title: Trunk restraint therapy: the continuous use of the harness could promote feedback dependence in poststroke patients: a randomized trial.
abstract: The objective of this study was to evaluate the long-term effects of the task-specific training with trunk restraint compared with the free one in poststroke reaching movements. The design was randomized trial. The setting was University of Campinas (Unicamp). Twenty hemiparetic chronic stroke patients were selected and randomized into 2 training groups: trunk restraint group (TRG) (reaching training with trunk restraint) and trunk free group (TFG) (unrestraint reaching). Twenty sessions with 45 minutes of training were accomplished. The patients were evaluated in pretreatment (PRE), posttreatment (POST) and 3 months after the completed training (RET) (follow-up). Main outcome measures were modified Ashworth scale, Barthel index, Fugl-Meyer scale, and kinematic analysis (movement trajectory, velocity, angles). A significant improvement, which maintained in the RET test, was found in the motor (P < 0.001) and functional (P = 0.001) clinical assessments for both groups. For trunk displacement, only TFG obtained a reduction statistical significance from PRE to the POST test (P = 0.002), supporting this result in the RET test. Despite both groups presenting a significant increase in the shoulder horizontal adduction (P = 0.003), only TRG showed a significant improvement in the shoulder (P = 0.001--PRE to POST and RET) and elbow (P = 0.038--PRE to RET) flexion extension, and in the velocity rate (P = 0.03--PRE to RET). The trunk restraint therapy showed to be a long-term effective treatment in the enhancement of shoulder and elbow active joint range and velocity rate but not in the maintenance of trunk retention. Trial registration: NCT02364141.
authors: From the Faculty of Health Science at Trairi - Federal University of Rio Grande do Norte (FACISA/UFRN) (RdOC, EWAC), Santa Cruz, RN; Department of Computer Engineering (RLO), Federal Institute of Education, Science and Technology of southern Minas (IFSULDEMINAS), Poços de Caldas, MG; Department of Electrical Engineering (AC), University of São Paulo - EESC/USP; Department of Orthopaedics and Traumatology (AC), Faculty of Medical Sciences, University of Campinas; and Department of Neurology and Neurosurgery (GB), Faculty of Medical Science, University of Campinas - UNICAMP, Campinas, SP, Brazil.
authors: Roberta
authors: R
authors: de Oliveira Cacho
authors: Enio Walker A
authors: EWA
authors: Cacho
authors: Rodrigo L
authors: RL
authors: Ortolan
authors: Alberto
authors: A
authors: Cliquet
authors: Guilherme
authors: G
authors: Borges
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D005246:Feedback; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D012149:Restraint, Physical; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*