Chung-Shan Hung1, Keh-Chung Lin2, Wan-Ying Chang3, Wen-Chih Huang4, Ya-Ju Chang5, Chia-Ling Chen6, Kaiping Grace Yao7, Ya-Yun Lee8. 1. Department of Community and Aging, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan. 2. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: kehchunglin@ntu.edu.tw. 3. Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan. 4. Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, Miaoli General Hospital, Ministry of Health and Welfare, Miaoli, Taiwan. 5. Physical Therapy Department and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan. 6. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 7. Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan. 8. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Abstract
OBJECTIVE: To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. DESIGN: A single-blind, randomized controlled trial. SETTING: Four hospitals. PARTICIPANTS: Outpatients with chronic stroke and mild to moderate motor impairment (N=44). INTERVENTION: UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. MAIN OUTCOME MEASURES: Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. RESULTS: The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01). CONCLUSIONS:BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
RCT Entities:
OBJECTIVE: To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. DESIGN: A single-blind, randomized controlled trial. SETTING: Four hospitals. PARTICIPANTS: Outpatients with chronic stroke and mild to moderate motor impairment (N=44). INTERVENTION: UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. MAIN OUTCOME MEASURES: Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. RESULTS: The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01). CONCLUSIONS:BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
Authors: Alexa B Keeling; Mark Piitz; Jennifer A Semrau; Michael D Hill; Stephen H Scott; Sean P Dukelow Journal: J Neuroeng Rehabil Date: 2021-01-21 Impact factor: 4.262
Authors: Khadijeh Moulaei; Abbas Sheikhtaheri; Mansour Shahabi Nezhad; AliAkbar Haghdoost; Mohammad Gheysari; Kambiz Bahaadinbeigy Journal: Arch Public Health Date: 2022-08-23