Article

Improved upper-extremity (UE) movement with stroke rehabilitation may
involve restoration of more normal or development of compensatory movement
patterns. OBJECTIVE: The authors investigated the differential effects of
functional task practice (FTP) and dynamic resistance training (POWER) on
clinical function and reaching kinematics in an effort to distinguish between
mechanisms of gains. METHODS: A total of 14 hemiparetic individuals were randomly
assigned to 10 weeks of either FTP or POWER and then crossed over to 10 weeks of
the alternate treatment. Treatment order A was FTP followed by POWER, whereas
treatment order B was POWER followed by FTP. Evaluation before and after each
treatment block included a battery of clinical evaluations and kinematics of
paretic UE functional reach to grasp. RESULTS: Both FTP and POWER improved
movement accuracy, as revealed by a shift toward normal, including fewer
submovements and reduced reach-path ratio. However, active range of motion
revealed differential treatment effects. Shoulder flexion and elbow extension
decreased with FTP and were associated with increased trunk displacement. In
contrast, shoulder flexion and elbow extension excursion increased with POWER and
were associated with significantly reduced trunk displacement. Treatment order B
(POWER followed by FTP) revealed greater overall improvements. CONCLUSION: FTP increases compensatory movement patterns to improve UE function. POWER leads to
more normal movement patterns. POWER prior to FTP may enhance the benefits of
repetitive task practice.

Langue : ANGLAIS