title: Impairment-oriented training or Bobath therapy for severe arm paresis after stroke: a single-blind, multicentre randomized controlled trial.
abstract: OBJECTIVE
  To study the effects of augmented exercise therapy time for arm rehabilitation as either Bobath therapy or the impairment-oriented training (Arm BASIS training) in stroke patients with arm severe paresis.
  
  
  METHODS
  Single blind, multicentre randomized control trial.
  
  
  METHODS
  Three inpatient neurorehabilitation centres.
  
  
  METHODS
  Sixty-two anterior circulation ischaemic stroke patients.
  
  
  METHODS
  Random assignment to three group: (A) no augmented exercise therapy time, (B) augmented exercise therapy time as Bobath therapy and (C) augmented exercise therapy time as Arm BASIS training.
  
  
  METHODS
  
  
  
  METHODS
  Fugl-Meyer arm motor score. Secondary measure: Action Research Arm Test (ARA). Ancillary measures: Fugl-Meyer arm sensation and joint motion/pain scores and the Ashworth Scale (elbow flexors).
  
  
  RESULTS
  An overall effect of augmented exercise therapy time on Fugl-Meyer scores after four weeks was not corroborated (mean and 95% confidence interval (CI) of change scores: no augmented exercise therapy time (n=20) 8.8, 5.2-12.3; augmented exercise therapy time (n=40) 9.9, 6.8-13.9; p = 0.2657). The group who received the augmented exercise therapy time as Arm BASIS training (n=20) had, however, higher gains than the group receiving the augmented exercise therapy time as Bobath therapy (n=20) (mean and 95% CI of change scores: Bobath 7.2, 2.6-11.8; BASIS 12.6, 8.4-16.8; p = 0.0432). Passive joint motion/pain deteriorated less in the group who received BASIS training (mean and 95% CI of change scores: Bobath -3.2, -5.2 to -1.1; BASIS 0.1, -1.8-2.0; p = 0.0090). ARA, Fugl-Meyer arm sensation, and Ashworth Scale scores were not differentially affected.
  
  
  CONCLUSIONS
  The augmented exercise therapy time as Arm BASIS training enhanced selective motor control. Type of training was more relevant for recovery of motor control than therapeutic time spent.
authors.affiliation: Department of Neurological Rehabilitation, Campus Benjamin Franklin, Charité-Universitatsmedizin Berlin, Germany. tplatz@zedat.fu-berlin.de
authors.forename: T
authors.initials: T
authors.lastname: Platz
authors.forename: C
authors.initials: C
authors.lastname: Eickhof
authors.forename: S
authors.initials: S
authors.lastname: van Kaick
authors.forename: U
authors.initials: U
authors.lastname: Engel
authors.forename: C
authors.initials: C
authors.lastname: Pinkowski
authors.forename: S
authors.initials: S
authors.lastname: Kalok
authors.forename: M
authors.initials: M
authors.lastname: Pause
mesh_terms: D001132:Arm / Q000503:physiopathology*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome