Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial
Question: In adults undergoing rehabilitation after stroke, does 1 hour of additional active repetitive reaching per day prevent or reduce upper limb contracture? Design: Multi-centre, randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Particip...
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doaj-6bcf7d113e86451898f717a7787a23672020-11-24T23:56:27ZengElsevierJournal of Physiotherapy1836-95532019-04-016528894Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trialSally Horsley0Natasha A Lannin1Kathryn S Hayward2Robert D Herbert3Allied Health, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Sunshine Coast, Australia; Correspondence: Sally Horsley, Allied Health, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Australia.School of Allied Health (Occupational Therapy), La Trobe University, Melbourne, Australia; Occupational Therapy Department, Alfred Health, Melbourne, AustraliaMount Isa Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia; Stroke Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; NHMRC CRE in Stroke Rehabilitation and Brain Recovery, Melbourne, AustraliaNeuroscience Research Australia (NeuRA), Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, AustraliaQuestion: In adults undergoing rehabilitation after stroke, does 1 hour of additional active repetitive reaching per day prevent or reduce upper limb contracture? Design: Multi-centre, randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Fifty adults undergoing rehabilitation after stroke who were unable to actively extend the affected wrist past neutral or were unable to flex the affected shoulder to 90 deg. Setting: Three inpatient rehabilitation units in Australia. Intervention: Both groups received usual upper limb therapy 5 days a week for 5 weeks. In addition, the experimental group received up to 1 hour a day of active, intensive, repetitive upper limb training using the SMART Arm device 5 days a week for 5 weeks. Outcome measures: Measures were collected at baseline (Week 0), after intervention (Week 5) and at follow-up (Week 7). The primary outcomes were passive range of wrist extension, elbow extension, and shoulder flexion at Week 5. The secondary outcomes were: the three primary outcomes measured at Week 7; passive range of shoulder external rotation; arm function; and pain at rest, on movement and during sleep measured at Weeks 5 and 7. Results: Following an average of 2310 reaching repetitions, the mean effect at Week 5 on passive range of wrist extension was 1 deg (95% CI –6 to 8), elbow extension –6 deg (95% CI –12 to –1), and shoulder flexion 5 deg (95% CI –8 to 17). There were no statistically significant or clinically important effects of the intervention on any secondary outcomes. Conclusion: In adults who are already receiving task-specific motor training for upper limb rehabilitation following stroke, 5 weeks of up to 1 hour of additional daily active repetitive motor training using the SMART Arm device did not prevent or reduce contracture in upper limb muscles. Trial registration: ACTRN12614001162606. Key words: Randomised controlled trial, Stroke, Contracture, Upper extremity, Active motor traininghttp://www.sciencedirect.com/science/article/pii/S1836955319300189 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sally Horsley Natasha A Lannin Kathryn S Hayward Robert D Herbert |
spellingShingle |
Sally Horsley Natasha A Lannin Kathryn S Hayward Robert D Herbert Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial Journal of Physiotherapy |
author_facet |
Sally Horsley Natasha A Lannin Kathryn S Hayward Robert D Herbert |
author_sort |
Sally Horsley |
title |
Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
title_short |
Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
title_full |
Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
title_fullStr |
Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
title_full_unstemmed |
Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
title_sort |
additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial |
publisher |
Elsevier |
series |
Journal of Physiotherapy |
issn |
1836-9553 |
publishDate |
2019-04-01 |
description |
Question: In adults undergoing rehabilitation after stroke, does 1 hour of additional active repetitive reaching per day prevent or reduce upper limb contracture? Design: Multi-centre, randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Fifty adults undergoing rehabilitation after stroke who were unable to actively extend the affected wrist past neutral or were unable to flex the affected shoulder to 90 deg. Setting: Three inpatient rehabilitation units in Australia. Intervention: Both groups received usual upper limb therapy 5 days a week for 5 weeks. In addition, the experimental group received up to 1 hour a day of active, intensive, repetitive upper limb training using the SMART Arm device 5 days a week for 5 weeks. Outcome measures: Measures were collected at baseline (Week 0), after intervention (Week 5) and at follow-up (Week 7). The primary outcomes were passive range of wrist extension, elbow extension, and shoulder flexion at Week 5. The secondary outcomes were: the three primary outcomes measured at Week 7; passive range of shoulder external rotation; arm function; and pain at rest, on movement and during sleep measured at Weeks 5 and 7. Results: Following an average of 2310 reaching repetitions, the mean effect at Week 5 on passive range of wrist extension was 1 deg (95% CI –6 to 8), elbow extension –6 deg (95% CI –12 to –1), and shoulder flexion 5 deg (95% CI –8 to 17). There were no statistically significant or clinically important effects of the intervention on any secondary outcomes. Conclusion: In adults who are already receiving task-specific motor training for upper limb rehabilitation following stroke, 5 weeks of up to 1 hour of additional daily active repetitive motor training using the SMART Arm device did not prevent or reduce contracture in upper limb muscles. Trial registration: ACTRN12614001162606. Key words: Randomised controlled trial, Stroke, Contracture, Upper extremity, Active motor training |
url |
http://www.sciencedirect.com/science/article/pii/S1836955319300189 |
work_keys_str_mv |
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