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Biofeedback interventions for short term upper limb function following stroke: A systematic review with meta-analysis

      Highlights

      • Biofeedback associated with conventional therapy showed a small clinical effect.
      • Most analysis showed no superiority of biofeedback compared to conventional therapy.
      • Biofeedback for upper limb function rehabilitation post stroke remains uncertain.

      Abstract

      Background

      Biofeedback has been used by rehabilitation professionals in the treatment of poststroke function impairments.

      Purpose

      Investigate the efficacy of any type of biofeedback intervention for the treatment of upper limb function in individuals following stroke.

      Study Design

      Systematic review of literature with meta-analysis.

      Methods

      Literature searches were conducted using MESH terms and text words in PubMed, Lilacs, Scielo, Scopus, PEDro, and Web of Science databases. The main outcome was improvement in upper limb's motor function and motor function in activities of daily living. We calculated the Mean Difference and Standardized Mean Difference for the assessment scales reported as primary outcome. The methodological quality of included studies was assessed using PEDro scale. The overall quality of the evidence was assessed using GRADE system.

      Results

      From 1360 articles identified, 16 were included in the review (09 in the meta-analysis). Three forest plots of hemiparesis and one of hemiplegia showed that biofeedback therapy associated with conventional therapy has a greater improvement in participants upper limb motor function when compared to isolated conventional therapy. Two forest plots of hemiparesis and one of hemiplegia showed no superiority in participants improvement for biofeedback associated with conventional therapy when compared to isolated conventional therapy.

      Conclusion

      Biofeedback therapy associated with conventional therapy showed a small clinical effect when associated to conventional therapy and very low quality of evidence. Although further research with higher quality evidence is needed.

      Keywords

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