Article

This study compared the efficacy of distributed
constraint-induced therapy (dCIT), bilateral arm training (BAT), and control
treatment (CT) on motor control and functional performance of the upper limb in
stroke patients. METHODS: A total of 66 patients with mean stroke onset of 16.20
months and mild to moderate motor impairment were randomized to dCIT, BAT, or CT
groups. Each group received treatment for 2 h/d and 5 d/wk for 3 weeks.
Pretreatment and posttreatment measures included reaching kinematic variables in
unilateral and bilateral tasks, the Wolf Motor Function Test (WMFT), and the
Motor Activity Log (MAL). RESULTS: The dCIT and BAT groups had smoother reaching
trajectories in the unilateral and bilateral tasks than the CT group. The BAT
group, but not the dCIT group, generated greater force at movement initiation
than the CT group during the unilateral and bilateral tasks. The dCIT patients
had decreased WMFT time and higher functional ability scores than the CT
patients. MAL results pointed to better performance in the amount and quality of
use of the affected arm than BAT and CT patients. CONCLUSIONS: BAT and dCIT
exhibited similar beneficial effects on movement smoothness but differential
effects on force at movement initiation and functional performance. Therefore,
BAT is a better option if improvement of force generation is the treatment goal,
and dCIT is more appropriate for improving functional ability and use of the
affected arm in daily life. These findings may assist in the planning of
individually tailored rehabilitation therapies.

Langue : ANGLAIS