10 years! With nothing done in your stroke hospital they all need to be fired, starting at the top with the board of directors.
The Effects of Bilateral Arm Training on Motor Control and Functional Performance in Chronic Stroke: A Randomized Controlled Study
2010, Neurorehabilitation and Neural Repair
Keh-chung Lin, ScD, 1,2
Yi-an Chen, MS, 3
Chia-ling Chen, MD, PhD, 4
Ching-yi Wu, ScD, 4
and Ya-fen Chang, MS 5
. Most studies of bilateral arm training (BAT) did not employ a randomized controlled trial design and involved very limited functional training tasks.
Objective
. Compare the effects of BAT with control intervention (CI) on motor control and motor performance of the upper extremity and also functional gains in patients with chronic stroke.
Methods
. This 2-group randomized controlled trial with pretreatment and post treatment measures enrolled 33 stroke patients (mean age = 53.85 years) 6 to 67 months after onset of a first stroke. They received either a BAT program concentrating on both upper extremities moving simultaneously in functional tasks by symmetric patterns or CI (control treatment) for 2 hours on weekdays for 3 weeks. Outcome measures included kinematic analyses assessing motor control strategies for unilateral and bimanual reaching and clinical measures involving the Fugl-Meyer Assessment (FMA) of motor-impairment severity and the Functional Independence Measure (FIM) and the Motor Activity Log (MAL) evaluating functional ability.
Results
. After treatment, the BAT group showed better temporal and spatial efficiency during unilateral and bilateral tasks and less online error correction only during the bilateral task than the control group. The BAT group showed a significantly greater improvement in the FMA than the control group but not in the FIM and MAL.
Conclusions
. Relative to CI, BAT improved the spatiotemporal control of the affected arm in both bilateral and unilateral tasks, decreased online corrections to perform bilateral tasks, and reduced motor impairment. These findings support the use of BAT to improve motor control and motor function of the affected upper limb in stroke patients.
Keh-chung Lin, ScD, 1,2
Yi-an Chen, MS, 3
Chia-ling Chen, MD, PhD, 4
Ching-yi Wu, ScD, 4
and Ya-fen Chang, MS 5
Abstract
Background. Most studies of bilateral arm training (BAT) did not employ a randomized controlled trial design and involved very limited functional training tasks.
Objective
. Compare the effects of BAT with control intervention (CI) on motor control and motor performance of the upper extremity and also functional gains in patients with chronic stroke.
Methods
. This 2-group randomized controlled trial with pretreatment and post treatment measures enrolled 33 stroke patients (mean age = 53.85 years) 6 to 67 months after onset of a first stroke. They received either a BAT program concentrating on both upper extremities moving simultaneously in functional tasks by symmetric patterns or CI (control treatment) for 2 hours on weekdays for 3 weeks. Outcome measures included kinematic analyses assessing motor control strategies for unilateral and bimanual reaching and clinical measures involving the Fugl-Meyer Assessment (FMA) of motor-impairment severity and the Functional Independence Measure (FIM) and the Motor Activity Log (MAL) evaluating functional ability.
Results
. After treatment, the BAT group showed better temporal and spatial efficiency during unilateral and bilateral tasks and less online error correction only during the bilateral task than the control group. The BAT group showed a significantly greater improvement in the FMA than the control group but not in the FIM and MAL.
Conclusions
. Relative to CI, BAT improved the spatiotemporal control of the affected arm in both bilateral and unilateral tasks, decreased online corrections to perform bilateral tasks, and reduced motor impairment. These findings support the use of BAT to improve motor control and motor function of the affected upper limb in stroke patients.
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