Is forced use of the paretic upper limb beneficial? A randomized pilot study during subacute post-stroke recovery.
OBJECTIVE
To evaluate the effect of two weeks of forced use of the paretic upper limb, as a supplement to the rehabilitation programme in the subacute phase after stroke, on self-rated use of that limb.


METHODS
A randomized, non-blind, parallel group, clinical, before-and-after trial. A forced use group and a conventional group were followed up one and three months after intervention.


METHODS
In- and outpatient units of rehabilitation at a University Hospital.


METHODS
Thirty patients were allocated to two groups, 15 in each, 1-6 months (mean 2.4) after stroke onset. Twenty-six patients completed the study.


METHODS
The patients of both groups participated in two weeks of daily training on weekdays. In addition, the forced use group wore a restraining sling on the non-paretic arm for up to 6 hours per weekday.


METHODS
The Motor Activity Log; patients scored 0-5 for 30 daily tasks concerning both amount of use and quality of movement.


RESULTS
The forced use group tended to achieve larger improvements immediately post-intervention, but this was not clearly demonstrated. The small differences also levelled out up to the three-month follow-up, with both groups earning an approximately 1.0 score point on both scales of the Motor Activity Log.


CONCLUSIONS
This pilot study did not reveal any additional benefit of forced use on self-rated performance in daily use of the paretic upper limb. Both groups performed fairly extensive, active training with a similar duration, amount and content.
Hammer
Ann
A
Department of Rehabilitation Medicine, Orebro University Hospital, School of Health and Medical Sciences, Orebro University, Orebro. ann.hammer@orebroll.se
Lindmark
Birgitta
B