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.)

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Perineal pad tests are simple, noninvasive functional tests which have been recommended for the evaluation of patients with urinary incontinence. Most are based on the one-hour pad test introduced by Sutherst and co-workers and standardized by the International Continence Society. The major problem with the one-hour pad test is its lack of sensitivity. Therefore a stringent test procedure was developed, whereby the limit of patient tolerance was reached. Mean end volumes of 568 ml (648 ml) immediately after the test (retest) confirmed that the patients had been examined with full bladders. Yet one in three of the incontinent patients remained dry during formal assessment. The use of the one-hour perineal pad test for clinical or research purposes should be seriously questioned.