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

Ana Clara Bonini-Rocha; Anderson Lúcio Souza de Andrade; Ruth Dos Santos Pereira; André Marques de Moraes; Liana Barbaresco Gomide Matheus; Sérgio Teixeira da Fonseca; Alexandre Lima de Araújo Ribeiro; Wagner Rodrigues Martins

doi:10.1016/j.jht.2022.05.001

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

J Hand Ther. 2023 Jul-Sep;36(3):693-705. doi: 10.1016/j.jht.2022.05.001. Epub 2022 Jul 8.

Authors

Ana Clara Bonini-Rocha¹, Anderson Lúcio Souza de Andrade², Ruth Dos Santos Pereira¹, André Marques de Moraes¹, Liana Barbaresco Gomide Matheus¹, Sérgio Teixeira da Fonseca³, Alexandre Lima de Araújo Ribeiro⁴, Wagner Rodrigues Martins¹

Affiliations

¹ University of Brasilia, Division of Physical Therapy, Brasilia, DF, Brazil.
² University of Brasilia, Division of Physical Therapy, Brasilia, DF, Brazil. Electronic address: andersons.andrade5@gmail.com.
³ Federal University of Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Belo Horizonte, MG, Brazil.
⁴ University of Brasilia, Faculty of Physical Education, Brasilia, DF, Brazil.

PMID: 35817688
DOI: 10.1016/j.jht.2022.05.001

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: Biofeedback; Rehabilitation; Stroke; Systematic review.