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Randomized, controlled trial to evaluate increased intensity of physiotherapy treatment of arm function after stroke
journal contribution
posted on 2018-04-24, 09:14 authored by Nadina B. Lincoln, Ruth ParryRuth Parry, Catherine D. VassBackground and Purpose—Many patients have impaired arm function after stroke, for which they receive physiotherapy. The aim of the study was to determine whether increasing the amount of physiotherapy early after stroke improved the recovery of arm function and to compare the effects of this therapy when administered by a qualified therapist or a trained, supervised assistant. The physiotherapy followed a typical British approach, which is Bobath derived. Ten hours of additional therapy were given over a 5-week period. Methods—The study design was a single-blind, randomized, controlled trial. Stroke patients were recruited from those admitted to the hospital in the 5 weeks after stroke. They were randomly allocated to routine physiotherapy, additional treatment by a qualified physiotherapist, or additional treatment by a physiotherapy assistant. Outcome was assessed after 5 weeks of treatment and at 3 and 6 months after stroke on measures of arm function and of independence in activities of daily living. Results—There were 282 patients recruited to the study. The median initial Barthel score was 6.5, and the median age of the patients was 73 years. The median initial Rivermead Motor Assessment Arm score was 1. There were no significant differences between the groups at randomization or on any of the outcome measures. Only half of the patients allocated to the 2 additional-therapy groups completed the program. Conclusions—This increase in the amount of physiotherapy for arm impairment with a typical British approach given early after stroke did not significantly improve the recovery of arm function in the patients studied. A number of other studies of interventions aimed at rehabilitation of arm function have reported positive results. Such findings may have been due to the content of these interventions, to the greater intensity of the interventions, or to the selection of patients to whom the treatments were applied.
Funding
This study was supported by the National Health Service (NHS) Executive, NHS Research and Development Programme on Cardiovascular Disease and Stroke.
History
School
- Social Sciences
Department
- Communication, Media, Social and Policy Studies
Published in
StrokeVolume
30Issue
3Pages
573 - 579Citation
LINCOLN, N.B., PARRY, R. and VASS, C.D., 1999. Randomized, controlled trial to evaluate increased intensity of physiotherapy treatment of arm function after stroke. Stroke, 30 (3), pp.573-579.Publisher
© American Heart AssociationVersion
- VoR (Version of Record)
Publisher statement
This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/Publication date
1999Notes
This paper is closed access.ISSN
0039-2499eISSN
1524-4628Publisher version
Language
- en