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Improvement of Upper Limb Motor Control and Function After Competitive and Noncompetitive Volleyball Exercises in Chronic Stroke Survivors: A Randomized Clinical Trial

Published:November 09, 2018DOI:https://doi.org/10.1016/j.apmr.2018.10.012

      Highlights

      • Volleyball exercise results in improvement of upper limb motor function in chronic stroke survivors.
      • Volleyball exercise decreases the feedback dependency of motor control in chronic stroke survivors.
      • Performing volleyball exercise in a competitive form could enhance its positive effects in both functional and motor control levels.

      Abstract

      Objectives

      To investigate the effects of competitive and noncompetitive volleyball exercises on the functional performance and motor control of the upper limbs in chronic stroke survivors.

      Design

      Randomized clinical trial.

      Setting

      Outpatient rehabilitation center.

      Participants

      Chronic stroke survivors (N=48).

      Interventions

      Participants were randomly assigned to competitive (n=16) or noncompetitive (n=16) volleyball exercise groups (60min/d volleyball exercise+30min/d traditional rehabilitation, 3d/wk for 7wk) and control group (n=16).

      Main Outcome Measures

      Reach and grasp motor control measures were evaluated through kinematic analysis. Functional outcomes were assessed via Motor Activity Log, Wolf Motor Function Test (WMFT), Box and Block Test, and Wrist Position Sense Test.

      Results

      Significant improvement of functional performance was observed in both competitive (P<.0001) and noncompetitive volleyball exercise groups (P<.01), but not in the control group (P>.05), with the exception of WMFT score. Volleyball training, in general, resulted in more efficient spatiotemporal control of reach and grasp functions, as well as less dependence on feedback control as compared to the control group. Moreover, the competitive volleyball exercise group exhibited greater improvement in both functional performance and motor control levels.

      Conclusions

      Volleyball team exercises, especially in a competitive format, resulted in enhancing the efficacy of the preprogramming and execution of reach and grasp movements, as well as a shift from feedback to feedforward control of the affected upper limb in chronic stroke survivors. This may well be a potential underlying mechanism for improving functional performance.

      Keywords

      List of abbreviations:

      ADL (activities of daily living), AOU (amount of use), BBT (Box and Block Test), FAS (functional ability scale), MAL (Motor Activity Log), MGA (maximum grip aperture), NMT (normalized movement time), NTD (normalized total distance), PMGA (percentage of movement time in which MGA occurs), PPV (percentage of movement time in which PV occurs), PV (peak velocity), QOM (quality of movement), WMFT (Wolf Motor Function Test), WPST (Wrist Position Sense Test)
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