When should upper limb function be trained after stroke? Evidence for and against early intervention

Turton, Ailie; Pomeroy, Valerie

doi:10.3233/nre-2002-17307

Cited by 25 publications

(13 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the NHPT, the patient progressively scored better across the different evaluations but the change was not significant. The MDC for this test, which is 32 seconds, was established in a sample of acute stroke patients who usually present a major room for improvement (Turton & Pomeroy, 2002). One possible explanation for the lack of results in this test may be that the MDC is difficult to achieve in chronic stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Time course of motor gains induced by music-supported therapy after stroke: An exploratory case study.

et al. 2017

View full text Add to dashboard Cite

This is the first study examining the pattern of motor recovery progression in MST, evidencing that gradual and continuous motor improvements are possible with the repeated application of MST training. Fast-acquisition in specific motor abilities was observed at the beginning of the MST training but generalization of these improvements to other motor tasks took place at the end or when another treatment period was provided. (PsycINFO Database Record

show abstract

Section: Discussionmentioning

confidence: 99%

Time course of motor gains induced by music-supported therapy after stroke: An exploratory case study.

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Many studies are trying to find the answer to the question of why early rehabilitation can produce better results than later rehabilitation. Neural reorganization has been thought to play an important role [ 19 20 21 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients.MethodsA total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training.ResultsPaired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%–100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9'ConclusionOur results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group.

show abstract

“…The suggestion that a lower dose of CIMT may be more beneficial than a potentially harmful higher dose during the acute phase after stroke is largely based on the results of the VECTORS study (8). These finding are, however, supported by several animal studies (9,10,30,31), which have found that intensive practice of the affected limb in rats is detrimental if it occurs too soon after the infarction, when cells in the penumbral tissue are presumably still vulnerable (32). For example, Kozlowski et al (10) found a disrupted recovery of function after immobilization of the nonimpaired forelimb during the first 15 days (22).…”

Section: Discussionmentioning

confidence: 99%

Constraint-Induced Movement Therapy for the Upper Paretic Limb in Acute or Sub-Acute Stroke: A Systematic Review

Nijland

Kwakkel

Bakers

et al. 2011

International Journal of Stroke

View full text Add to dashboard Cite

Constraint-induced movement therapy is a commonly used intervention to improve upper limb function after stroke. However, the effectiveness of constraint-induced movement therapy and its optimal dosage during acute or sub-acute stroke is still under debate. To examine the literature on the effects of constraint-induced movement therapy in acute or sub-acute stroke. A literature search was performed to identify randomized, controlled trials; studies with the same outcome measure were pooled by calculating the mean difference. Separate quantitative analyses for high-intensity and low-intensity constraint-induced movement therapy were applied when possible. Five randomized, controlled trials were included, comprising 106 participants. The meta-analysis demonstrated significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer arm, the Action Research Arm Test, the Motor Activity Log, Quality of Movement and the Grooved Pegboard Test. Nonsignificant mean difference in favor of constraint-induced movement therapy were found for the Motor Activity Log, Amount of Use. Separate analyses for high-intensity and low-intensity constraint-induced movement therapy resulted in significant favorable mean differences for low-intensity constraint-induced movement therapy for all outcome measures, in contrast to high-intensity constraint-induced movement therapy. This meta-analysis demonstrates a trend toward positive effects of high-intensity and low-intensity constraint-induced movement therapy in acute or sub-acute stroke, but also suggests that low-intensity constraint-induced movement therapy may be more beneficial during this period than high-intensity constraint-induced movement therapy. However, these results were based on a small number of studies. Therefore, more trials are needed applying different doses of therapy early after stroke and a better understanding is needed about the different time windows in which underlying mechanisms of recovery operate.

show abstract

When should upper limb function be trained after stroke? Evidence for and against early intervention

Cited by 25 publications

References 67 publications

Time course of motor gains induced by music-supported therapy after stroke: An exploratory case study.

Time course of motor gains induced by music-supported therapy after stroke: An exploratory case study.

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

Constraint-Induced Movement Therapy for the Upper Paretic Limb in Acute or Sub-Acute Stroke: A Systematic Review

Contact Info

Product

Resources

About