Article

Few therapeutic options exist for the millions of persons living with
severe arm impairment after stroke to increase their dose of arm rehabilitation.
This study compared self-guided, high-repetition home therapy with a mechanical
device (the resonating arm exerciser [RAE]) to conventional therapy in patients
with chronic stroke and explored RAE use for patients with subacute stroke.
METHODS: A total of 16 participants with severe upper-extremity impairment (mean
Fugl-Meyer [FM] score = 21.4 +/- 8.8 out of 66) >6 months poststroke were
randomized to 3 weeks of exercise with the RAE or conventional exercises. The
primary outcome measure was FM score 1 month posttherapy. Secondary outcome
measures included Motor Activity Log, Visual Analog Pain Scale, and Ashworth
Spasticity Scale. After a 1-month break, individuals in the conventional group
also received a 3-week course of RAE therapy. RESULTS: The change in FM score was
significant in both the RAE and conventional groups after training (2.6 +/- 1.4
and 3.4 +/- 2.4, P = .008 and .016, respectively). These improvements were not
significant at 1 month. Exercise with the RAE led to significantly greater
improvements in distal FM score than conventional therapy at the 1-month
follow-up (P = .02). In a separate cohort of patients with subacute stroke, the
RAE was found feasible for exercise. DISCUSSION: In those with severe arm
impairment after chronic stroke, home-based training with the RAE was feasible
and significantly reduced impairment without increasing pain or spasticity. Gains
with the RAE were comparable to those found with conventional training and also
included distal arm improvement.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS