A review of 165 studies on the efficacy of rehabilitation methods in the treatment of hemiplegia after a stroke is presented. Intervention studies on stroke rehabilitation wards as well as specific forms of physical and occupational therapy -- including functional electro-stimulation, different types of feedback therapy and visual perception training -- are critically evaluated. The general conclusion to be drawn is that stroke patients benefit from expert care. An important aspect of the efficacy of expert care is the early start of intensive treatment after stroke -- some studies going as far as to suggest that patients should also be stimulated to walk at an early stage. In a large number of studies, facilitation and inhibition techniques, different forms of feedback therapy and functional electro-stimulation have produced positive effects but only for those parameters on which training was specifically given: the transfer to ADL -- where investigated -- appears to be minimal. Postural sway feedback therapy was shown to produce specific treatment effects on standing balance, but showed no transfer to walking. Visual perception training not only resulted in specific training effects on neuropsychological tasks, but also showed some transfer to reading and writing. It is concluded that, in addition to the heterogeneity of the stroke population, the lack of generalization of treatment effects to ADL posess a major problem for rehabilitation research. It is concluded that ADL should be trained in a task-specific way.

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