Your results are bogus since the FT and ST groups got an extra 20 hours of therapy. And your mentors and senior researchers were so INCOMPETENT THEY ALLOWED THE RESEARCH TO GO ON LIKE THAT?
A Randomized Controlled Comparison of Upper-Extremity Rehabilitation Strategies in Acute Stroke: A Pilot Study of Immediate and Long-Term Outcomes
Carolee J. Winstein, PhD, Dorian K. Rose, MS, Sylvia M. Tan, MS, Rebecca Lewthwaite, PhD,
Helena C. Chui, MD, Stanley P. Azen, PhD. Winstein CJ, Rose DK, Tan SM, Lewthwaite
R, Chui HC, Azen SP.
Arch Phys Med Rehabil 2004;85:620-8.
ABSTRACT
Objective:
To evaluate the immediate and long-term effects
of 2 upper-extremity rehabilitation approaches for stroke com-
pared with standard care in participants stratified by stroke
severity.
Design: Nonblinded, randomized controlled trial (baseline,
postintervention, 9mo) design.
Setting:
Inpatient rehabilitation hospital and outpatient
clinic.
Participants:
Sixty-four patients with recent stroke admitted
for inpatient rehabilitation were randomized within severity
strata (Orpington Prognostic Scale) into 1 of 3 intervention
groups. Forty-four patients completed the 9-month follow-up.
Interventions:
Standard care (SC), functional task practice
(FT), and strength training (ST). The FT and ST groups re-
ceived 20 additional hours of upper-extremity therapy beyond
standard care distributed over a 4- to 6-week period.
Main Outcome Measures:
Performance measures of impairment (Fugl-Meyer Assessment), strength (isometric
torque), and function (Functional Test of the Hemiparetic Upper Extremity [FTHUE]).
Results:
Compared with SC participants, those in the FT and
ST groups had significantly greater increases in Fugl-Meyer
motor scores (P=.04) and isometric torque (P=.02) posttreatment. Treatment benefit was primarily in the less severe participants, where improvement in FT and ST group Fugl-Meyer
motor scores more than doubled that of the SC group. Similar
results were found for the FTHEU and isometric torque. Dur-
ing the long term, at 9 months, the less severe FT group
continued to make gains in isometric muscle torque, signifi-
cantly exceeding those of the ST group (P.05).
Conclusions:
Task specificity and stroke severity are important factors for rehabilitation of arm use in acute stroke.
Twenty hours of upper extremity–specific therapy over 4 to 6
weeks significantly affected functional outcomes. The immediate benefits of a functional task approach were similar to
those of a resistance-strength approach, however, the former
was more beneficial in the long-term.
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