Interventions to improve the occupational performance of people with post stroke with upper limb apraxia - A systematic review and meta-analysis

Introduction: Upper limb apraxia is a post stroke disorder affecting the persons' ability to perform everyday activities. This review aimed to determine the effectiveness of interventions on occupational performance outcomes. Method: A systematic review of literature (2000-2022) across five electronic databases was conducted. PRISMA guidelines were applied. Data were pooled using RevMan. Findings: Four studies reporting findings from three randomised controlled trials were included. The methodological quality of studies was low. Three treatment approaches were reported: (1) strategy training (2) gesture training (3) combined gesture and strategy training. Strategy training alone or in combination with gesture training was significantly more effective than control interventions in improving occupational performance scores (FEM, mean difference: 1.08, 95% confidence interval: -6.01-8.16, I2 = 0%). Conclusion: This review provides low quality evidence to support the use of strategy training alone, or in combination with gesture training, by Occupational Therapists to improve occupational performance and apraxia scores post intervention among people with post stroke upper limb apraxia.