Unilateral vs bilateral hybrid approaches for upper limb rehabilitation in chronic stroke: A randomized controlled trial

You'll have to ask your doctor to get the RT protocol.

Unilateral vs bilateral hybrid approaches for upper limb rehabilitation in chronic stroke: A randomized controlled trial

Archives of Physical Medicine and Rehabilitation , Volume 100(12) , Pgs. 2225-2232.

NARIC Accession Number: J82774.  What's this?
ISSN: 0003-9993.
Author(s): Hung, Chung-shan; Lin, Keh-chung; Chang, Wan-ying; Huang, Wen-chih; Chang, Ya-Ju; Chen, Chia-ling; Yao, Kaiping G.; Lee, Ya-yun.
Publication Year: 2019.
Number of Pages: 8.

Abstract: 

Study investigated the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. A single-blind, randomized controlled trial was conducted at four hospitals. Forty-four outpatients with chronic stroke and mild-to-moderate motor impairment were randomly allocated to the UHT, BHT, or RT groups. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 minutes a day, 3 days a week for 6 weeks. The Fugl-Meyer Assessment (FMA), divided into the proximal and distal subscale, and the Stroke Impact Scale (SIS) were administered before, immediately after, and 3 months after treatment. The Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) were assessed before and immediately after treatment. The results favored BHT over UHT on the FMA total score and distal score at the post test and follow-up assessment and BHT over RT on the follow-up FMA distal scores. At the post test assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group. BHT was more effective for improving upper-extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
Descriptor Terms: BODY MOVEMENT, INTERVENTION, LIMBS, MOTOR SKILLS, OCCUPATIONAL THERAPY, ROBOTICS, STROKE, THERAPEUTIC TRAINING.


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Citation: Hung, Chung-shan, Lin, Keh-chung, Chang, Wan-ying, Huang, Wen-chih, Chang, Ya-Ju, Chen, Chia-ling, Yao, Kaiping G., Lee, Ya-yun. (2019). Unilateral vs bilateral hybrid approaches for upper limb rehabilitation in chronic stroke: A randomized controlled trial.  Archives of Physical Medicine and Rehabilitation , 100(12), Pgs. 2225-2232. Retrieved 3/16/2020, from REHABDATA database.


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Validity and Responsiveness of the Revised Nottingham Sensation Assessment for Outcome Evaluation in Stroke Rehabilitation

Stupid, stupid, stupid. If you want to predict outcomes you look at damage size and location. I sometimes wonder if our stroke medical professionals have two functioning neurons to rub together.
http://ajot.aota.org/article.aspx?articleid=2488103

Ching-yi Wu; I-ching Chuang; Hui-ing Ma; Keh-chung Lin; Chia-ling Chen

American Journal of Occupational Therapy, February 2016, Vol. 70, 7002290040p1-7002290040p8. doi:10.5014/ajot.2016.018390

Abstract

OBJECTIVE. This study establishes the concurrent validity, predictive validity, and responsiveness of the Revised Nottingham Sensation Assessment (rNSA) during rehabilitation for people with stroke.

METHOD. The study recruited 147 patients with stroke. The main assessment used was the rNSA, and outcome measures were the Fugl-Meyer Assessment sensory subscale (FMA–S) and motor subscale (FMA–M) and the Nottingham Extended Activities of Daily Living (NEADL) scale.

RESULTS. Correlation coefficients were good to excellent between the rNSA and the FMA–S. The rNSA proprioception measure was a predictor for the FMA–S. The rNSA stereognosis and tactile-pinprick measures for the proximal upper limb were predictors for the FMA–M and the NEADL scale, respectively. Responsiveness was moderate to large for three subscales of the rNSA (standardized response mean = .51–.83).

CONCLUSION. This study may support the concurrent validity, predictive validity, and responsiveness of the rNSA for people with stroke.

 

 

Rasch Validation of a Combined Measure of Basic and Extended Daily Life Functioning After Stroke

This is something for your doctor to evaluate and implement
http://nnr.sagepub.com/cgi/content/abstract/27/2/125?etoc

Abstract

Background. Tools used to measure poststroke functional status must include basic and instrumental activities of daily living and reflect the patient’s and the clinician’s perspective of the disease and its effect on daily living performance. Objective. The authors combined the Functional Independence Measure (FIM) and the Nottingham Extended Activities of Daily Living (NEADL) to create a scale providing a comprehensive evaluation of ADLs functional status in patients with stroke. Methods. The study participants were 188 patients completing the FIM and the NEADL. The psychometric properties of the combined measure were examined with Rasch analysis. Results. A 3-point scale and a dichotomous scale were suggested for use in the FIM and the NEADL, respectively. The combined 40 items worked consistently to reflect a single construct, and “bladder management” and “bowel management” were highly related. After “bowel management” was removed from the combined scale, all but 3 items fit the model’s expectations, and the 39-item scale showed reasonable item difficulty hierarchy, with high reliability. The 3 misfit items were removed, and no differences in unidimensionality, differential item functioning, and reliability were found between the 36-item and 39-item scales. Conclusions. The combined measure of the FIM and the NEADL provides a comprehensive picture of ADLs. It extends the utility of the FIM and the NEADL and is recommended for use to measure the independence of patients after discharge home.