title: Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke.
abstract: Previous studies have shown that multiple sessions of reach training lead to long-term improvements in movement time and smoothness in individuals post-stroke. Yet such long-term training regimens are often difficult to implement in actual clinical settings. In this study, we evaluated the long-term and generalization effects of short-duration and intensive reach training in 16 individuals with chronic stroke and mild to moderate impairments. Participants performed 2 sessions of unassisted intensive reach training, with 600 movements per session, and with display of performance-based feedback after each movement. The participants' trunks were restrained with a belt to avoid compensatory movements. Training resulted in significant and durable (1 month) improvements in movement time (20.4% on average) and movement smoothness (22.7% on average). The largest improvements occurred in individuals with the largest initial motor impairments. In addition, training induced generalization to nontrained targets, which persisted in 1-day and in 1-month retention tests. Finally, there was a significant improvement in the Box and Block test from baseline to 1-month retention test (23% on average). Thus, short-duration and intensive reach training can lead to generalized and durable benefits in individuals with chronic stroke and mild to moderate impairments.
authors.affiliation: University of Southern California, Los Angeles, CA, USA hyeshinp@usc.edu.
authors.forename: Hyeshin
authors.initials: H
authors.lastname: Park
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: Sujin
authors.initials: S
authors.lastname: Kim
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: Carolee J
authors.initials: CJ
authors.lastname: Winstein
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Gordon
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Schweighofer
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D056228:Feedback, Sensory / Q000502:physiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity
keywords: arm movements; generalization; long-term retention; reach training; stroke rehabilitation