Early and repetitive stimulation of the arm can substantially improve the long-term outcome after stroke: a 5-year follow-up study of a randomized trial.
OBJECTIVE
Several studies have investigated the effect of therapeutic interventions for the arm in the acute phase after stroke, with follow-ups at a maximum of 12 months. The aim of this study was to examine the effect of repetitive sensorimotor training of the arm at 5 years after stroke.


METHODS
One hundred consecutive stroke patients were randomly allocated either to an experimental group that received daily additional sensorimotor stimulation of the arm or to a control group. The intervention period was 6 weeks. Assessments of the patients were made before, midway, and after intervention, and at 6 and 12 months after stroke. In this study, 62 patients were reassessed at 5 years after stroke. The Brunnström-Fugl-Meyer (BFM) test, Action Research Arm (ARA) test, and Barthel index (BI) were used as the primary outcome measures.


RESULTS
At the 5-year follow-up, there was a statistically significant difference for both the BFM and ARA tests in favor of the experimental group. The mean differences in improvement between the groups from the initial evaluation to the 5-year assessment corresponded to 17 points on the BFM and 17.4 on the ARA. No effect was found for the BI. The treatment was most effective in patients with a severe initial motor deficit.


CONCLUSIONS
Adding a specific intervention for the arm during the acute phase after a stroke resulted in a clinically meaningful and long-lasting effect on motor function. The effect can be attributed to early, repetitive, and targeted stimulation.
Feys
Hilde
H
Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Leuven, Belgium. Hilde.Feys@flok.kuleuven.ac.be
De Weerdt
Willy
W
Verbeke
Geert
G
Steck
Gail Cox
GC
Capiau
Chris
C
Kiekens
Carlotte
C
Dejaeger
Eddy
E
Van Hoydonck
Gustaaf
G
Vermeersch
Guido
G
Cras
Patrick
P
D000328:Adult; D000368:Aged; D001132:Arm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D026741:Physical Therapy Modalities; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome