Long-term rehabilitation for chronic stroke arm movements: a randomized controlled trial
Cauraugh, JH and Naik, SK and Lodha, N and Coombes, SA and Summers, JJ, Long-term rehabilitation for chronic stroke arm movements: a randomized controlled trial, Clinical Rehabilitation, 25, (12) pp. 1086-1096. ISSN 0269-2155 (2011) [Refereed Article]
Objective: We investigated the effect of long-term practice on motor improvements in chronic stroke
Design: Randomized parallel group controlled study.
Setting: Motor Behavior Laboratory, University of Florida.
Subjects: Eighteen individuals who experienced a stroke more than nine months prior to enrolling.
Interventions: The treatment interventions were bilateral arm movements coupled with active neuromuscular
stimulation on the impaired arm for both practice duration groups. The short-term group
received one treatment protocol, whereas, over 16 months, the long-term practice group completed
10 treatment protocols. All protocol sessions were 6 hours long (90 minutes 1 day/week/4 weeks) and
were separated by 22 days.
Main outcome measures: Repeated data collection on three primary outcome measures (i.e. Box and
Block test, fractionated reaction times, and sustained force production) evaluated motor capabilities
across rehabilitation times.
Results: Mixed design ANOVAs (GroupxRetention Test: 2x4; GroupxRetention TestxArm
Condition: 2x4x2) revealed improved motor capabilities for the long-term practice duration group
on each primary measure. At the 16-month delayed retention test, when compared to the short-term
group, the long-term group demonstrated: (a) more blocks moved (43 v 32), (b) faster premotor reaction
times (158 v 208 ms), and (c) higher force production (75 v 45 N).
Conclusion: Sixty hours of rehabilitation over 16 months provided by various bilateral arm movements
and coupled active stimulation improved motor capabilities in chronic stroke.
Chronic stroke, motor recovery, upper extremity rehabilitation, bilateral movements and active