Interventions to Improve Functional Use of Hemiplegic Upper Extremity Post-stroke: A Systematized Review

Authors

Brieana R. Dean, University of Nebraska Medical CenterFollow
Sarah N. Wamsley, University of Nebraska Medical CenterFollow
Halle Clary, University of Nebraska Medical CenterFollow
Max W. Granstrom, University of Nebraska Medical CenterFollow
Danielle Westmark, University of Nebraska Medical CenterFollow
Bridgette Quinn, University of Nebraska Medical CenterFollow
Stacey Smallfield, University of Nebraska Medical CenterFollow
Molly Whitlow, University of Nebraska Medical CenterFollow

Files

Abstract

Purpose: Stroke is a leading cause of long-term disability with upper limb hemiplegia, significantly limiting participation in daily life (Lee & Howe, 2024; Long et al., 2020). This systematized review was conducted to address interventions within the scope of OT used to improve functional use of hemiplegic UE for adults post-stroke. Design: A systematized review protocol was used with inclusion criteria of full-text, English-language articles addressing rehabilitation interventions for hemiplegic UEs post-stroke containing participants ranging from ages 18-85. A medical librarian at the McGoogan Health Sciences library conducted a search across multiple databases for articles meeting the criteria for the clinical question. Method: Data were collected using a structured review process and synthesis of findings. The U.S. Preventive Services Task Force (USPSTF) definitions were used to characterize the strength of evidence and guide clinical recommendations. The procedure was a thematic analysis with findings categorized into 5 emergent themes based on primary intervention type. Results: A total of 21 articles were included, representing Level 1A, 1B, 2B, 3B, and 4 studies. Four themes emerged: (1) Movement Therapy/TOT; (2) Electrical Stimulation; (3) Robotics/Technology; and (4) Non-Invasive Brain Stimulation. Various strengths of evidence (SOE) emerged from synthesizing the findings; strong SOE supports NIBS from two Level 1A studies; moderate to strong SOE supports movement therapy and TOT from one Level 1A and 3 Level 1B studies; moderate to low SOE supports the use of e-stim from 4 Level 1B, one Level 2B and one Level 4 studies; and moderate to low SOE supports robotics and technology from seven Level 1B, one Level 2B, and one Level 3B studies. Conclusion: This study found that movement Therapy/TOT should be used routinely. All other interventions should be used on a case-by-case basis due to the variability of interventions, patient context, and technological supports of the other themes. Impact Statement: This systematized review will guide practitioners in choosing effective interventions for improving UE functional use in adults post-stroke.

Publication Date

2025

Keywords

Hemiplegia, post-stroke, functional use

Disciplines

Occupational Therapy

Comments

2025 Copyright, the authors

Recommended Citation

Dean, Brieana R.; Wamsley, Sarah N.; Clary, Halle; Granstrom, Max W.; Westmark, Danielle; Quinn, Bridgette; Smallfield, Stacey; and Whitlow, Molly, "Interventions to Improve Functional Use of Hemiplegic Upper Extremity Post-stroke: A Systematized Review" (2025). Student Systematized Reviews: Occupational Therapy. 27.
https://digitalcommons.unmc.edu/cahp_ot_sysrev/27