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(Stroke. 2004;35:924.)
© 2004 American Heart Association, Inc.

Original Contributions

Early and Repetitive Stimulation of the Arm Can Substantially Improve the Long-Term Outcome After Stroke: A 5-Year Follow-up Study of a Randomized Trial

Hilde Feys, PT, PhD; Willy De Weerdt, PT, PhD; Geert Verbeke, PhD; Gail Cox Steck, PT; Chris Capiau, PT, MSc; Carlotte Kiekens, MD; Eddy Dejaeger, MD, PhD; Gustaaf Van Hoydonck, PT; Guido Vermeersch, MD Patrick Cras, MD, PhD

From Department of Rehabilitation Sciences (H.F., W.D.W., C.C.), Faculty of Physical Education and Physiotherapy, University of Leuven, Belgium; Biostatistical Center (G.V.), Faculty of Medicine, University of Leuven, Belgium; Department of the Rehabilitation Center of the Medical Clinic (G.C.S.), Bürgerspital, Solothurn, Switzerland; Department of Physical Medicine and Rehabilitation (C.K.), University Hospital Pellenberg, University of Leuven, Belgium; Department of Geriatrics (E.D.), University Hospitals Leuven, University of Leuven, Belgium; Department of Physiotherapy (G.V.H.), Rehabilitation Center Hof ter Schelde, Antwerpen, Belgium; Department of Physical Medicine and Rehabilitation (G.V.), O. L. Vr. Hospital, Aalst, Belgium; Department of Neurology (P.C.), University of Antwerpen, Belgium.

Correspondence 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— Several studies have investigated the effect of therapeutic interventions for the arm in the acute phase after stroke, with follow-ups at a maximum of 12 months. The aim of this study was to examine the effect of repetitive sensorimotor training of the arm at 5 years after stroke.

Subjects and Methods— One hundred consecutive stroke patients were randomly allocated either to an experimental group that received daily additional sensorimotor stimulation of the arm or to a control group. The intervention period was 6 weeks. Assessments of the patients were made before, midway, and after intervention, and at 6 and 12 months after stroke. In this study, 62 patients were reassessed at 5 years after stroke. The Brunnström-Fugl-Meyer (BFM) test, Action Research Arm (ARA) test, and Barthel index (BI) were used as the primary outcome measures.

Results— At the 5-year follow-up, there was a statistically significant difference for both the BFM and ARA tests in favor of the experimental group. The mean differences in improvement between the groups from the initial evaluation to the 5-year assessment corresponded to 17 points on the BFM and 17.4 on the ARA. No effect was found for the BI. The treatment was most effective in patients with a severe initial motor deficit.

Conclusions— Adding a specific intervention for the arm during the acute phase after a stroke resulted in a clinically meaningful and long-lasting effect on motor function. The effect can be attributed to early, repetitive, and targeted stimulation.

Key Words: stroke • rehabilitation • clinical trial

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