Article

OBJECTIVES: To compare user acceptance and arm and hand function changes after
technology-supported training at home with conventional exercises in chronic
stroke. Secondly, to investigate the relation between training duration and clinical changes. DESIGN: A randomised controlled trial. SETTING: Training at
home, evaluation at research institute. SUBJECTS: Twenty chronic stroke patients
with severely to mildly impaired arm and hand function. INTERVENTIONS:
Participants were randomly assigned to six weeks (30 minutes per day, six days a
week) of self-administered home-based arm and hand training using either a
passive dynamic wrist and hand orthosis combined with computerised gaming
exercises (experimental group) or prescribed conventional exercises from an
exercise book (control group). MAIN MEASURES: Main outcome measures are the
training duration for user acceptance and the Action Research Arm Test for arm
and hand function. Secondary outcomes are the Intrinsic Motivation Inventory,
Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength.
RESULTS: The control group reported a higher training duration (189 versus 118
minutes per week, P = 0.025). Perceived motivation was positive and equal between
groups ( P = 0.935). No differences in clinical outcomes over training between
groups were found (P 0.165). Changes in Box and Block Test correlated positively
with training duration ( P = 0.001). CONCLUSIONS: Both interventions were
accepted. An additional benefit of technology-supported arm and hand training
over conventional arm and hand exercises at home was not demonstrated. Training
duration in itself is a major contributor to arm and hand function improvements.

Langue : ANGLAIS