title: Benefits of a repetitive facilitative exercise program for the upper paretic extremity after subacute stroke: a randomized controlled trial.
abstract: BACKGROUND
  Repetitive facilitative exercise (RFE), a combination of high repetition rate and neurofacilitation, is a recently developed approach to the rehabilitation of stroke-related limb impairment. Preliminary investigations have been encouraging, but a randomized controlled evaluation has yet to be performed.
  
  
  OBJECTIVE
  To compare the efficacy of RFE with that of conventional rehabilitation in adults with subacute stroke.
  
  
  METHODS
  A total of 52 adults with stroke-related upper-limb impairment (Brunnstrom stage ≥III) of 3 to 13 weeks' duration participated in this randomized, controlled, observer-blinded trial. Participants were randomized into 2 groups and received treatment on a 4-week, 40 min/d, 5 d/wk schedule. Those assigned to RFE received 100 standardized movements of at least 5 joints of their affected upper extremity, whereas those in the control group participated in a conventional upper-extremity rehabilitation program. Primary and secondary outcomes (improvement in group action research arm test [ARAT] and Fugl-Meyer Arm [FMA] scores, respectively) were assessed at the end of training.
  
  
  RESULTS
  In all, 49 participants (26 receiving RFE) completed the trial. ARAT and FMA scores at baseline were 19 ± 21 and 39 ± 21 (mean ± standard deviation). Evaluation at the trial's completion revealed significantly larger improvements in the RFE group than in the control group in both ARAT (F = 7.52; P = .009) and FMA (F = 5.98; P = .019) scores.
  
  
  CONCLUSIONS
  These findings suggest that RFE may be more effective than conventional rehabilitation in lessening impairment and improving upper-limb motor function during the subacute phase of stroke.
authors.affiliation: Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. rihakoza@m2.kufm.kagoshima-u.ac.jp
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimodozono
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Noma
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nomoto
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hisamatsu
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kamada
authors.forename: Ryuji
authors.initials: R
authors.lastname: Miyata
authors.forename: Shuji
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Atsuko
authors.initials: A
authors.lastname: Ogata
authors.forename: Seiji
authors.initials: S
authors.lastname: Etoh
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Basford
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kawahira
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*