Abstract
In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound,
dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase
II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive
practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm
robotic therapy, were compared with 5 hours of intensive daily practice alone. Although
no significant between-group differences were found on the primary outcome measure
of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor
score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test
and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke.
However, the underlying mechanisms that drive these improvements remain poorly understood.
The approximately $1000 cost reduction per patient calculated for the use of motor
learning (ML) methods alone or combined with FES, compared with the combination of
ML and shoulder-arm robotics, further emphasizes the need for cost considerations
when making clinical decisions about selecting the most appropriate therapy for the
upper paretic limb in patients with chronic stroke.
Keywords
List of abbreviations:
CIMT (constraint-induced movement therapy), FES (functional electrical stimulation), ML (motor learning)To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: February 13, 2015
Footnotes
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
