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http://nnr.sagepub.com/content/26/7/842.abstract?etoc
Abstract
Background. Improved upper-extremity (UE) movement with stroke rehabilitation may involve restoration of more normal or development of
compensatory movement patterns. Objective. The authors investigated the differential effects of functional task practice (FTP) and dynamic resistance training (POWER)
on clinical function and reaching kinematics in an effort to distinguish between mechanisms of gains. Methods.
A total of 14 hemiparetic individuals were randomly assigned to 10
weeks of either FTP or POWER and then crossed over to
10 weeks of the alternate treatment. Treatment
order A was FTP followed by POWER, whereas treatment order B was POWER
followed
by FTP. Evaluation before and after each treatment
block included a battery of clinical evaluations and kinematics of
paretic
UE functional reach to grasp. Results.
Both FTP and POWER improved movement accuracy, as revealed by a shift
toward normal, including fewer submovements and reduced
reach-path ratio. However, active range of motion
revealed differential treatment effects. Shoulder flexion and elbow
extension
decreased with FTP and were associated with
increased trunk displacement. In contrast, shoulder flexion and elbow
extension
excursion increased with POWER and were associated
with significantly reduced trunk displacement. Treatment order B (POWER
followed by FTP) revealed greater overall
improvements. Conclusion. FTP increases compensatory movement patterns to improve UE function. POWER leads to more normal movement patterns. POWER
prior to FTP may enhance the benefits of repetitive task practice.
Power training produced more active movement but the group that improved the most had functional task training afterwards. Clients who are shown what their new motor skills are good for are better at generalizing the gains they made in therapy.
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