Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial
Journal
Archives of physical medicine and rehabilitation
Journal Volume
100
Journal Issue
12
Pages
2225
Date Issued
2019-12
Author(s)
Hung, Chung-Shan
Chang, Wan-Ying
Huang, Wen-Chih
Chang, Ya-Ju
Chen, Chia-Ling
Abstract
OBJECTIVE:
To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke.
DESIGN:
A single-blind, randomized controlled trial.
SETTING:
Four hospitals.
PARTICIPANTS:
Outpatients with chronic stroke and mild to moderate motor impairment (N=44).
INTERVENTION:
UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks.
MAIN OUTCOME MEASURES:
Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment.
RESULTS:
The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01).
CONCLUSIONS:
BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
Subjects
Randomized controlled trial; Rehabilitation; Robotics; Stroke; Therapy
SDGs
Other Subjects
adult; Article; bilateral hybrid therapy; brain hemorrhage; brain ischemia; cerebrovascular accident; clinical article; constraint induced therapy; controlled study; daily life activity; female; follow up; functional status; hand function; hand movement; hand strength; human; intermethod comparison; male; mental health; middle aged; Mini Mental State Examination; mobilization; motor dysfunction; motor function test; motor performance; National Institutes of Health Stroke Scale; Nottingham extended activities of daily living scale; outpatient; randomized controlled trial; single blind procedure; stroke rehabilitation; unilateral hybrid therapy; upper limb; aged; biomechanics; chronic disease; clinical trial; convalescence; disability; joint characteristics and functions; kinesiotherapy; multicenter study; pathophysiology; procedures; robotics; stroke rehabilitation; upper limb; Activities of Daily Living; Adult; Aged; Biomechanical Phenomena; Chronic Disease; Disability Evaluation; Exercise Therapy; Female; Humans; Male; Middle Aged; Range of Motion, Articular; Recovery of Function; Robotics; Single-Blind Method; Stroke Rehabilitation; Upper Extremity
Publisher
W B SAUNDERS CO-ELSEVIER INC
Type
journal article