Later in the article they talk about stratifying the patients so they once again cherry pick to only address the easiest cases. Fucking lazy assholes. I expect 100% recovery for ALL. The mentors and senior researchers should be keel hauled for proposing such simplistic research.
Added-value of Early Post-stroke Spasticity Reduction during Arm-hand Rehabilitation in Improving Functional Arm-hand Skill Performance: A Multiple Baseline Single Case Experimental Design Study
International Journal of Neurorehabilitation ISSN: 2376-0281
International Journal of Neurorehabilitation
Franck et al., Int J Neurorehabilitation Eng 2018, 5:4
DOI:
10.4172/2376-0281.1000323
Open Access
Research Article
Volume 5 • Issue 4 • 1000323
Int J Neurorehabilitation, an open access journal
ISSN: 2376-0281
*Corresponding author:
Johan Anton Franck, Adelante Rehabilitation Centre,
Hoensbroek, Netherlands, Tel: +31647155506; E-mail:
h.franck@adelante-zorggroep.nl
Received
July 13, 2018;
Accepted
August 24, 2018;
Published August 31, 2018 Citation: Franck JA, Smeets RJEM, Renders K, Seelen HAM (2018) Added- value of Early Post-stroke Spasticity Reduction during Arm-hand Rehabilitation in Improving Functional Arm-hand Skill Performance: A Multiple Baseline Single Case Experimental Design Study. Int J Neurorehabilitation 5: 323. doi: 10.4172/2376- 0281. 1000323 Copyright: © 2018 Franck JA, et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Focal spasticity management in patients in the sub-acute phase after a stroke is mainly based on expert opinion. Evidence for the optimal type and intensity of multidisciplinary rehabilitation programs is scarce. This study will investigate the added-value of reduction of early signs of spasticity in the sub-acute phase after stroke on arm-hand rehabilitation outcome involving a well-described rehabilitation intervention. Reduction of early signs of spasticity will be done using abobotulinum toxin A.
Methods/design: This study comprises three methodological approaches, i.e.: i) a (multiple baseline) single case experimental design involving 10 individuals; ii) a meta-analysis of the data of all single cases (single armed group design); iii) non-randomized double armed group design, i.e. a case-matched control design in which each patient receiving early post-stroke spasticity reduction treatment will be matched (according to arm-hand capacity, spasticity level, age, gender, and Utrechtse Arm-hand Test scores) to a case from a prospective cohort study on changes in arm- hand status in 89 stroke patients performed previously. Improvement of arm-hand skill performance will be gauged using: a) the Action Research Arm Test, gauging functional capacity; b) the ABILHAND, gauging perceived level of arm-hand skill proficiency; and c) bilateral arm accelerometry, gauging actual arm-hand skill performance in daily life. Furthermore, arm-hand function will be measured using: a) Fugl-Meyer Motor Assessment; b) hand-held dynamometry (grip strength); c) Motricity Index (functional strength); and d) Modified Ashworth Scale (spasticity levels in the upper extremity). Statistical analyses include permutation tests involving the time series of each subject separately, Kruskal-Wallis tests and Mann-Whitney U-tests.
Published August 31, 2018 Citation: Franck JA, Smeets RJEM, Renders K, Seelen HAM (2018) Added- value of Early Post-stroke Spasticity Reduction during Arm-hand Rehabilitation in Improving Functional Arm-hand Skill Performance: A Multiple Baseline Single Case Experimental Design Study. Int J Neurorehabilitation 5: 323. doi: 10.4172/2376- 0281. 1000323 Copyright: © 2018 Franck JA, et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Focal spasticity management in patients in the sub-acute phase after a stroke is mainly based on expert opinion. Evidence for the optimal type and intensity of multidisciplinary rehabilitation programs is scarce. This study will investigate the added-value of reduction of early signs of spasticity in the sub-acute phase after stroke on arm-hand rehabilitation outcome involving a well-described rehabilitation intervention. Reduction of early signs of spasticity will be done using abobotulinum toxin A.
Methods/design: This study comprises three methodological approaches, i.e.: i) a (multiple baseline) single case experimental design involving 10 individuals; ii) a meta-analysis of the data of all single cases (single armed group design); iii) non-randomized double armed group design, i.e. a case-matched control design in which each patient receiving early post-stroke spasticity reduction treatment will be matched (according to arm-hand capacity, spasticity level, age, gender, and Utrechtse Arm-hand Test scores) to a case from a prospective cohort study on changes in arm- hand status in 89 stroke patients performed previously. Improvement of arm-hand skill performance will be gauged using: a) the Action Research Arm Test, gauging functional capacity; b) the ABILHAND, gauging perceived level of arm-hand skill proficiency; and c) bilateral arm accelerometry, gauging actual arm-hand skill performance in daily life. Furthermore, arm-hand function will be measured using: a) Fugl-Meyer Motor Assessment; b) hand-held dynamometry (grip strength); c) Motricity Index (functional strength); and d) Modified Ashworth Scale (spasticity levels in the upper extremity). Statistical analyses include permutation tests involving the time series of each subject separately, Kruskal-Wallis tests and Mann-Whitney U-tests.
Discussion:
Results of this study will provide evidence on the added-value of reduction of early signs of spasticity
in the upper extremity on functional arm-hand skill performance in sub-acute stroke patients with either a severely or
moderately affected arm-hand and moderate to severe grades of spasticity.
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