title: Dexamphetamine improves upper extremity outcome during rehabilitation after stroke: a pilot randomized controlled trial.
abstract: BACKGROUND
  For early inpatient stroke rehabilitation, the effectiveness of amphetamine combined with physiotherapy varies across studies.
  
  
  OBJECTIVE
  To investigate whether the recovery of activities of daily living (ADL, primary outcome) and motor function (secondary outcome) can be improved by dexamphetamine added to physiotherapy.
  
  
  METHODS
  In a double-blind, placebo-controlled trial, 16 patients, from 918 who were screened, were randomized to the experimental group (EG, dexamphetamine + physiotherapy) or control group (CG, placebo + physiotherapy). Both groups received multidisciplinary inpatient rehabilitation. Dexamphetamine (10 mg oral) or placebo was administered 2 days per week before physiotherapy. ADL and motor function were measured using the Chedoke-McMaster Stroke Assessment (CMSA) twice during baseline, every week during the 5-week treatment period, and at follow-up 1 week, 6 months, and 12 months after intervention.
  
  
  RESULTS
  The majority of ineligible patients had too little paresis, were on anticoagulants, or had a stroke >60 days prior to entry. Participants (EG, n = 7, age 70.3 ± 10 years, 5 women, 37.9 ± 9 days after stroke; CG, n = 9, age 65.2 ± 17 years, 3 women, 40.3 ± 9 days after stroke) did not differ at baseline except for the leg subscale. Analysis of variance from baseline to 1 week follow-up revealed significant improvements in favor of EG for subscales ADL (P = .023) and arm function (P = .020) at end of treatment. No adverse events were detected.
  
  
  CONCLUSIONS
  In this small trial that was based on prior positive trials, significant gains in ADL and arm function suggest that the dose and timing of dexamphetamine can augment physiotherapy. Effect size calculation suggests inclusion of at least 25 patients per group in future studies.
authors.affiliation: Reha Rheinfelden, Rheinfelden, Switzerland.
authors.forename: Corina
authors.initials: C
authors.lastname: Schuster
authors.forename: Gerd
authors.initials: G
authors.lastname: Maunz
authors.forename: Karin
authors.initials: K
authors.lastname: Lutz
authors.forename: Udo
authors.initials: U
authors.lastname: Kischka
authors.forename: Rolf
authors.initials: R
authors.lastname: Sturzenegger
authors.forename: Thierry
authors.initials: T
authors.lastname: Ettlin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003913:Dextroamphetamine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D020127:Recovery of Function / Q000187:drug effects* / Q000502:physiology; D020521:Stroke / Q000188:drug therapy*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology*
chemical_list: D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine