Article

OBJECTIVE: To evaluate the effectiveness of reinforced feedback in virtual
environment (RFVE) treatment combined with conventional rehabilitation (CR) in
comparison with CR alone, and to study whether changes are related to stroke
etiology (ie, ischemic, hemorrhagic). DESIGN: Randomized controlled trial.
SETTING: Hospital facility for intensive rehabilitation. PARTICIPANTS: Patients
(N=136) within 1 year from onset of a single stroke (ischemic: n=78, hemorrhagic:
n=58). INTERVENTIONS:
The experimental treatment was based on the combination of
RFVE with CR, whereas control treatment was based on the same amount of CR. Both
treatments lasted 2 hours daily, 5d/wk, for 4 weeks. MAIN OUTCOME MEASURES:
Fugl-Meyer upper extremity scale (F-M UE) (primary outcome), FIM, National
Institutes of Health Stroke Scale (NIHSS), and Edmonton Symptom Assessment Scale
(ESAS) (secondary outcomes). Kinematic parameters of requested movements included
duration (time), mean linear velocity (speed), and number of submovements (peak)
(secondary outcomes). RESULTS: Patients were randomized in 2 groups (RFVE with
CR: n=68, CR: n=68) and stratified by stroke etiology (ischemic or hemorrhagic).
Both groups improved after treatment, but the experimental group had better
results than the control group (Mann-Whitney U test) for F-M UE (P<.001), FIM
(P<.001), NIHSS (P</=.014), ESAS (P</=.022), time (P<.001), speed (P<.001), and
peak (P<.001). Stroke etiology did not have significant effects on patient
outcomes. CONCLUSIONS:
The RFVE therapy combined with CR treatment promotes
better outcomes for upper limb than the same amount of CR, regardless of stroke etiology.
CI - Copyright (c) 2018 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS