LOCALIZATION OF OCCUPATIONAL THERAPY CLINICAL PRACTICE GUIDELINE TO IMPROVE THE UPPER EXTREMITY FUNCTION IN PATIENTS WITH STROKE: AN INTEGRATIVE REVIEW AND EXPERT PANEL

摘要

Background and Aim: Stroke is a major cause of disability in adults and functional disability of upper limb. It is the most important difficulty that makes the person unable to perform activities of daily living. Rehabilitation interventions in the guidelines format can result in integrated therapists’ performance and increases the process of recovery and decrease the level of functional disability after stroke. The purpose of this study was to make an integrative review and localization of occupational therapy practice guideline in rehabilitation of upper limb function in stroke patients according to available evidences and experts’ opinions. Materials and Methods: This study is a combination of two steps. In the first phase, the integrated review was done in all domestic and foreign published articles and practical guidelines of the previous ten years. The key words of Clinical practice guide, stroke, occupational therapy interventions and of upper limb function were used and the found articles were extracted. In the second phase, the quality of the results were analyzed and discussed in the expert panel that included of 10 occupational therapists in CVA area. Then final results were presented in a booklet format. Results: In this study 268 articles in the field of stroke and upper limb function and 11 clinical practice guidelines were found. Initially, abstracts and then 70 full texts of articles relating to hand function interventions in stroke patients which had inclusion criteria were investigated. Robotic aids interventions, induced constraint movement therapy, splinting, mirror therapy, sensory training, mental training, taskoriented approach, resistive exercises, bilateral exercises and electrical stimulation of the upper extremities in stroke patients were enrolled in these articles. Conclusion: The results of the study and the experts were focused on induced constraint movement therapy, robotic assistive devices, mirror therapy, sensory re-education, mental practice and task-based approach in the rehabilitation of hand function in stroke patients. Results were presented in the field of occupational therapy in improving upper extremity function of stroke patients in booklet format.