Article

In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe
and colleagues report findings from their methodologically sound, dose-matched
clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial,
the effects of 60 treatment sessions, each involving 3.5 hours of intensive
practice plus either 1.5 hours of functional electrical stimulation (FES) or a
shoulder-arm robotic therapy, were compared with 5 hours of intensive daily
practice alone. Although no significant between-group differences were found on
the primary outcome measure of Arm Motor Ability Test and the secondary outcome
measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains
were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically
meaningful for patients with stroke. However, the underlying mechanisms that
drive these improvements remain poorly understood. The approximately $1000 cost
reduction per patient calculated for the use of motor learning (ML) methods alone
or combined with FES, compared with the combination of ML and shoulder-arm
robotics, further emphasizes the need for cost considerations when making
clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS