Abstract
Objective
To identify the baseline motor characteristics of the patients who responded to 3
prominent intervention programs.
Design
Observational cohort study.
Setting
Outpatient rehabilitation clinics.
Participants
Individuals with chronic stroke (N=174).
Interventions
Participants received 30 hours of constraint-induced movement therapy (CIMT), robot-assisted
therapy, or mirror therapy (MT).
Main Outcome Measures
The primary outcome measure was the change score of the Upper Extremity Fugl-Meyer
Assessment (UE-FMA). The potential predicting variables were baseline proximal, distal,
and total UE-FMA and Action Research Arm Test scores. We combined polynomial regression
analyses and the minimal clinically important difference to stratify the patients
as responders and nonresponders for each intervention approach.
Results
Baseline proximal UE-FMA scores significantly predicted clinically important improvement
on the primary outcome measure after all 3 interventions. Participants with baseline
proximal UE-FMA scores of approximately <30 benefited significantly from CIMT and
robot-assisted therapy, whereas participants with scores between 21 and 35 demonstrated
significant improvement after MT. Baseline distal and total UE-FMA and Action Research
Arm Test scores could also predict upper limb improvement after CIMT and MT, but not
after robot-assisted therapy.
Conclusions
This study could inform clinicians about the selection of suitable rehabilitation
approaches to help patients achieve clinically meaningful improvement in upper extremity
function.
Keywords
List of abbreviations:
ARAT (Action Research Arm Test), CIMT (constraint-induced movement therapy), FMA (Fugl-Meyer Assessment), MCID (minimal clinically important difference), MG (mesh glove), MT (mirror therapy), UE (upper extremity), UE-FMA (Upper Extremity Fugl-Meyer Assessment)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 07, 2015
Footnotes
Supported in part by the National Health Research Institutes (grant no. NHRI-EX103-10010PI), the Ministry of Science and Technology (grant nos. MOST 103-2314-B-182-002, MOST 103-2314-B-182-004-MY3, and MOST 102-2314-B-002-154-MY2), the Healthy Aging Research Center of Chang Gung University (grant nos. EMRPD1D0291 and CMRPD1B0331), and the Chang Gung Memorial Hospital (grant no. CMRPD 1C0402).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
