From the Department of Rehabilitation Sciences, Faculty of Physical
Education and Physiotherapy, University of Leuven (H.M.F., W.J. De W.); the
Department of Rehabilitation and Geriatric Medicine, Bürgerspital,
Solothurn (B.E.S., G.A.C.S., R.S.); the Department of Physical Medicine and
Rehabilitation, University Hospital, Antwerpen-Edegem (L.E.V.); the Department
of Physiotherapy, O.L.Vr. Hospital, Aalst (K.D.P.); and the Department of
Physiotherapy, Rehabilitation Center Hof ter Schelde, Antwerpen (G.A. Van H.),
Belgium.
Correspondence and reprint requests to Hilde Feys, Faculty of Physical Education and Physiotherapy, Tervuursevest 101, B-3001 Heverlee-Leuven, Belgium. E-mail Hilde.Feys{at}flok.kuleuven.ac.be
Background and Purpose—Arm function
recovery is notoriously poor in stroke patients. The effect of
treatment modalities, particularly those directed at improving upper
limb function, has been studied primarily in chronic stroke patients.
The purpose of this study was to investigate the effect of a specific
therapeutic intervention on arm function in the acute phase after
stroke.
Methods—In a single-blind, randomized, controlled multicenter
trial, 100consecutive patients were allocated to either an experimental
group that received an additional treatment of sensorimotor stimulation
or to a control group. The intervention was applied for 6 weeks.
Patients were evaluated for level of impairment
(Brunnström-Fugl-Meyer test) and disability (Action Research Arm
test, Barthel Index) before, midway, and after the intervention period
and at follow-up 6 and 12 months after stroke.
Results—Patients in the experimental group performed better on
the Brunnström-Fugl-Meyer test than those in the control group
throughout the study period, but differences were significant only at
follow-up. Results on the Action Research Arm test and Barthel Index
revealed no effect at the level of disability. The effect of the
therapy was attributed to the repetitive stimulation of muscle
activity. The treatment was most effective in patients with a severe
motor deficit and hemianopia or hemi-inattention. No adverse effects
due to the intervention were found.
Conclusions—Adding a specific intervention during the acute phase
after stroke improved motor recovery, which was apparent 1 year later.
These results emphasize the potential beneficial effect of therapeutic
interventions for the arm.
© 1998 American Heart Association, Inc.
Original Contributions
Effect of a Therapeutic Intervention for the Hemiplegic Upper Limb in the Acute Phase After Stroke
A Single-Blind, Randomized, Controlled Multicenter Trial
Key Words: clinical trials • rehabilitation • stroke
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