Article

Total reaching range of motion (work area) diminishes as a function
of shoulder abduction loading in the paretic arm in individuals with chronic
hemiparetic stroke. This occurs when reaching outward against gravity or during
transport of an object. OBJECTIVES: This study implements 2 closely related
impairment-based interventions to identify the effect of a subcomponent of
reaching exercise thought to be a crucial element in arm rehabilitation. METHODS:
A total of 14 individuals with chronic moderate to severe hemiparesis
participated in the participant-blinded, randomized controlled study. The
experimental group progressively trained for 8 weeks to actively support the
weight of the arm, up to and beyond, while reaching to various outward targets.
The control group practiced the same reaching tasks with matched frequency and
duration with the weight of the arm supported. Work area and isometric strength
were measured before and after the intervention. RESULTS: Change scores for work
area at 9 loads were calculated for each group. Change scores were significantly
larger for the experimental group indicating a larger increase in work area,
especially shoulder abduction loads equivalent to those experienced during object
transport. Changes in strength were not found within or between groups.
CONCLUSIONS: Progressive shoulder abduction loading can be utilized to ameliorate
reaching range of motion against gravity. Future work should investigate the
dosage response of this intervention, as well as test whether shoulder abduction
loading can augment other therapeutic techniques such as goal-directed functional
task practice and behavioral shaping to enhance real-world arm function.

Langue : ANGLAIS