Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early after Stroke : The EXPLICIT-Stroke Randomized Clinical Trial
| Autor: | Kwakkel, G., Winters, C., Wegen, E.E.H. van, Nijland, R.H.M., Kuijk, A.A.A. van, Visser-Meily, A., Groot, J. de, Vlugt, E. de, Arendzen, J.H., Geurts, A.C.H., Meskers, C.G.M., EXPLICIT-Stroke Consortium |
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| Přispěvatelé: | Rehabilitation medicine, MOVE Research Institute, Kinesiology, Human Movement Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
030506 rehabilitation Neurology medicine.medical_treatment Severity of Illness Index Functional Laterality law.invention 0302 clinical medicine constraint-induced movement therapy (CIMT) Randomized controlled trial law Single-Blind Method Stroke Rehabilitation Stroke Rehabilitation General Medicine Middle Aged Neurofeedback Prognosis Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] stroke Multicenter Study Treatment Outcome medicine.anatomical_structure Randomized Controlled Trial Arm Upper limb Female 0305 other medical science Adult Restraint Physical medicine.medical_specialty Clinical Neurology upper limb electromyography-triggered neuromuscular stimulation (EMG-NMS) Upper Extremity 03 medical and health sciences Physical medicine and rehabilitation SDG 3 - Good Health and Well-being randomized controlled trial (RCT) Upper limb training medicine Journal Article Humans In patient Physical Therapy Modalities Aged Retrospective Studies business.industry medicine.disease Ischemic stroke Physical therapy business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Kwakkel, G, Winters, C, van Wegen, E E H, Nijland, R H M, van Kuijk, A A A, Visser-Meily, A, de Groot, J, de Vlugt, E, Arendzen, J H, Geurts, A C H & Meskers, C G M 2016, ' Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early After Stroke: The EXPLICIT-Stroke Randomized Clinical Trial ', Neurorehabilitation and Neural Repair, vol. 30, no. 9, pp. 804-816 . https://doi.org/10.1177/1545968315624784 Neurorehabilitation and Neural Repair, 30, 804-16 Neurorehabilitation and Neural Repair, 30(9), 804-816. SAGE Publications Inc. Kwakkel, G, Winters, C, Van Wegen, E E H, Nijland, R H M, Van Kuijk, A A A, Visser-Meily, A, De Groot, J, De Vlugt, E, Arendzen, J H, Geurts, A C H & Meskers, C G M 2016, ' Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early after Stroke : The EXPLICIT-Stroke Randomized Clinical Trial ', Neurorehabilitation and Neural Repair, vol. 30, no. 9, pp. 804-816 . https://doi.org/10.1177/1545968315624784 Neurorehabilitation and Neural Repair, 30(9), 804-816 Neurorehabilitation and Neural Repair, 30, 9, pp. 804-16 Neurorehabilitation and Neural Repair, 30(9), 804. SAGE Publications Inc. Neurorehabilitation and Neural Repair |
| ISSN: | 1545-9683 |
| DOI: | 10.1177/1545968315624784 |
| Popis: | Item does not contain fulltext Background and Objective Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10 degrees of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only. Both interventions started within 14 days poststroke, lasted up until 5 weeks, focused at preservation or return of FE. Results Upper limb capacity was measured with the Action Research Arm Test (ARAT), assessed weekly within the first 5 weeks poststroke and at postassessments at 8, 12, and 26 weeks. Clinically relevant differences in ARAT in favor of mCIMT were found after 5, 8, and 12 weeks poststroke (respectively, 6, 7, and 7 points; P < .05), but not after 26 weeks. We did not find statistically significant differences between mCIMT and usual care on impairment measures, such as the Fugl-Meyer assessment of the arm (FMA-UE). EMG-NMS did not result in significant differences. Conclusions Three weeks of early mCIMT is superior to usual care in terms of regaining upper limb capacity in patients with a favorable prognosis; 3 weeks of EMG-NMS in patients with an unfavorable prognosis is not beneficial. Despite meaningful improvements in upper limb capacity, no evidence was found that the time-dependent neurological improvements early poststroke are significantly influenced by either mCIMT or EMG-NMS. |
| Databáze: | OpenAIRE |
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