title: Repetitive training of complex hand and arm movements with shaping is beneficial for motor improvement in patients after stroke.
abstract: OBJECTIVE
  Repetitive training of simple upper limb movements is effective in stroke rehabilitation. For the repetitive training of complex movements, however, results are inconsistent. The aim of this study was to determine whether repetitive training of complex upper limb movements, focussing on strength and velocity as shaping elements, is effective in stroke rehabilitation.
  
  
  METHODS
  Longitudinal study, A-B-A design.
  
  
  METHODS
  Fifteen first-ever stroke patients.
  
  
  METHODS
  Phases (A): "house-typical" therapy and repetitive training of: (i) grasping and transport movements; and (ii) sawing movements of the affected arm with shaping elements and focussing on velocity over 10 min each, twice daily, 5 days per week. Phase B: "house-typical" occupational and physiotherapy. Each phase lasted 3 weeks.
  
  
  RESULTS
  Patients experienced continuous functional improvement. Voluntary forces improved significantly during the first training phase. Sawing movement improved significantly only during phases A. The grasping and transport movement improved considerably during phase A with a trend of further improvement during the other phases. The transported weight clearly increases only during phases A.
  
  
  CONCLUSIONS
  Repetitive training of complex movements results in motor improvement in stroke patients without relevant transfer to functional improvement if strength and velocity are to be enhanced as shaping elements.
authors.affiliation: Neurologisches Rehabilitationszentrum Leipzig, University of Leipzig, Muldentalweg 1, Bennewitz bei Leipzig, German. woldag@sachsenklinik.de
authors.forename: Hartwig
authors.initials: H
authors.lastname: Woldag
authors.forename: Katharina
authors.initials: K
authors.lastname: Stupka
authors.forename: Horst
authors.initials: H
authors.lastname: Hummelsheim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000502:physiology*; D005260:Female; D006225:Hand / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D026741:Physical Therapy Modalities; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome