Article

OBJECTIVE: To identify the baseline motor characteristics of the patients who
responded to 3 prominent intervention programs. DESIGN: Observational cohort
study. SETTING: Outpatient rehabilitation clinics. PARTICIPANTS: Individuals with
chronic stroke (N=174). INTERVENTIONS: Participants received 30 hours of
constraint-induced movement therapy (CIMT), robot-assisted therapy, or mirror
therapy (MT). MAIN OUTCOME MEASURES: The primary outcome measure was the change
score of the Upper Extremity Fugl-Meyer Assessment (UE-FMA). The potential
predicting variables were baseline proximal, distal, and total UE-FMA and Action
Research Arm Test scores. We combined polynomial regression analyses and the
minimal clinically important difference to stratify the patients as responders
and nonresponders for each intervention approach. RESULTS: Baseline proximal
UE-FMA scores significantly predicted clinically important improvement on the
primary outcome measure after all 3 interventions. Participants with baseline
proximal UE-FMA scores of approximately <30 benefited significantly from CIMT and
robot-assisted therapy, whereas participants with scores between 21 and 35
demonstrated significant improvement after MT. Baseline distal and total UE-FMA
and Action Research Arm Test scores could also predict upper limb improvement
after CIMT and MT, but not after robot-assisted therapy. CONCLUSIONS: This study
could inform clinicians about the selection of suitable rehabilitation approaches
to help patients achieve clinically meaningful improvement in upper extremity
function.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS