Journal
NEUROREHABILITATION AND NEURAL REPAIR
Volume 24, Issue 1, Pages 42-51Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1545968309345268
Keywords
cerebrovascular accident; motor activity; kinematics; rehabilitation; randomized controlled trial; upper extremity
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Funding
- National Health Research Institutes [NHRI-EX98-9742PI]
- National Science Council in Taiwan [NSC 96-2320-B-182-029, NSC 96-2628-B-002-033-MY2, NSC 97-2314-B-002-008-MY3, NSC 98-2811-B-002-073]
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Background. Most studies of bilateral arm training (BAT) did not employ a randomized controlled trial design and involved very limited functional training tasks. Objective. Compare the effects of BAT with control intervention (CI) on motor control and motor performance of the upper extremity and also functional gains in patients with chronic stroke. Methods. This 2-group randomized controlled trial with pretreatment and posttreatment measures enrolled 33 stroke patients (mean age = 53.85 years) 6 to 67 months after onset of a first stroke. They received either a BAT program concentrating on both upper extremities moving simultaneously in functional tasks by symmetric patterns or Cl (control treatment) for 2 hours on weekdays for 3 weeks. Outcome measures included kinematic analyses assessing motor control strategies for unilateral and bimanual reaching and clinical measures involving the Fugl-Meyer Assessment (FMA) of motor-impairment severity and the Functional Independence Measure (FIM) and the Motor Activity Log (MAL) evaluating functional ability. Results. After treatment, the BAT group showed better temporal and spatial efficiency during unilateral and bilateral tasks and less online error correction only during the bilateral task than the control group. The BAT group showed a significantly greater improvement in the FMA than the control group but not in the FIM and MAL. Conclusions. Relative to Cl, BAT improved the spatiotemporal control of the affected arm in both bilateral and unilateral tasks, decreased online corrections to perform bilateral tasks, and reduced motor impairment. These findings support the use of BAT to improve motor control and motor function of the affected upper limb in stroke patients.
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