Background and Purpose-Arm function recovery is notoriously poor in stroke patients. The effect of treatment modalities, particularly those directed at improving upper limb function, has been studied primarily in chronic stroke patients. The purpose of this study was to investigate the effect of a specific therapeutic intervention on arm function in the acute phase after stroke. Methods-In a single-blind, randomized, controlled multicenter trial, 100consecutive patients were allocated to either an experimental group that received an additional treatment of sensorimotor stimulation or to a control group. The intervention was applied for 6 weeks. Patients were evaluated for level of impairment (Brunnström-Fugl-Meyer test) and disability (Action Research Arm test, Barthel Index) before, midway, and after the intervention period and at follow-up 6 and 12 months after stroke. Results-Patients in the experimental group performed better on the Brunnström-Fugl-Meyer test than those in the control group throughout the study period, but differences were significant only at follow-up. Results on the Action Research Arm test and Barthel Index revealed no effect at the level of disability. The effect of the therapy was attributed to the repetitive stimulation of muscle activity. The treatment was most effective in patients with a severe motor deficit and hemianopia or hemi-inattention. No adverse effects due to the intervention were found. Conclusions-Adding a specific intervention during the acute phase after stroke improved motor recovery, which was apparent 1 year later. These results emphasize the potential beneficial effect of therapeutic interventions for the arm.(Stroke. 1998;29:785-792.)

This study clearly indicates that trunk performance is still impaired in non-acute and chronic stroke patients. When planning future follow-up studies, use of the Trunk Impairment Scale has the advantage that it has no ceiling effect.

The purpose of this study was to provide age specific normative data of clinical gait and balance tests and to determine to what extent gender contributes to differences in postural control. Standing balance and walking performance was tested in 318 asymptomatic adults. The logistic regression, using both 10- and 30-second time limits as a dichotomization point, revealed a significant age effect for standing on foam with eyes closed, tandem Romberg with eyes closed (TR-EC), and one leg stance (eyes open and closed). The actual effect of decline was different for each test. Both tandem gait and dynamic gait index showed a ceiling effect up to 60 years of age, with a rapid decline of performance for subjects in their seventies. Linear regression equations indicated that for both men and women, timed up and go test (TUG) times increased with age, but even older subjects should perform the TUG in 10 seconds or less. Women performed significantly poorer on the TUG and TR-EC (30-second time limit).

The findings of this review suggest that most spatiotemporal parameters significantly differ across different age groups. Elderly populations show a reduction of preferred walking speed, cadence, step and stride length, all related to a more cautious gait, while gait variability measures remain stable over time. A preliminary framework of normative reference data is provided, enabling insights into the influence of aging on spatiotemporal parameters, however spatiotemporal parameters of middle-aged adults should be investigated more thoroughly.

In addition to conventional therapy, truncal exercises have a beneficial effect on truncal function, standing balance, and mobility in people after stroke.