A pilot study of activity-based therapy in the arm motor recovery post stroke: a randomized controlled trial.
OBJECTIVE
To determine the efficacy of activity-based therapies using arm ergometer or robotic or group occupational therapy for motor recovery of the paretic arm in patients with an acute stroke (< or =4 weeks) admitted to an inpatient rehabilitation facility, and to obtain information to plan a large randomized controlled trial.


METHODS
Prospective, randomized controlled study.


METHODS
Stroke unit in a rehabilitation hospital.


METHODS
Thirty patients with an acute stroke (< or =4 weeks) who had arm weakness (Medical Research Council grade 2 or less at the shoulder joint).


METHODS
Occupational therapy (OT) group (control) (n = 10), arm ergometer (n = 10) or robotic (n = 10) therapy group. All patients received standard, inpatient, post-stroke rehabilitation training for 3 hours a day, plus 12 additional 40-minute sessions of the activity-based therapy.


METHODS
The primary outcome measures were discharge scores in the Fugl-Meyer Assessment Scale for upper limb impairment, Motor Status Scale, total Functional Independence Measure (FIM) and FIM-motor and FIM-cognition subscores.


RESULTS
The three groups (OT group versus arm ergometer versus robotic) were comparable on clinical demographic measures except the robotic group was significantly older and there were more haemorrhagic stroke patients in the arm ergometer group. After adjusting for age, stroke type and outcome measures at baseline, a similar degree of improvement in the discharge scores was found in all of the primary outcome measures.


CONCLUSIONS
This study suggests that activity-based therapies using an arm ergometer or robot when used over shortened training periods have the same effect as OT group therapy in decreasing impairment and improving disability in the paretic arm of severely affected stroke patients in the subacute phase.
Rabadi
Mh
M
Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA. mhrabadi@gmail.com
Galgano
M
M
Lynch
D
D
Akerman
M
M
Lesser
M
M
Volpe
Bt
B
D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009788:Occupational Therapy / Q000295:instrumentation / Q000379:methods*; D010291:Paresis / Q000209:etiology / Q000628:therapy*; D010865:Pilot Projects; D012371:Robotics; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation