Popis: |
Background Upper limb disabilities after a stroke compromise the activities of daily living. Several approaches to improve motor control and reduce disability are proposed, including specific unilateral training of the contralesional limb or bilateral training with appropriate equipment and/or robotic assistance. These approaches can be used with rhythmic or discrete movements along with usual therapy, but the most effective approach has never been determined. The objective of this study will be to verify the effect of training with rhythmic or discrete movements in conjunction with the usual therapy on motor function and participation regarding the patients’ upper limbs after chronic stroke. Methods/Design This is a 3-arm, assessor-blinded, randomized controlled trial. Seventy-five patients with chronic stroke (> 6 months) and upper limb paresis will be included. Participants will be randomly allocated into 3 groups: 1) discrete movement training and usual therapy (n = 25), 2) rhythmic movement training and usual therapy (n = 25) and 3) a control group, (n = 25) which will only receive the usual therapy. A five-week intervention period (10 sessions) with two sessions per week will be carried out. Outcome measures include participation, activity and motor function measured by the Stroke Impact Scale (SIS), Motor Activity Log (MAL) and Fugl-Meyer Scale, respectively; other measures are aiming movement performance, grip strength and spasticity, which will be obtained at follow-up assessments 5 weeks and 3 months after randomization. Discussion The results of this trial can support allied health professionals’ decision-making processes in the treatment of motor impairment and disability after chronic stroke and reduce this condition’s health-related costs. |