Article

Phase III trials of rehabilitation of paresis after stroke have
proven the effectiveness of intensive and extended task practice, but they have
also shown that many patients do not qualify, because of severity of impairment,
and that many of those who are treated are left with clinically significant
deficits. Objective. To test the value of 2 potential adjuvants to normal
learning processes engaged in constraint-induced movement therapy (CIMT): greater
distribution of treatment over time and the coadministration of d-cycloserine, a
competitive agonist at the glycine site of the N-methyl-D-aspartate glutamate
receptor. Methods. A prospective randomized single-blind parallel-group trial of
more versus less condensed therapy (2 vs 10 weeks) and d-cycloserine (50 mg) each
treatment day versus placebo (in a 2 x 2 design), as potential adjuvants to 60
hours of CIMT. Results. Twenty-four participants entered the study, and 22
completed it and were assessed at the completion of treatment and 3 months later.
Neither greater distribution of treatment nor treatment with d-cycloserine
significantly augmented retention of gains achieved with CIMT. Conclusions.
Greater distribution of practice and treatment with d-cycloserine do not appear
to augment retention of gains achieved with CIMT. However, concentration of CIMT
over 2 weeks ("massed practice") appears to confer no advantage either.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS