Strokes, defined as some degree of cerebral (brain) function loss, are common in the U.S., with about 795,000 people experiencing a stroke every year. The majority of these stroke victims (about 80%) are over the age of 65, and as our aging population continues to grow, the number of strokes is expected to grow as well. The main goal of stroke rehabilitation is to help patients return to basic activities of daily living (ADLs) like feeding and self-care. Physical therapy is often prescribed as a key component of this rehab process to help this aging population recover their ADLs. Though physical therapy is widely used and generally supported by evidence, guidelines that instruct the best methods of treatment based on this evidence are slightly outdated. In order to provide optimal recommendations for physical therapy, a massive review was performed on all available literature.
To find data for this review, medical databases were searched for randomized controlled trials (RCTs), which are powerful studies that provide reliable evidence. Each RCT had to include physical therapy to improve body functions and ADLs as part of a stroke rehabilitation program. This search turned out a total of 467 RCTs involving 25,373 stroke patients who underwent various types of physical therapy treatments, and outcomes from all trials were analyzed to determine effectiveness.
Results from this review provided strong evidence, in the majority of treatment interventions analyzed, that physical therapy led to beneficial effects in one or more outcomes of stroke rehabilitation. Additional findings showed that treatment programs that included intense, task-specific training (relearning how to complete basic tasks) with high amounts of repetition were the most beneficial for improving outcomes. Based on these results, it appears physical therapy, with the various types of interventions it offers, should continue to play a central role in stroke rehabilitation. Furthermore, treatment programs should include the elements listed above and begin within the first month after stroke to be most effective, and it is important that stroke patients discuss treatment options with their physical therapist before proceeding with it.
-As reported in the February '14 edition of PLoS One