title: Self-training to improve UE function at the chronic stage post-stroke: a pilot randomized controlled trial.
abstract: On-going practice and use of the weaker upper extremity (UE) are important for maintaining and improving function in individuals with chronic stroke. The effectiveness of two self-training programs for UE function and daily-use was compared.
  
  
  
  In this pilot, single-blinded clinical trial, individuals with chronic stroke were randomized to video-games or traditional self-training (1-hour/day, 6-times/week, 5 weeks). Assessments were performed pre-intervention (an average of two assessments), post-intervention, and at 4-week follow-up. The primary outcome was the functional ability of the upper extremity [The Action Research Arm Test (ARAT)]. Secondary measures were the daily use of the upper extremity [Motor Activity Log (MAL)] and manual dexterity (Box and Block Test). Repeated measures ANOVA was used to test the effectiveness and estimate effect sizes.
  
  
  
  Twenty-four of the 142 participants screened by phone were randomized to video-games [N = 13, mean (SD) age - 59.1 (10.5)] or traditional [N = 11, mean (SD) age - 64.9 (6.9)] self-training. Significant between-group differences were not detected. ARAT significantly improved by 13.9% and 9.6% following the video-games and traditional self-training programs (respectively), with a large effect size. MAL (quantity) also improved significantly between pre- intervention to follow-up with medium-large effect size.
  
  
  
  UE functional improvement can be achieved by self-training at the chronic stage and, therefore, should be encouraged by clinicians. Implications for rehabilitation Video-games or traditional self-training programs can be used to practice repetitive UE movements without the supervision of a clinician Self-training of the UE is beneficial at the chronic stage post-stroke and, therefore, should be encouraged The type of self-training (video-games or traditional) should be suited to the client's abilities and preferences. The compliance of self-training using video-games during the follow-up period was higher than the traditional self-training. This is important since self-training programs for chronic stroke need to be long-term and sustainable.
authors: a Department of Occupational Therapy, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Debbie
authors: D
authors: Rand
authors: b The Chaim Sheba Medical Center at Tel-HaShomer , Tel- HaShomer, Israel.
authors: Harold
authors: H
authors: Weingarden
authors: a Department of Occupational Therapy, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Ronit
authors: R
authors: Weiss
authors: a Department of Occupational Therapy, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Anat
authors: A
authors: Yacoby
authors: a Department of Occupational Therapy, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Shlomit
authors: S
authors: Reif
authors: a Department of Occupational Therapy, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Rachel
authors: R
authors: Malka
authors: b The Chaim Sheba Medical Center at Tel-HaShomer , Tel- HaShomer, Israel.
authors: David Andrew
authors: DA
authors: Shiller
authors: b The Chaim Sheba Medical Center at Tel-HaShomer , Tel- HaShomer, Israel.|c The Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors: Gabi
authors: G
authors: Zeilig
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation*; D010865:Pilot Projects; D020127:Recovery of Function; D012648:Self Care / Q000379:methods*; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology; D018910:Video Games
keywords: Stroke rehabilitation; chronic stroke; virtual reality