IMPORTANCE: Interventions for improving upper extremity (UE) recovery have become a priority in stroke rehabilitation because UE disability can undermine a person's capacity to perform daily activities after stroke. A better understanding of the use of activity-based task-oriented training (TOT) will inform the development of more effective UE interventions in stroke rehabilitation. OBJECTIVE: To examine the effectiveness of activity-based TOT in improving the UE recovery of adults with stroke. DATA SOURCES: CINAHL Plus, MEDLINE, and PubMed. STUDY SELECTION AND DATA COLLECTION: Inclusion criteria included quantitative studies published between June 2012 and December 2022 that reported UE recovery as an outcome, including measurements of motor function, motor performance, and performance of activities of daily living (ADLs); a sample age >= 18 yr, with stroke in all phases; and interventions that incorporated real-world daily activities. We assessed articles for inclusion, quality, and risk of bias following Cochrane methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. FINDINGS: Sixteen studies (692 participants, Level 1 to 4 evidence) were included. Strong to moderate evidence supported the effectiveness of activity-based TOT in UE motor function, motor performance, and ADL performance for adults with stroke. Strong evidence supported the effectiveness of hospital-based TOT, and moderate evidence supported the effectiveness of home-based TOT. CONCLUSIONS AND RELEVANCE: The RESULTS not only showed the value of activity-based TOT as an effective UE intervention in stroke rehabilitation but also supported the occupational therapy philosophy of using functional and meaningful activities in practice. Further research on home-based TOT is needed.
Copyright by the Amerrican Occupational Therapy Association Inc. Reprinted with permission.

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