A Cochrane review [Abstract] 1 included 3 studies with a total of 132 subjects examining the effect of experimental therapeutic interventions for motor apraxia in stroke compared with standard care (including usual occupational therapy). There was evidence of a small and short-lived therapeutic effect in the two studies that reported change in activities of daily living (change in Barthel ADL Index at end experimental therapy: MD 1.28, 95% CI 0.19 to 2.38, P = 0.02, in favour of the experimental group; 2 studies, n=102), but this was not considered clinically significant and did not persist at the longer-term follow up (change in Barthel Index at six months after end of therapy: MD 0.17, 95% CI -1.41 to 1.75, P = 0.83, in favour of the experimental group; 1 study, n=83).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment), by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison). The authors state that they did not review whether patients with apraxia benefit from rehabilitation input in general, and patients should continue to receive general stroke rehabilitation services.
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