Do people with acquired brain impairment benefit from additional therapy specifically directed at the hand? A randomized controlled trial.
OBJECTIVE
To determine the benefits of additional therapy specifically directed at the hand in people with acquired brain impairment.


METHODS
An assessor-blinded randomized controlled trial.


METHODS
Rehabilitation hospital.


METHODS
A sample of 39 adults with hand impairment following stroke (90%) or traumatic brain injury (10%). The median (interquartile) time since injury was 1.6 months (0.5-3.5 months).


METHODS
The experimental group (n = 20) received an additional one-hour session of task-specific motor training for the hand five times a week over a six-week period. The training was administered on a one-to-one basis. The control group (n = 19) received standard care which consisted of 10 minutes of hand therapy three times a week. Both groups continued to receive therapy directed at the shoulder and elbow.


METHODS
Primary outcomes were the Action Research Arm and Summed Manual Muscle Tests measured at the beginning and end of the six-week period.


RESULTS
The mean (SD) Action Research Arm Test values for experimental participants improved from the beginning to the end of study from 10 points (15) to 21 points (23) and the equivalent values for the Summed Manual Muscle Test improved from 35% (33) to 49% (35). There were similar improvements in control participants. The mean between-group differences for the Action Research Arm and Summed Manual Muscle Tests were -6 points (95% confidence interval (CI), -20 to 8) and 3% (95% CI, -10 to 16), respectively.


CONCLUSIONS
Hand and overall arm function of all participants improved over the six-week period, however there was not a clear benefit from providing additional hand therapy.
Ross
Leo F
LF
Ipswich Hospital, Brisbane, Australia.
Harvey
Lisa A
LA
Lannin
Natasha A
NA