Additional therapy promotes a continued pattern of improvement in upper-limb function and independence post-stroke

Journal article


Thompson-Butel, Angelica G., Ashcroft, Sarah K., Lin, Gaven, Trinh, Terry and McNulty, Penelope A.. (2023). Additional therapy promotes a continued pattern of improvement in upper-limb function and independence post-stroke. Journal of Stroke and Cerebrovascular Diseases. 32(4), p. Article 106995. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.106995
AuthorsThompson-Butel, Angelica G., Ashcroft, Sarah K., Lin, Gaven, Trinh, Terry and McNulty, Penelope A.
Abstract

Background
Upper-limb motor impairment after stroke is common and disabling. Growing evidence suggests that rehabilitation is effective in the chronic period. However, there is limited knowledge on the effects of ongoing targeted rehabilitation programs on patient outcomes.

Objectives
This study investigated the effects of delivering two programs of dose-matched evidence-based upper-limb rehabilitation to community-dwelling post-acute stroke patients with low, moderate and high motor-function.

Materials and methods
12 patients (2 female) aged 50.5±18.2 years and 13.8±10.8 months post-stroke completed 2-weeks of modified-Constraint-Induced Movement Therapy followed by 2-weeks of Wii-based Movement Therapy after a mean interval of 9.6±1.1 months (range 6-19months). Function was assessed at 6 time points (i.e. before and after each therapy program and 6-month follow-up after each program). Primary outcome measures were the Wolf Motor Function Test timed-tasks (WMFT-tt), upper-limb Fugl-Meyer Assessment (F-M) and the Motor Activity Log Quality of Movement Scale (MALQOM). Improvement and maintenance was analyzed using Paired T-Tests and Wilcoxon Signed Rank Tests.

Results
Upper-limb function significantly improved on all primary outcome measures with the first therapy program (WMFT-tt p=0.008, F-M p=0.007 and MALQOM p<0.0001). All scores continued to improve with the second therapy program with significant improvements in the F-M (p=0.048) and the MALQOM (p=0.001).

Conclusions
All patients showed a pattern of continued improvement in upper-limb motor-function and independence in activities of daily living. These improvements demonstrate the benefit of ongoing post-stroke rehabilitation for community-dwelling stroke survivors for individuals of varying baseline functional status.

Keywordschronic stroke; continued improvement; upper-limb; ongoing therapy; increased independence
Year2023
JournalJournal of Stroke and Cerebrovascular Diseases
Journal citation32 (4), p. Article 106995
PublisherElsevier Inc.
ISSN1052-3057
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.106995
PubMed ID36681009
Scopus EID2-s2.0-85146734369
Page range1-10
FunderNational Health and Medical Research Council (NHMRC)
New South Wales Office of Science and Medical Research
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online19 Jan 2023
Publication process dates
Accepted13 Jan 2023
Deposited29 Apr 2025
Additional information

© 2023 Published by Elsevier Inc.

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