title: Functional outcomes can vary by dose: learning-based sensorimotor training for patients stable poststroke.
abstract: OBJECTIVE
  This study aimed to determine whether the dose of learning-based sensorimotor training (LBSMT) significantly enhances gains in upper limb function in patients stable post stroke.
  
  
  METHODS
  A total of 45 subjects stable poststroke participated in a 6-8-week LBSMT program of varied dosage: group I (n = 18; 1x/week, 1.5 hours/visit); group II (n = 19, 3x/week, 0.75 hours/visit); and group III (n = 8; 4x/week, 3 hours/visit). All subjects reinforced their training with home-based practice. The primary outcome measures were functional independence, strength, sensory discrimination, and fine motor skills.
  
  
  RESULTS
  Across all individual subjects, significant gains were measured on the 4 dependent variables (improvement ranging from 9.0% to 38.9%; P < .001). Group III made greater gains than groups I and II on functional independence, sensory discrimination, and fine motor skills, with a significant linear trend by dose for functional independence (P < .001). Only 2-3 subjects in groups I and II, respectively, would need to be treated at the high dosage of group III for one more subject to achieve >50% gain in functional independence.
  
  
  CONCLUSIONS
  Learning-based sensorimotor training based on the principles of neuroplasticity was associated with improved function in patients stable poststroke. The gains were dose specific with the greatest change measured in subjects participating in the high-intensity treatment group.
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, USA.
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Byl
authors.forename: Erica A
authors.initials: EA
authors.lastname: Pitsch
authors.forename: Gary M
authors.initials: GM
authors.lastname: Abrams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D056228:Feedback, Sensory; D005260:Female; D005684:Gait; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D011214:Practice, Psychological; D020127:Recovery of Function; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome