Does Task-Oriented Practice Improve Upper Extremity Motor Recovery after Stroke? A Systematic Review

Table 1

Characteristics of Included Studies.

First author Year	𝑛 participants; Description	Description of intervention; Experimental (E), Control (C)	Additional Deliberate; u/e Practice	u/e or Functional Outcome Measures
Blennerhassett, 2004 [37]	𝑛=30, 2 groups; 55 yrs (mean); No u/e entry criteria; 43 days after stroke; (avg.)	In addition to usual care; E: upper limb group, functional tasks to improve reach, grasp, coordination, 𝑛=15; C: mobility group, sit-to-stand, walking, stairs, 𝑛=15	A: upper limb group: 5 hours per week for 4 weeks; C: mobility group: no additional upper extremity practice	Motor assessment scale (MAS) upper limb/extremity^∧; MAS hand; Jebsen hand function test (3 subsets)
Donaldson, 2009 [38]	𝑛=30, 3 groups; 72.8 yrs (mean); Some movement required in paretic u/e; 20 days after stroke; (avg.)	In addition to usual care; E: Functional upper extremity training, using progressive task training, 𝑛=10; C1: additional session of usual (exercise based) care, 𝑛=10; C2: nothing in addition to usual (exercise based) care, 𝑛=10	A: 4 hours per week for six weeks; C1: 4 hours per week for six weeks; C2: no additional upper extremity practice	Action Research Arm Test (ARAT)^∧; Nine hole peg test (9HPT); Grip force; Pinch force; Elbow flexion/extension force
Han, 2013 [39]	𝑛=32, 3 groups; 50.2 yrs (mean); u/e impairment, no spasticity, no pain; 40 days after stroke; (avg.)	In addition to usual care, strength training and functional activity practice in three doses: E: 3 hours/day, 5 days/week, 𝑛=11; C1: 2 hours/day, 5 days/week, 𝑛=10; C2: 1 hour/day, 5 days/week, 𝑛=11	A: 15 hours/week for 6 weeks; C1: 10 hours/week for 6 weeks; C2: 5 hours/week for 6 weeks	ARAT^∧; Fugl-Meyer (arm items); Barthel index
Harris, 2009 [40]	𝑛=103, 2 groups; 69 yrs (mean); u/e impairment, some mov’t; 20 days after stroke; (avg.)	In addition to usual care: E: task-oriented, unsupervised home-based exercise program; C: education program	A: 3.75 hours/week for 4 weeks; C: 0.75 hours/week for 4 weeks	Chedoke Arm and Hand Activity Inventory (CAHAI)^∧; ARAT; Motor activity Log-14 (MAL); Grip strength; Short form-12 (SF-12); Pain visual analog scale; Fatigue severity scale
Kwakkel, 1999; [41]	𝑛=101, 3 groups; 66 yrs (mean); some u/e impairment; 7 days after stroke; (avg.)	In addition to usual care: E: intense arm training, functional exercises, 𝑛=33; C1: intense leg training, sitting/standing/walking activities, 𝑛=31; C2: Control (air splint), 𝑛=37	A: 2.5 hours per week, 20 weeks; C1: No additional upper extremity practice; C2: No additional upper extremity practice	ARAT^∧; Barthel Index; Nottingham Health Profile; Sickness Impact Profile; Frenchay Activities Index
Winstein, 2004 [42]	𝑛=64, 3 groups; Mean age, 95% between 35 and 75 years; Upper extremity impairment (inferred from FIM score); 16 days after stroke; (avg.)	In addition to usual care: E: functional task practice (FTP) (repetitive and progressive), 𝑛=22; C1: strength and motor control training (ST), exercise based, 𝑛=21; C2: usual care (UC), 𝑛=21	A: 5 hours per week for 4 weeks (task); C1: 5 hours per week for 4 weeks (exercise); C2: no additional task-oriented practice	Functional test of the hemiparetic upper extremity (FTHUE)^∧; FIM; Fugl-Meyer Upper extremity; (motor, sensory, ROM); Grip force; Pinch force; Shoulder/elbow/wrist torque; FIM self-care

𝑛: sample size; u/e: upper extremity; OT: occupational therapy; PT: physical therapy; ROM: range of motion; FIM: Functional Independence Measure; ∧primary outcome.