ºÚÁÏÍø

Abstract

Background: Stroke is one of the leading cause for chronic impairments, damage to the cortex due to disruption of blood flow results in long term impairments. These impairments however due to the plasticity of the brain, have a potential chance of recovery. This recovery gets enhanced with various neurorehabilitaton techniques which work on various neurophysiologic principles of recovery. Previous studies done were mostly longitudinal study and therefore high quality evidences are still lacking that suggests motor related cortical reorganization, which is the basis of neuroplasticity. These changes can be best calculated using enhanced imaging techniques and previous studies mostly evaluated these changes using functional outcome measures, and to quantify this into a single unit always remained a difficult task. Aim: The aim of the study is to analyse the overall mean effect of various neurorehabilitaton techniques on cortical reorganization by the use of functional Magnetic Resonance Imaging techniques. Methodology: A thorough electronic database search was performed. Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid/MEDLINE(R) (1980 to Jan 2012), Pubmed (1980 to Jan 2012), PEDro (1980 to Jan 2012), ScienceDirect, SCOPUS, Google Scholar, and CINAHL/EBSCO (1982-2011). The studies selected were on the basis of inclusion and exclusion criteria and only high quality studies were selected. After selection, quality assessment was performed using PEDro scoring to grade the study. Data extraction was done for meta-analysis, and a pre and post value for laterality index (LI) was extracted. Fixed and random model effects were calculated, the heterogeneity of the study was calculated using T square variation method. Results: Eleven RCT�s were included and the methodological quality of most of the studies was moderate. The primary fixed effects model revealed a significant overall effect size which on analysis was 0.28 with a confidence interval of 95% and the mean effect size ranging in between 0.08 to 0.48. The overall cumulative effect size was large and significant. Two studies had the highest weighted size compared to the other included studies. Conclusion: This review found evidence of cortical reorganization and neuroplastic changes in patient with stroke post neurorehabilitaton techniques.

Biography

Email: dr.sandeepdhar@hotmail.com