http://nnr.sagepub.com/cgi/content/abstract/27/2/173?etoc
Abstract
Background and Purpose. Observation of
action with intention-to-imitate (OTI) might enhance motor recovery.
This early phase trial investigated
whether OTI followed by physical practice (OTI +
PP) enhanced the benefits of conventional physical therapy (CPT) on
upper
limb recovery early after stroke. Methods.
Participants were 3 to 31 days poststroke. They had substantial paresis
and ability to imitate action with their ipsilesional
arm. After baseline measures, participants were
randomized to either OTI + PP in addition to CPT or to CPT only. Outcome
measures
were made after 15 days of treatment. The
measurement battery was the Motricity Index (MI) and the Action Research
Arm Test
(ARAT). Change, baseline to outcome, was examined
using the Wilcoxon test for within group and Mann–Whitney U test for between groups. Results.
Sixty-five of 570 stroke survivors were eligible, 55 were able to
imitate, 37 gave informed consent, 7 were transferred
out of area before baseline, and 29 were
randomized. Outcome measures were completed with 13 CPT participants and
9 OTI +
PP participants. Both groups showed statistically
significant improvements for the MI (CPT median change 8, P = .003; OTI + PP median change 10, P = .012) but the median (95% confidence interval [CI]) between-group difference was 0.0 (−11, 16), P = 1.000. For the ARAT, only the CPT group showed a statistically significant improvement (median 9, P = .006). The median (95% CI) between-group difference of 1.0 (−18, 23) was not statistically significant (P = .815). Conclusions. These findings suggest that OTI + PP might add little to the benefits of CPT early after stroke.
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