Effects of passive-active movement training on upper limb motor function and cortical activation in chronic patients with stroke: a pilot study.
OBJECTIVE
To explore how repetitive passive-active movement training effects upper limb motor function and cortical activation in patients with stroke.


METHODS
Single-group treatment trial with baseline comparisons.


METHODS
Ten chronic patients with stroke with paresis of the upper limb.


METHODS
Assessments were performed during a 4-week baseline period before and once after 4 weeks of training using the Motor Assessment Scale of the upper limb, Nine Hole Peg Test, goniometer for range of movement and the modified Ashworth scale for muscle tone. Two patients underwent functional magnetic resonance imaging pre- and post-training. The treatment consisted of daily sessions of repeated functional reaching and grasping movements guided passively and attempted actively during 4 weeks.


RESULTS
The group improved in range of motion and Motor Assessment Scale scores. Subjects reported improvements in a variety of daily tasks requiring the use of the affected upper limb. Increases in cortical activation in prefrontal and sensorimotor areas were observed in parallel with improvements of upper limb motor function in the 2 patients scanned.


CONCLUSIONS
The 4-week training programme improved hand motor function and ability. Cortical activation on functional magnetic resonance imaging changed in parallel suggesting reorganization of areas related to movements of the paretic limb.
Lindberg
Påvel
P
Department of Neuroscience, Rehabilitation Medicine, Uppsala University Hospital, Uppsala, Sweden. Pavel.Lindberg@rehab.uu.se
Schmitz
Christina
C
Forssberg
Hans
H
Engardt
Margareta
M
Borg
Jörgen
J
D002540:Cerebral Cortex / Q000503:physiopathology*; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D016059:Range of Motion, Articular; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity