Karen VisserBASEMA FATHI EBRAHEEM TEMEHY2022-05-292022-05-29https://drepo.sdl.edu.sa/handle/20.500.14154/44168Background: The recommended time for a physiotherapy session for stroke patients is 45 minutes for five days per week (NICE 2013). However, some studies suggest a positive relationship between time spent in rehabilitation (in minutes) and the motor outcome; that is, increasing the length of rehabilitation sessions results in a higher recovery rate than conventional therapy time (Lohse et al. 2014). Furthermore, it is known that the most significant steps in the recovery of a stroke patient takes place in the first three months (Beebe and Lang 2009; Buma et al. 2013). Therefore, this review suggests that increasing the time spent in rehabilitation (in minutes) in the first three months interacts beneficially with the patient’s spontaneous recovery and results in better motor functioning and ADLs. Methodology: A comprehensive literature search for RCTS was conducted through MEDLINE (Ovid), Emcare (Ovid), Embase (Ovid), CINAHL (EBSCO), AMED (Ovid), the Cochrane Library, PubMed, and PEDro on November 12, 2019. Eight RCTs met the inclusion criteria and were appraised by two individual reviewers. Six out of eight RCTs were involved in narrative synthesis due to heterogeneity in the intervention and outcome measures. All six studies were moderate to high quality according to the JBI assessment tool (JBI 2013) and involved 363 participants in total. Results: Four studies measuring ADLs found better results for the intensive therapy group (the group which had more therapy, as measured in minutes) than conventional rehabilitation (the group which had less therapy, as measured in minutes) but were not statistically significant (P > 0.05). For motor function, intervention involved a high treatment contrast (difference in the number of hours provided) between the intervention and control groups (30 hours) showed statistically significant motor function recovery (ARAT, p = 0.008). Interventions that began later in the rehabilitation process (34 days in Cooke et al. 2009; 40.86 days in Han et al. 2013) also showed statistically significant motor recovery. Interventions aimed to assess motor function and included patients who were independently mobile with moderate stroke severity; these patients found intensive therapy superior to standard care (Cooke et al. 2009; Han et al. 2013). Greater motor-function improvement was noted in younger participants (50.2 years in Han et al. 2013), and where the interventions were more specific to either the upper or lower motor-function area (Cooke et al. 2009; Han et al. 2013). Conclusion: Providing intensive rehabilitation during the first three months of therapy did not lead to statistically significant improvements in stroke patients’ ADLs. However, there is a trend in favour of intensive therapy over conventional therapy. In motor function, the results were mixed, younger and less severely impaired participants demonstrated greater improvement of motor functions. However, these results are still inconclusive and further research is needed.en