Mechanical Arm Trainer for the Treatment of the Severely Affected Arm After a Stroke: A Single-Blinded Randomized Trial in Two Centers
By Hesse, S.; Werner, C.; Pohl, M.; Mehrholz, J.; Puzich, U.; Krebs, H.I.; American Journal of Physical Medicine and Rehabilitation, Vol. 87, No. 10, pp. 779-788Publication Date: October 2008
Study assessed the efficacy of a mechanical arm trainer (AT) versus electrical stimulation (ES) in subacute stroke patients with severe upper-limb paresis. For the study, 54 inpatients enrolled 4 to 8 weeks from stroke onset, in addition to standard therapy, were randomly assigned to 20 minutes of either AT or ES training 5 days a week for 6 weeks. The AT training involved repetitive bilateral movements using a Reha-Slide mechanical trainer consisting of two handles connected by a rod and mounted on two sledges. Patients in the ES group received an electrical muscle stimulation of their paretic wrist extensions. Primary outcome measure used was the Fugl-Meyer assessment. A secondary outcome measure was the Box and Block test. Participants were blindly assessed at enrollment, after 6 weeks, and at 3-month follow-up. Both groups were shown to be homogenous at study onset. Shoulder pain occurred in two AT patients. The Fugl-Meyer outcome, which improved for both groups over time, did not differ between groups. In the Box and Block test, no patient could transport a block initially, but at completion, significantly more AT patients were able to transport at least 3 blocks. No significant differences were observed between the groups on the Box and Block outcome at follow-up. The study concludes that AT training did not lead to a superior primary outcome over ES training; however, “good performers” on the Box and Block test seemed to benefit more from the AT training.
Published by: Lippincott, Williams, & Wilkins (Website:http://www.lww.com)
Association of Academic Physiatrists (Web Site: http://physiatry.org )
