Dose response of task ‐specific upper limb training in people at least 6 months poststroke: A phase II, single‐blind, randomized, controlled trial

The objectives of this work were to (1) determine whether higher doses of motor therapy in chronic poststroke hemiparesis result in better outcomes, compared to lower doses, and (2) evaluate potential modifiers of the dose‐response relationship. MethodsEighty‐five adults with upper extremity paresis ≥6 months poststroke were randomized to one of four dose groups in this single‐blind, parallel, randomized, control trial. The dosing parameter manipulated was amount of task‐specific training, as indexed by the number of task repetitions. Groups received 3,200, 6,400, 9,600, or individualized maximum (IM) repetitions, during 1‐hour sessions, 4 days/week for 8 weeks. The intervention was an individualized, progressive, task‐specific upper‐limb training program designed to improve upper‐limb functional motor capacity. The primary outcome was the slope of the Action Research Arm Test (ARAT) during the intervention. Effects of dose and potential modifiers of the dose‐response relationship were evaluated with hierarchical linear models. ResultsARAT scores for the 3,200, 9,600, and IM groups improved over time as indicated by slopes (ΔARAT/week, mean ± standard errors) of 0.40 ± 0.15, 0.31 ± 0.16, and 0.66 ± 0.14, respectively (p < 0.05). The slope of the 6,400 group was smaller (−0.05 ± 0.15) and significantly different from the 3,200 and IM groups (p < 0.001). Initial motor capacity, neglect, and other tested characteristi...
Source: Annals of Neurology - Category: Neurology Authors: Tags: Research Article Source Type: research