Limits...
Effects of Computer-Aided Interlimb Force Coupling Training on Paretic Hand and Arm Motor Control following Chronic Stroke: A Randomized Controlled Trial.

Lin CH, Chou LW, Luo HJ, Tsai PY, Lieu FK, Chiang SL, Sung WH - PLoS ONE (2015)

Bottom Line: The computer-aided interlimb force coupling training task with visual feedback included different grip force generation methods on both hands.The training group demonstrated greater improvement on the FMA-UE (p<.001), WMFT (p<.001), MAS (p = .004) and BI (p = .037) than the control group after 4 weeks of intervention.In addition, a moderate correlation was found between the improvement of scores for hand scales of the FMA and other portions of the FMA UE (r = .528, p = .018) or MAS (r = .596, p = .015) in the training group.

View Article: PubMed Central - PubMed

Affiliation: School of Gerontology Health Management & Master Program in Long-Term Care, Taipei Medical University, Taipei, Taiwan (R.O.C.).

ABSTRACT

Objective: We investigated the training effects of interlimb force coupling training on paretic upper extremity outcomes in patients with chronic stroke and analyzed the relationship between motor recovery of the paretic hand, arm and functional performances on paretic upper limb.

Design: A randomized controlled trial with outcome assessment at baseline and after 4 weeks of intervention.

Setting: Taipei Veterans General Hospital, National Yang-Ming University.

Participants: Thirty-three subjects with chronic stroke were recruited and randomly assigned to training (n = 16) and control groups (n = 17).

Interventions: The computer-aided interlimb force coupling training task with visual feedback included different grip force generation methods on both hands.

Main outcome measures: The Barthel Index (BI), the upper extremity motor control Fugl-Meyer Assessment (FMA-UE), the Motor Assessment Score (MAS), and the Wolf Motor Function Test (WMFT). All assessments were executed by a blinded evaluator, and data management and statistical analysis were also conducted by a blinded researcher.

Results: The training group demonstrated greater improvement on the FMA-UE (p<.001), WMFT (p<.001), MAS (p = .004) and BI (p = .037) than the control group after 4 weeks of intervention. In addition, a moderate correlation was found between the improvement of scores for hand scales of the FMA and other portions of the FMA UE (r = .528, p = .018) or MAS (r = .596, p = .015) in the training group.

Conclusion: Computer-aided interlimb force coupling training improves the motor recovery of a paretic hand, and facilitates motor control and enhances functional performance in the paretic upper extremity of people with chronic stroke.

Trial registration: ClinicalTrials.gov NCT02247674.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of the randomization procedure and the outcome measurements.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4507879&req=5

pone.0131048.g001: Flow diagram of the randomization procedure and the outcome measurements.

Mentions: Thirty-three patients who met the criteria (mean age = 55.1±10.5, four females and 29 males, mean time since stroke onset, 23.6 months) were recruited and agreed to join the study. These patients were randomly assigned to either a bilateral isometric handgrip force training group (N = 16) or a control group (N = 17).The patients were recruited from the Taipei Veterans General Hospital between January 2013 and October 2013 (this study was approved and valid from Dec 7, 2012 to Nov 15, 2013).The flow chart of the study is presented in Fig 1. The target sample size of 32 per group was chosen to give 95% power to detect at the 5% significance level a difference of FMA score for bilateral training between the intervention and control groups(effect size = 0.842) [28]using G*Power (Version3.1.9.2).The clinical history, demographic characteristics, and baseline outcome measurements of the participants in each group are shown in Table 1. The inclusion criteria for the stroke people were as following: (1) at least 6 months since the stroke [21, 29], (2) three or fewer incidents of unilateral stroke as confirmed by collecting each participant’s medical history, (3) the ability to follow the researcher’s instructions [29], (4) the ability to flex and extend the paretic arm and hand, (5) a Modified Ashworth Score (MAS) ≦3 for the wrist and finger joints [29, 30], (6) a Mini-Mental State Examination (MMSE) score of 24 or higher[19, 21, 31], (7) no other orthopedic or neurological disorders [19], (8) Brunnstrom stage 3 or 4, and (9) no participation in other experimental rehabilitation or drug studies [19]. The exclusion criteria were as follow: (1) unstable cardiovascular conditions [21], (2) uncontrolled hypertension (190/110 mm Hg) [21], (3) severe orthopedic or pain conditions, (4) aphasia with an inability to follow the researcher’s commands, and (5) severe joint contracture of the bilateral upper extremities that would impact the movement performance of the upper extremities[21].


Effects of Computer-Aided Interlimb Force Coupling Training on Paretic Hand and Arm Motor Control following Chronic Stroke: A Randomized Controlled Trial.

Lin CH, Chou LW, Luo HJ, Tsai PY, Lieu FK, Chiang SL, Sung WH - PLoS ONE (2015)

Flow diagram of the randomization procedure and the outcome measurements.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507879&req=5

pone.0131048.g001: Flow diagram of the randomization procedure and the outcome measurements.
Mentions: Thirty-three patients who met the criteria (mean age = 55.1±10.5, four females and 29 males, mean time since stroke onset, 23.6 months) were recruited and agreed to join the study. These patients were randomly assigned to either a bilateral isometric handgrip force training group (N = 16) or a control group (N = 17).The patients were recruited from the Taipei Veterans General Hospital between January 2013 and October 2013 (this study was approved and valid from Dec 7, 2012 to Nov 15, 2013).The flow chart of the study is presented in Fig 1. The target sample size of 32 per group was chosen to give 95% power to detect at the 5% significance level a difference of FMA score for bilateral training between the intervention and control groups(effect size = 0.842) [28]using G*Power (Version3.1.9.2).The clinical history, demographic characteristics, and baseline outcome measurements of the participants in each group are shown in Table 1. The inclusion criteria for the stroke people were as following: (1) at least 6 months since the stroke [21, 29], (2) three or fewer incidents of unilateral stroke as confirmed by collecting each participant’s medical history, (3) the ability to follow the researcher’s instructions [29], (4) the ability to flex and extend the paretic arm and hand, (5) a Modified Ashworth Score (MAS) ≦3 for the wrist and finger joints [29, 30], (6) a Mini-Mental State Examination (MMSE) score of 24 or higher[19, 21, 31], (7) no other orthopedic or neurological disorders [19], (8) Brunnstrom stage 3 or 4, and (9) no participation in other experimental rehabilitation or drug studies [19]. The exclusion criteria were as follow: (1) unstable cardiovascular conditions [21], (2) uncontrolled hypertension (190/110 mm Hg) [21], (3) severe orthopedic or pain conditions, (4) aphasia with an inability to follow the researcher’s commands, and (5) severe joint contracture of the bilateral upper extremities that would impact the movement performance of the upper extremities[21].

Bottom Line: The computer-aided interlimb force coupling training task with visual feedback included different grip force generation methods on both hands.The training group demonstrated greater improvement on the FMA-UE (p<.001), WMFT (p<.001), MAS (p = .004) and BI (p = .037) than the control group after 4 weeks of intervention.In addition, a moderate correlation was found between the improvement of scores for hand scales of the FMA and other portions of the FMA UE (r = .528, p = .018) or MAS (r = .596, p = .015) in the training group.

View Article: PubMed Central - PubMed

Affiliation: School of Gerontology Health Management & Master Program in Long-Term Care, Taipei Medical University, Taipei, Taiwan (R.O.C.).

ABSTRACT

Objective: We investigated the training effects of interlimb force coupling training on paretic upper extremity outcomes in patients with chronic stroke and analyzed the relationship between motor recovery of the paretic hand, arm and functional performances on paretic upper limb.

Design: A randomized controlled trial with outcome assessment at baseline and after 4 weeks of intervention.

Setting: Taipei Veterans General Hospital, National Yang-Ming University.

Participants: Thirty-three subjects with chronic stroke were recruited and randomly assigned to training (n = 16) and control groups (n = 17).

Interventions: The computer-aided interlimb force coupling training task with visual feedback included different grip force generation methods on both hands.

Main outcome measures: The Barthel Index (BI), the upper extremity motor control Fugl-Meyer Assessment (FMA-UE), the Motor Assessment Score (MAS), and the Wolf Motor Function Test (WMFT). All assessments were executed by a blinded evaluator, and data management and statistical analysis were also conducted by a blinded researcher.

Results: The training group demonstrated greater improvement on the FMA-UE (p<.001), WMFT (p<.001), MAS (p = .004) and BI (p = .037) than the control group after 4 weeks of intervention. In addition, a moderate correlation was found between the improvement of scores for hand scales of the FMA and other portions of the FMA UE (r = .528, p = .018) or MAS (r = .596, p = .015) in the training group.

Conclusion: Computer-aided interlimb force coupling training improves the motor recovery of a paretic hand, and facilitates motor control and enhances functional performance in the paretic upper extremity of people with chronic stroke.

Trial registration: ClinicalTrials.gov NCT02247674.

No MeSH data available.


Related in: MedlinePlus