on March 4, 2004
Published online before print March 4, 2004, doi: 10.1161/01.STR.0000121645.44752.f7
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Submitted on August 11, 2003
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. * To whom correspondence should be addressed. 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.
Accepted on January 5, 2004
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*;
Key words: stroke • rehabilitation • clinical trial
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