Efeitos da terapia de contensão induzida sobre a atividade e participação pós acidente vascular cerebral: revisão sistemática e metanálise

Abstract

After stroke, hemiparesis is the main sensorimotor deficit, resulting in limitations in engaging in daily activities and social participation. Hemiparesis can be treated with behavioral techniques of intensive use of the affected arm, such as constraint-induced movement therapy (CIMT), but it remains unclear whether motor improvement can lead to increased activity and participation. Objective. Identify whether (CIMT) is superior to usual techniques to favor activity and participation outcomes in stroke survivors.5 Method. Systematic review with meta-analysis, based on the PRISMA guideline. The search for articles was carried out in the PubMed, LILACS, Embase, SciELO, Cochrane Library, Scopus, Medline and Web of Science databases, with no language restriction. Meta-analysis was performed with Review Manager (version 5.3) and a significance level of p = 0.05 was established. Results. 658 articles were found, but only 21 were included. After analysis, superior effects were observed on motor function and performance of activities of daily living of patients treated with (CIMT), outcomes assessed by FuglMeyer Assessment (p=0.00001); Wolf motor function test (p=0.01); Modified Barthel Index (p=0.00001); engine activity log [MAL] Amount (p=0.01); engine activity log [MAL]QL (p=0.00001); Action Research Arm Test-ARAT (p=0.00001); MIF (p=0.0007). Conclusion. Our results show that this therapy, when compared to others, results in much more significant gains in the functional use of the affected limb in daily activities and provides an improvement in functional independence, configuring itself as a superior treatment technique to favor activity and participation.