OBJECTIVE: To describe a treatment protocol for the upper limb that standardizes intensity of therapy input regardless of the severity of presentation. DESIGN: The protocol is described (Part 1) and feasibility and effect explored (Part 2). SUBJECTS: Participants (n = 11) had a single ischaemic stroke in the middle cerebral artery territory more than one year previously, and had residual weakness of the hand with some extension present at the wrist and the ability to grasp. INTERVENTIONS: Following two baseline assessments, participants attended therapy for 1 hour a day for 10 consecutive working days. Treatment consisted of a combination of strength and functional task training. Outcomes were measured immediately after training, at one month and three months. OUTCOME MEASURES: Intensity was measured with Borg Rating of Perceived Exertion. Secondary outcome measures included Action Research Arm Test (ARAT), nine-hole peg test, and Goal Attainment Scale. RESULTS: Borg scores indicated that the level of intensity was appropriate and similar across all participants despite individual differences in the severity of their initial presentation (median (interquartile range) = 14 (13-15)). The mean ARAT score significantly increased by 6.8 points (chi(2)(3) = 15.618, P<0.001), and was maintained at three-month follow-up (z = - 2.384, P = 0.016). The nine-hole peg test also showed a main effect of time and 88% of goals set were achieved. CONCLUSIONS: The physiotherapy protocol standardized intensity of treatment by grading exercise and task-related practice according to the person's residual ability, rather than simply standardizing treatment times. It was feasible and well tolerated in this group.
OBJECTIVE: To describe a treatment protocol for the upper limb that standardizes intensity of therapy input regardless of the severity of presentation. DESIGN: The protocol is described (Part 1) and feasibility and effect explored (Part 2). SUBJECTS: Participants (n = 11) had a single ischaemic stroke in the middle cerebral artery territory more than one year previously, and had residual weakness of the hand with some extension present at the wrist and the ability to grasp. INTERVENTIONS: Following two baseline assessments, participants attended therapy for 1 hour a day for 10 consecutive working days. Treatment consisted of a combination of strength and functional task training. Outcomes were measured immediately after training, at one month and three months. OUTCOME MEASURES: Intensity was measured with Borg Rating of Perceived Exertion. Secondary outcome measures included Action Research Arm Test (ARAT), nine-hole peg test, and Goal Attainment Scale. RESULTS: Borg scores indicated that the level of intensity was appropriate and similar across all participants despite individual differences in the severity of their initial presentation (median (interquartile range) = 14 (13-15)). The mean ARAT score significantly increased by 6.8 points (chi(2)(3) = 15.618, P<0.001), and was maintained at three-month follow-up (z = - 2.384, P = 0.016). The nine-hole peg test also showed a main effect of time and 88% of goals set were achieved. CONCLUSIONS: The physiotherapy protocol standardized intensity of treatment by grading exercise and task-related practice according to the person's residual ability, rather than simply standardizing treatment times. It was feasible and well tolerated in this group.
Authors: J H Van der Lee; V De Groot; H Beckerman; R C Wagenaar; G J Lankhorst; L M Bouter Journal: Arch Phys Med Rehabil Date: 2001-01 Impact factor: 3.966
Authors: Carolee J Winstein; Dorian K Rose; Sylvia M Tan; Rebecca Lewthwaite; Helena C Chui; Stanley P Azen Journal: Arch Phys Med Rehabil Date: 2004-04 Impact factor: 3.966
Authors: Penelope Talelli; Amanda Wallace; Michelle Dileone; Damon Hoad; Binith Cheeran; Rupert Oliver; Mehdi VandenBos; Ulrike Hammerbeck; Karen Barratt; Cecilia Gillini; Gabriella Musumeci; Marie-Hélène Boudrias; Geoffrey C Cloud; Joanna Ball; Jonathan F Marsden; Nicholas S Ward; Vincenzo Di Lazzaro; Richard G Greenwood; John C Rothwell Journal: Neurorehabil Neural Repair Date: 2012-03-12 Impact factor: 3.919
Authors: Sarah A Moore; Ruth Da Silva; Madelaine Balaam; Lianne Brkic; Dan Jackson; Dan Jamieson; Thomas Ploetz; Helen Rodgers; Lisa Shaw; Frederike van Wijck; Christopher Price Journal: Trials Date: 2016-10-21 Impact factor: 2.279
Authors: Patrícia Graef; Stella M Michaelsen; Maria L R Dadalt; Daiana A M S Rodrigues; Franciele Pereira; Aline S Pagnussat Journal: Braz J Phys Ther Date: 2016-09-16 Impact factor: 3.377