Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis

J Rehabil Med. 2010 Jan;42(1):9-14. doi: 10.2340/16501977-0473.


Objective: To determine if repetitive task training after stroke improves functional activity.

Design: Systematic review and meta-analysis of trials comparing repetitive task training with attention control or usual care.

Data sources: The Cochrane Stroke Trials Register, electronic databases of published, unpublished and non-English language papers; conference proceedings, reference lists, and trial authors.

Review methods: Included studies were randomized/quasi-randomized trials in adults after stroke where an active motor sequence aiming to improve functional activity was performed repetitively within a single training session. We used Cochrane Collaboration methods, resources, and software.

Results: We included 14 trials with 17 intervention-control pairs and 659 participants. Results were statistically significant for walking distance (mean difference 54.6, 95% confidence interval (95% CI) 17.5, 91.7); walking speed (standardized mean difference (SMD) 0.29, 95% CI 0.04, 0.53); sit-to-stand (standard effect estimate 0.35, 95% CI 0.13, 0.56), and activities of daily living: SMD 0.29, 95% CI 0.07, 0.51; and of borderline statistical significance for measures of walking ability (SMD 0.25, 95% CI 0.00, 0.51), and global motor function (SMD 0.32, 95% CI -0.01, 0.66). There were no statistically significant differences for hand/arm functional activity, lower limb functional activity scales, or sitting/standing balance/reach.

Conclusion: Repetitive task training resulted in modest improvement across a range of lower limb outcome measures, but not upper limb outcome measures. Training may be sufficient to have a small impact on activities of daily living. Interventions involving elements of repetition and task training are diverse and difficult to classify: the results presented are specific to trials where both elements are clearly present in the intervention, without major confounding by other potential mechanisms of action.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Activities of Daily Living
  • Adult
  • Arm / physiopathology
  • Humans
  • Leg / physiopathology
  • Motor Activity / physiology
  • Movement / physiology
  • Physical Therapy Modalities
  • Postural Balance / physiology
  • Recovery of Function / physiology
  • Stroke / physiopathology
  • Stroke Rehabilitation*
  • Task Performance and Analysis
  • Walking / physiology