Table 1.
Main characteristics of the randomized controlled trials included in the systematic review and meta-analysis.
| Study | Participants | Intervention | Outcome | Measuring instrument | Results | |||||||
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Sample size (male and female), N | Characteristics | Sample size and age (years) | EGa | CGb | Duration and frequency |
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| El-Shamy and Alsharif [41], 2017 | 40 (27 and 13) | NLc: C5-C6; weight (kg)—EG: 21.65 (SD 1.76) and CG: 22.2 (SD 1.51); height (cm)—EG: 116.95 (SD 5.62) and CG: 119.41 (SD 5.41); affected side (RAd)—EG: 12 and CG: 13 | EG: 20 (mean 6.35, SD 0.93); CG: 20 (mean 6.60, SD 1.05) | ASPe | CPTf | 12 weeks; 3 sessions/week; 45 min/session | Functional activity; active ROMg; muscle strength | MSSh; goniometer; handheld dynamometer | Significant differences (EG or CG); SERi: P<.001, HNj: P<.001, HSk: P<.001, and HMl: P<.001 for functional activity; SABDm: P<.001 and SER: P<.001 for active ROM; SABD: P<.001 and SER: P<.001 for muscle strength | |||
| Tarakci et al [43], 2019 | 19 (11 and 8) | NL: C5-C6, C5-C7, or C5-T1; weight (kg)—EG: 15.82 (SD 2.71) and CG: 16.85 (SD 2.74); height (cm)—NDn; affected side (RA)—EG: 8 and CG: 9 | EG: 9 (mean 8.22, SD 2.58); CG: 10 (mean 8.30, SD 2.21) | LMCo | CPT | 8 weeks; 3 sessions/week; 60 min/session | Functional activity; fine motor skills; muscle strength | DHIp, JTHFTq, and CHAQr; 9HPTs; handheld dynamometer (HGt) or hydraulic pinch gauge (TGu) | Significant intragroup differences; DHI—EG: P=.006 and CG: P<.001 for functional activity; JTHFT—EG: P=.04 and CG: P=.001 for functional activity; EG: P=.02 and CG: P=.01 for fine motor skills; HG—EG: P=.007 and CG: P=.002 for muscle strength; TG—EG: P=.03 and CG: P=.003 for muscle strength | |||
| Alsakhawi and Atya [40], 2020 | 45 (20 and 25) | NL: C5-C6, C5-C7, or C6-C7; weight (kg)—EG: 29.51 (SD 2.46) and CG: 30.25 (SD 2.90); height (cm)—EG: 129.67 (SD 1.67) and CG: 132 (SD 2.59); affected side (RA)—ND | EG: 22 (mean 6.55, SD 1.01); CG: 23 (mean 6.09, SD 0.95) | E-L ULEv | CPT | 6 weeks; 3 sessions/week; 60 min/session | Active ROM; functional activity; muscle strength | Inclinometer; MSS; AMSw | Significant differences (EG or CG); SFx (elbow flexion): P=.007, SF (elbow extension): P=.002, SABD: P=.002, and SER: P=.001 for active ROM; SABD: P=.01, SER: P=.03, HN: P=.001, HS: P=.004, and HM: P=.04 for functional activity; SF: P=.001, SABD: P=.001, and SER: P=.006 for muscle strength | |||
| Yeves-Lite et al [11], 2020 | 12 (6 and 6) | NL: C5-C6 and C5-C7; weight (kg)—ND; height (cm)—ND; affected side (RA)—EG: 5 and CG: 3 | EG: 6 (mean 8.50, SD 3.50); CG: 6 (mean 8.42, SD 3.40) | VRMTy app | CMTz | 4 weeks; 3 sessions/week; 20 min/session | Functional activity; quality of life | Children’s Hand-use Experience Questionnaire; Pediatric Quality of Life Inventory 4.0 | Significant intragroup differences; independent tasks—EG: P=.02 for functional activity; use of the affected hand with grasp—EG: P=.04 for functional activity; children answers—EG: P=.04 for quality of life | |||
| Karas et al [42], 2022 | 22 (11 and 11) | NL: C5-C6; weight (kg)—EG: 26.6 (SD 11.37) in female participants and 23.17 (SD 6.68) in male participant, CG: 24.33 (SD 7.03) in female participants and 28.6 (SD 5.03) in male participant; height (cm)—EG: 115.67 (SD 15.27) in female participants and 115.5 (SD 20.74) in male participants, CG: 116.0 (SD 13.19) in female participants and 106.5 (SD 10.71) in male participant; affected side (RA)—EG: 4 and CG: 7 | EG: 11 (mean 7.33, SD 2.34 for female participants and mean 7.80, SD 4.09 for male participants); CG: 11 (mean 8.40, SD 2.19 for female participants and mean 6.67, SD 2.80 for male participants) | CG+ Wii Sports | CPT | 6 weeks; 4 sessions/week; 40 min/session | Muscle strength; functional activity; active ROM | AMS; MSS; goniometer | Significant differences (EG or CG); SER: P=.001, shoulder internal rotation: P=.02, and forearm pronation: P=.03 for active ROM | |||
aEG: experimental group.
bCG: control group.
cNL: nerve lesion.
dRA: right arm.
eASP: Armeo Spring Pediatric.
fCPT: conventional physical therapy.
gROM: range of movement.
hMSS: Mallet scoring system.
iSER: shoulder external rotation.
jHN: hand to neck.
kHS: hand to spine.
lHM: hand to mouth.
mSABD: shoulder abduction.
nND: not described.
oLMC: Leap Motion Controller.
pDHI: Duruoz Hand Index.
qJTHFT: Jebsen-Taylor Hand Function Test.
rCHAQ: Childhood Health Assessment Questionnaire.
s9HPT: Nine-Hole Peg Test.
tHG: hand grip.
uTG: tip grip.
vE-L ULE: E-LINK Upper Limb Exerciser.
wAMS: Active Movement Scale.
xSF: shoulder flexion.
yVRMT: virtual reality mirror therapy.
zCMT: conventional mirror therapy.