To determine whether task-specific training with trunk-restraint (TR) produces greater improvements in arm impairment and function than training without TR in patients with chronic hemiparesis.
- Physical therapy Behavioral
Randomized, controlled, double-blind trial.
Participants were stratified with Fugl-Meyer (FM) Arm scores to less (FM>/=50) or more severe (FM <50)strata and randomly assigned by a research assistant to experimental (TR) or control (nonrestraint, C) groups resulting in 7 and 8 patients in less (mild) and more severe (moderate) strata respectively per group. Participants received a 1-hour therapist-supervised home program with object-related reach-to-grasp training 3 times per week for 5 weeks. Both groups practiced the same tasks except that in TR, trunk movements (sagittal displacement, rotation) were prevented by body and shoulder belts attached to the chairback. Scapular elevation/protraction was not restricted. Group C wore unfastened belts without limiting trunk movements. Evaluations were repeated before, immediately after, and 1 month postintervention by blind evaluators.
|Type||Measure||Time Frame||Safety Issue|
|Primary||Two primary clinical outcomes characterizing training program effectiveness for improving arm impairment and motor function were FM (Fugl-Meyer Arm Section)and Upper Extremity performance Test (TEMPA). Two primary outcome measures of training program efficacy were trunk displacement and elbow extension ranges.|
|Secondary||Isometric force and manual dexterity (Box and Blocks Test [BBT]), range of shoulder flexion, peak arm tangential velocity, smoothness and hand trajectory straightness.|