Abstract
Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke.
Objective.
The questions were the following: (1) Is there need for long-dose
therapy or is there a mid-treatment plateau? (2) Are the observed gains
from the prior-studied protocol retained after treatment?
Methods.
Single-blind, stratified/randomized design, with 3 applied technology
treatment groups, combined with motor learning, for long-duration
treatment (300 hours of treatment). Measures were Arm Motor Ability Test
time and coordination-function (AMAT-T, AMAT-F, respectively), acquired
pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM),
acquired similarly with addition of mid-treatment.
Findings. There was no group difference in treatment response (P
≥ .16), therefore data were combined for remaining analyses (n = 31;
except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and
Mid-to-Posttreatment gains of FM were statistically and clinically
significant (P < .0001; 4.7 points and P < .001; 5.1
points, respectively), indicating no plateau at 150 hours and benefit
of second half of treatment. From baseline to 3moF/U: (1) FM gains were
twice the clinically significant benchmark, (2) AMAT-F gains were
greater than clinically significant benchmark, and (3) there was
statistically significant improvement in FM (P < .0001); AMAT-F (P < .0001); AMAT-T (P
< .0001). These gains indicate retained clinically and statistically
significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM
were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003.
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