A Meta-Analysis Evaluating the Effectiveness of Two Different Upper Limb Hemiparesis Interventions on Improving Health-Related Quality of Life Following Stroke

Abstract

Purpose: The aim of this article is to quantitatively assess the efficacy of different upper limb interventions on health-related quality of life (QOL) in stroke patients. Method: Two botulinum type A injection (BTX-A) studies and 4 constraint-induced movement therapy (CIMT) studies were separately combined in a meta-analysis using a fixed effects model. QOL mean scores were extracted and transformed into weighted mean differences. Results: Combined, the BTX-A studies showed no significant improvements in overall health-related QOL. Similarly, a meta-analysis of 4 CIMT studies revealed nonsignificant findings for the domains of activities of daily living, communication, and hand function. A separate meta-analysis of 3 CIMT studies showed a significant increase in strength scores (P = .007); however, sensitivity analysis for this domain due to significant heterogeneity led to a newP value of .078, showing a nonsignificant increase in strength. Further results for memory, mobility, mood, participation, and overall recovery were all nonsignificant. Conclusion: This report did not show these types of upper limb interventions to be effective in improving health-related QOL in the poststroke population.

Keywords:

• botulinum
• constraint-induced therapy
• intervention
• meta-analysis
• paresis
• quality of life
• stroke