CONTEXT AND TASK RELATED APPROACH IN REHABILITATION AFTER STROKE: A SYSTEMATIC REVIEW

Background: Stroke is one of the leading causes of death and disability in both the developing and developed nations of the world. Stroke rehabilitation is an organized endeavor to help patients to maximize all opportunities for returning to an active lifestyle1. Neuro-rehabilitation is a method for relearning a previously learned task in a different way, either by compensatory strategies or by adaptively recruiting alternative pathways. There are several different approaches to physiotherapy treatment after stroke. These can broadly be divided into approaches that are based on neurophysiological, motor learning, or orthopedic principles. Some physiotherapists base their treatment on a single approach, whereas others use a mixture of components from a number of different approaches10. Neurological rehabilitation and the contribution of physical therapy have changed considerably over the past decades as scientific and technological developments have enabled greater understanding of brain reorganization and the mechanisms of motor control, motor performance, impairments and adaptations. Aim: This paper is a report of a review conducted to provide an overview of the evidence in the literature on the effect of Context and Task related approach in management stroke survivors. Data Sources: A range of databases was searched to identify papers addressing Context and Task related approach in stroke rehabilitation, including PubMed, Cochrane Library of systematic reviews, ICMR database and various online journals of Stroke and Physiotherapy. The selected papers were assessed for quality. Important characteristics and outcomes were extracted and summarized. Results: Studies of Context and Task related showed benefits for functional outcome in stroke survivors. Active use of task-oriented training with stroke survivors will lead to improvements in functional outcomes and overall health related quality of life. Conclusion: Clinical practice in neuro-rehabilitation continues to vary widely and depends largely on the preferred approach of the individual therapist and on the continuing dominance of therapeutic methods developed half a century ago. Physiotherapists need to embrace the responsibility of using evidence-based, or at least scientifically acceptable, methods of intervention and objective measurements of outcome.