evidence. However, gains in motor function and in use of extremity members were measured by the Fugl-Meyer Assessment (UE-FMA). Regarding sensory priming, we found moderate-quality evidence and effect size for UE-FMA, corresponding to the body function domain (MD 4.77, 95% CI 3.25-6.29, Z = 6.15, P < .0001), and for the Action Research Arm Test, corresponding to the activity domain (MD 7.47, 95% CI 4.52-10.42, Z = 4.96, P < .0001). Despite the low-quality evidence, we found an effect size (MD 8.64, 95% CI 10.85-16.43, Z = 2.17, P = .003) in movement priming. Evidence for action observation priming was inconclusive. Conclusion. Combining priming and task-oriented training for the upper extremities of chronic stroke patients can be a promising intervention strategy. Studies that identify which priming techniques combined with task-oriented training for upper extremity function in chronic stroke yield effective outcomes in each ICF domain are needed and may be beneficial for the recovery of upper extremities poststroke. (AU)

• Processo FAPESP: 17/25185-4 - O efeito do exercício aeróbio associado à terapia de contensão induzida modificada em indivíduos hemiparéticos crônicos: ensaio cliníco randomizado
• Beneficiário: Erika Shirley Moreira da Silva
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 17/22173-5 - Caracterização da pressão intracraniana por método não invasivo em indivíduos pós AVC: relação com sedentarismo e sistema cardiovascular
• Beneficiário: Gabriela Nagai Ocamoto
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto