Article

For early inpatient stroke rehabilitation, the effectiveness of
amphetamine combined with physiotherapy varies across studies. OBJECTIVE: To
investigate whether the recovery of activities of daily living (ADL, primary
outcome) and motor function (secondary outcome) can be improved by dexamphetamine
added to physiotherapy. METHODS: In a double-blind, placebo-controlled trial, 16
patients, from 918 who were screened, were randomized to the experimental group
(EG, dexamphetamine + physiotherapy) or control group (CG, placebo +
physiotherapy). Both groups received multidisciplinary inpatient rehabilitation.
Dexamphetamine (10 mg oral) or placebo was administered 2 days per week before
physiotherapy. ADL and motor function were measured using the Chedoke-McMaster
Stroke Assessment (CMSA) twice during baseline, every week during the 5-week
treatment period, and at follow-up 1 week, 6 months, and 12 months after
intervention. RESULTS: The majority of ineligible patients had too little
paresis, were on anticoagulants, or had a stroke >60 days prior to entry.
Participants (EG, n = 7, age 70.3 +/- 10 years, 5 women, 37.9 +/- 9 days after
stroke; CG, n = 9, age 65.2 +/- 17 years, 3 women, 40.3 +/- 9 days after stroke)
did not differ at baseline except for the leg subscale. Analysis of variance from
baseline to 1 week follow-up revealed significant improvements in favor of EG for
subscales ADL (P = .023) and arm function (P = .020) at end of treatment. No
adverse events were detected. CONCLUSION: In this small trial that was based on
prior positive trials, significant gains in ADL and arm function suggest that the
dose and timing of dexamphetamine can augment physiotherapy. Effect size
calculation suggests inclusion of at least 25 patients per group in future
studies.

Langue : ANGLAIS