Marco Y Pang1, Jocelyn E Harris, Janice J Eng. 1. School of Rehabilitation Sciences, University of British Columbia, Rehabilitation Research Laboratory, GF Strong Centre, Vancouver, BC, Canada.
Abstract
OBJECTIVE: To assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke. DESIGN: Randomized controlled trial. SETTING: Rehabilitation research laboratory and a community hall. PARTICIPANTS: A sample of 63 people (> or =50y) with chronic deficits resulting from stroke (onset > or =1y). INTERVENTIONS: The arm group underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The leg group underwent a lower-extremity exercise program. MAIN OUTCOME MEASURES: The Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (FMA), hand-held dynamometry (grip strength), and the Motor Activity Log. RESULTS: Multivariate analysis showed a significant group by time interaction (Wilks lambda=.726, P=.017), indicating that overall, the arm group had significantly more improvement than the leg group. Post hoc analysis demonstrated that gains in WMFT (functional ability) (P=.001) and FMA (P=.001) scores were significantly higher in the arm group. The amount of improvement was comparable to other novel treatment approaches such as constraint-induced movement therapy or robot-aided exercise training previously reported in chronic stroke. Participants with moderate arm impairment benefited more from the program. CONCLUSIONS: The pilot study showed that a community-based exercise program can improve upper-extremity function in persons with chronic stroke. This outcome justifies a larger clinical trial to further assess efficacy and cost effectiveness.
RCT Entities:
OBJECTIVE: To assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke. DESIGN: Randomized controlled trial. SETTING: Rehabilitation research laboratory and a community hall. PARTICIPANTS: A sample of 63 people (> or =50y) with chronic deficits resulting from stroke (onset > or =1y). INTERVENTIONS: The arm group underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The leg group underwent a lower-extremity exercise program. MAIN OUTCOME MEASURES: The Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (FMA), hand-held dynamometry (grip strength), and the Motor Activity Log. RESULTS: Multivariate analysis showed a significant group by time interaction (Wilks lambda=.726, P=.017), indicating that overall, the arm group had significantly more improvement than the leg group. Post hoc analysis demonstrated that gains in WMFT (functional ability) (P=.001) and FMA (P=.001) scores were significantly higher in the arm group. The amount of improvement was comparable to other novel treatment approaches such as constraint-induced movement therapy or robot-aided exercise training previously reported in chronic stroke. Participants with moderate arm impairment benefited more from the program. CONCLUSIONS: The pilot study showed that a community-based exercise program can improve upper-extremity function in persons with chronic stroke. This outcome justifies a larger clinical trial to further assess efficacy and cost effectiveness.
Authors: A Sunderland; D J Tinson; E L Bradley; D Fletcher; R Langton Hewer; D T Wade Journal: J Neurol Neurosurg Psychiatry Date: 1992-07 Impact factor: 10.154
Authors: Elena V Donoso Brown; Sarah Westcott McCoy; Amber S Fechko; Robert Price; Torey Gilbertson; Chet T Moritz Journal: Arch Phys Med Rehabil Date: 2014-03-19 Impact factor: 3.966
Authors: Margit Alt Murphy; Steve Murphy; Hanna C Persson; Ulla-Britt Bergström; Katharina Stibrant Sunnerhagen Journal: J Vis Exp Date: 2018-03-28 Impact factor: 1.355
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24
Authors: Jill Whitall; Sandy McCombe Waller; John D Sorkin; Larry W Forrester; Richard F Macko; Daniel F Hanley; Andrew P Goldberg; Andreas Luft Journal: Neurorehabil Neural Repair Date: 2010-10-07 Impact factor: 3.919