Rehabilitation interventions for persons with upper extremity impairment following neurological disease: scoping review
DOI:
https://doi.org/10.47197/retos.v82.119090Keywords:
Mobility Limitation, Nervous System Diseases, Rehabilitation, Upper extremityAbstract
Introduction: Neurological diseases are one of the leading causes of disability worldwide, often associated with changes in upper extremity mobility that compromise independence and quality of life. Early and intensive rehabilitation plays a key role in promoting functional recovery.
Objective: To map rehabilitation interventions aimed at people with upper extremity impairment after neurological disease, in the acute and subacute phases, in a hospital setting.
Methodology: The review was conducted according to the methodology of the Joana Briggs Institute for scoping reviews. The search was performed in the MEDLINE (PubMed), CINAHL, Scopus, and Web of Science databases. Data selection and extraction were performed by two independent reviewers.
Results: Seventeen studies published between 2012 and 2025 were included. The interventions identified were grouped into three categories: technological interventions, task-oriented interventions, and interventions based on sensory and visual feedback. Intensive and repetitive training programs, adjusted to the person's functional capacity, predominated, lasting between 2 and 12 weeks and with a frequency of 2 to 7 sessions per week.
Discussion: The diversity of interventions identified reflects the complexity of the recovery process, with different therapeutic modalities often being combined. The variability in the characterization of interventions highlights the lack of standardization, making it difficult to compare results and define parameters.
Conclusions: The evidence reinforces the importance of intensive, repetitive, task-oriented approaches integrated into a multidisciplinary practice. Gaps in the characterization of interventions are highlighted, pointing to the need for more methodologically robust studies.
References
Agostinho, I., Temudo, A., & Picoito, R. (2024). Abordagem de Enfermagem de Reabilitação na Utilização de Slime em Pessoas com Alteração dos Membros Superiores. Ordem dos Enfermei-ros Sul.
Büsching, I., Sehle, A., Stürner, J., & Liepert, J. (2018). Using an upper extremity exoskeleton for semi-autonomous exercise during inpatient neurological rehabilitation- a pilot study. Journal of Neuroengineering and Rehabilitation, 15(1), 72. https://doi.org/10.1186/s12984-018-0415-6
Ceradini, M., Losanno, E., Micera, S., Bandini, A., & Orlandi, S. (2024). Immersive VR for upper-extremity rehabilitation in patients with neurological disorders: A scoping review. Journal of Neuroengineering and Rehabilitation, 21(1), 75. https://doi.org/10.1186/s12984-024-01367-0
Chatterjee, K., Stockley, R. C., Lane, S., Watkins, C., Cottrell, K., Ankers, B., Davies, S., Morris, M. F., Fal-lon, N., & Nurmikko, T. (2019). PULSE-I - Is rePetitive Upper Limb SEnsory stimulation early af-ter stroke feasible and acceptable? A stratified single-blinded randomised controlled feasibility study. Trials, 20, 388. https://doi.org/10.1186/s13063-019-3428-y
Chen, L., Xiao, L. D., Chamberlain, D., & Newman, P. (2021). Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review. Journal of Clinical Nursing, 30(19–20), 2786–2807. https://doi.org/10.1111/jocn.15807
Chen, X., Liu, X., Cui, Y., Xu, G., Liu, L., Zhang, X., Jiang, K., & Li, Z. (2020). Efficacy of functional magnet-ic stimulation in improving upper extremity function after stroke: A randomized, single-blind, controlled study. Journal of International Medical Research, 48(6), 0300060520927881. https://doi.org/10.1177/0300060520927881
Deluzio, S., Vora, I., Kumble, S., Zink, E. K., Stevens, R. D., & Bahouth, M. N. (2018a). Feasibility of Early, Motor-Assisted Cycle Ergometry in Critically Ill Neurological Patients with Upper Limb Weak-ness and Variable Cognitive Status: A Case Series. 97(5), e37–e41. Scopus. https://doi.org/10.1097/PHM.0000000000000857
Deluzio, S., Vora, I., Kumble, S., Zink, E. K., Stevens, R. D., & Bahouth, M. N. (2018b). Feasibility of Early, Motor-Assisted Cycle Ergometry in Critically Ill Neurological Patients With Upper Limb Weak-ness and Variable Cognitive Status: A Case Series. American Journal of Physical Medicine & Re-habilitation, 97(5), e37–e41. https://doi.org/10.1097/PHM.0000000000000857
Demain, S., Metcalf, C. D., Merrett, G. V., Zheng, D., & Cunningham, S. (2013). A narrative review on haptic devices: Relating the physiology and psychophysical properties of the hand to devices for rehabilitation in central nervous system disorders. Disability and Rehabilitation. Assistive Technology, 8(3), 181–189. https://doi.org/10.3109/17483107.2012.697532
Duret, C., & Mazzoleni, S. (2017). Upper limb robotics applied to neurorehabilitation: An overview of clinical practice. NeuroRehabilitation, 41(1), 5–15. https://doi.org/10.3233/NRE-171452
Endzelytė, E., Petruševičienė, D., Kubilius, R., Mingaila, S., Rapolienė, J., & Rimdeikienė, I. (2025). Inte-grating Brain-Computer Interface Systems into Occupational Therapy for Enhanced Independ-ence of Stroke Patients: An Observational Study. Medicina, 61(5), 932. https://doi.org/10.3390/medicina61050932
Freitas, S. C. C. de, Rodrigues, C. M. Â., Pratas, L. F. P., & Almeida, S. I. F. de. (2022). Terapia de espelho na reabilitação do membro superior pós Acidente Vascular Cerebral: Estudo de caso. Revista Portuguesa de Enfermagem de Reabilitação, 5(1), 15–19. https://doi.org/10.33194/rper.2021.192
Gao, Z., Pang, Z., Chen, Y., Lei, G., Zhu, S., Li, G., Shen, Y., & Xu, W. (2022). Restoring After Central Nerv-ous System Injuries: Neural Mechanisms and Translational Applications of Motor Recovery. Neuroscience Bulletin, 38(12), 1569–1587. https://doi.org/10.1007/s12264-022-00959-x
Hakim, R. M., Tunis, B. G., & Ross, M. D. (2017). Rehabilitation robotics for the upper extremity: Review with new directions for orthopaedic disorders. Disability and Rehabilitation: Assistive Tech-nology, 12(8), 765–771. https://doi.org/10.1080/17483107.2016.1269211
Hortal, E., Planelles, D., Resquin, F., Climent, J. M., Azorín, J. M., & Pons, J. L. (2015). Using a brain-machine interface to control a hybrid upper limb exoskeleton during rehabilitation of patients with neurological conditions. Journal of Neuroengineering and Rehabilitation, 12, 92. https://doi.org/10.1186/s12984-015-0082-9
Lee, M.-J., Lee, J.-H., & Lee, S.-M. (2018). Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: A single-blinded, randomized, controlled trial. Technology and Health Care, 26(4), 659–666. https://doi.org/10.3233/THC-181336
Lopes, A. (2019). Reabilitação funcional do membro superior em doentes pós AVC - Revisão Sistemáti-ca da Literatura [Escola Superior de Saúde de Bragança]. http://hdl.handle.net/10198/19675
Morris, J. H., John, A., Wedderburn, L., Rauchhaus, P., & Donnan, P. T. (2019). Dynamic Lycra® or-thoses as an adjunct to arm rehabilitation after stroke: A single-blind, two-arm parallel group, randomized controlled feasibility trial. Clinical Rehabilitation, 33(8), 1331–1343. https://doi.org/10.1177/0269215519840403
Morris, J. H., & Van Wijck, F. (2012). Responses of the less affected arm to bilateral upper limb task training in early rehabilitation after stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 93(7), 1129–1137. https://doi.org/10.1016/j.apmr.2012.02.025
Murdolo, Y., Brown, T., Fielding, L., Elliott, S., & Castles, E. (2017). Stroke survivors’ experiences of using the Graded Repetitive Arm Supplementary Program (GRASP) in an Australian acute hos-pital setting: A mixed-methods pilot study. Australian Occupational Therapy Journal, 64(4), 305–313. https://doi.org/10.1111/1440-1630.12363
Peters, M., Godfrey, C., Mclnerney, P., Munn, Z., Tricco, A., & Khalil, H. S. R. (2020). BI Manual for Evi-dence Synthesis. https://doi.org/10.46658/JBIMES-24-09
Regulamento no392/2019, 2a série, No85 (2019). https://www.ordemenfermeiros.pt/media/11871/1356513568.pdf
Ribeiro, O. (2021). Enfermagem de Reabilitação—Conceções e Práticas. Lidel.
Suárez-Iglesias, D., Ayán Perez, C., Mendoza-Laiz, N., & Villa-Vicente, J. G. (2020). Boccia as a Rehabili-tation Intervention for Adults With Severe Mobility Limitations Due to Neuromuscular and Other Neurological Disorders: Feasibility and Effects on Upper Limb Impairments. Frontiers in Psychology, 11, 581. https://doi.org/10.3389/fpsyg.2020.00581
Thielen, C. C., Marino, R. J., Duff, S., Kaplan, G., & Mulcahey, M. (2018). Activity-based Rehabilitation Interventions of the Neurologically Impaired Upper Extremity: Description of a Scoping Re-view Protocol. Topics in Spinal Cord Injury Rehabilitation, 24(3), 288–294. https://doi.org/10.1310/sci2403-288
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Vanderlelie, L., Bosich, S., O’Grady, H., Azizi, K., Lally, J., Micks, S., Sandhu, S., Whyte, B., & Kho, M. E. (2024). Arm cycle ergometry in critically ill patients: A systematic review. Australian Critical Care, 37(6), 985–993. https://doi.org/10.1016/j.aucc.2024.01.008
Wi, S., Shin, H.-I., Hyun, S. E., Sung, K.-S., & Lee, W. H. (2024). Feasibility and safety of in-bed cy-cling/stepping in critically ill patients: A study protocol for a pilot randomized controlled clini-cal trial. PloS One, 19(5), e0301368. https://doi.org/10.1371/journal.pone.0301368
World Health Organization. (2024). Spinal cord injury. https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury
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