We thank Dr Jang for his interest in our recent article titled “The Effects of a Robot-Assisted
Arm Training Plus Hand Functional Electrical Stimulation on Recovery After Stroke:
A Randomized Clinical Trial.”
1
He suggests considering stroke site lesion, arm severity, and corticospinal tract
(CST) integrity as potential sources of bias in our results, given that all these
variables can affect spontaneous recovery in a subacute phase after stroke. His useful
comments point toward some methodologic issues that are shared by most upper limb
stroke rehabilitation research. In our study, we did not use stratification. Instead,
we performed a simple block randomization, without any stratification for patients’
baseline characteristics. This approach is consistent with most of the stroke trials
published so far.
2
Indeed, a recent meta-analysis revealed that only 21.6% of stroke trials used stratification
of participants, and that it was more common in larger trials.
2
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References
- Effects of a robot-assisted arm training plus hand functional electrical stimulation on recovery after stroke: a randomized clinical trial.Arch Phys Med Rehabil. 2019 Nov 1; ([Epub ahead of print])
- Rationale for intervention and dose is lacking in stroke recovery trials: a systematic review.Stroke Res Treat. 2018; 2018: 8087372
- A stroke recovery trial development framework: consensus-based core recommendations from the Second Stroke Recovery and Rehabilitation Roundtable.Int J Stroke. 2019; 14: 792-802
- Lesion location impact on functional recovery of the hemiparetic upper limb.PLoS One. 2019; 14e0219738
- PREP2: a biomarker-based algorithm for predicting upper limb function after stroke.Ann Clin Transl Neurol. 2017; 4: 811-820
Article info
Publication history
Published online: February 10, 2020
Footnotes
Supported by Emilia Romagna Region (grant no. 1786/2012).
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter to the Editor Re: “The Effects of a Robot-Assisted Arm Training Plus Hand Functional Electrical Stimulation on Recovery After Stroke: A Randomized Clinical Trial”Archives of Physical Medicine and RehabilitationVol. 101Issue 5
- PreviewI read with interest the article by Straudi et al1 comparing the effects of unilateral, proximal arm robot-assisted therapy (RAT) combined with hand functional electrical stimulation (FES) with those from intensive conventional therapy (ICT) for restoring arm function in survivors of subacute stroke. I think this article is valuable because robotics and FES are important rehabilitative modalities that will be further developed in the future although they are already being used widely in the rehabilitation field.
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