ArticlesArm ability training for stroke and traumatic brain injury patients with mild arm paresis: A single-blind, randomized, controlled trial☆,☆☆,★,★★,♢,♢♢
Section snippets
Subjects
Sixty patients (45 with stroke, 15 with TBI) with mild central paresis completed the study. All admissions to the Department of Neurological Rehabilitation at the Free University, Berlin, between June 1996 and December 1998 were screened to determine their eligibility for the study. Admission criteria were (1) a first unilateral supratentorial stroke (localized intracerebral hemorrhage or ischemic stroke) in the subacute phase from 3 weeks to 6 months poststroke or a TBI in the subacute or
Subjects
Seventy-four patients were enrolled in the study, of whom 14 were lost during the intervention period because of personal, organizational, or medical reasons. Five of the lost subjects had been assigned to the no AAT group, 4 to the AAT group, and 5 to the AAT+KR group. Characteristics of the 60 patients completing the study are shown in table 2.Empty Cell Experimental Groups Control Group Empty Cell Characteristic AAT AAT+KR Empty Cell
Discussion
Our results indicate that focal disability of the upper limb in stroke and TBI patients with mild central arm paresis can be significantly improved by the AAT. On average, control subjects showed an 8% reduction in the time needed to perform the TEMPA tasks from pre- to posttest; patients receiving the AAT improved 18%, indicating a clinically relevant 10% improvement attributable to AAT. A differential functional benefit for patients who had AAT was also suggested for a subgroup of AAT
Conclusion
The study demonstrates the AAT's efficacy for patients with mild central arm paresis after stroke and TBI. This is the first clinical therapeutic study to show promotion of arm motor recovery for these specific patient groups. Therefore, the AAT can be recommended as part of a rehabilitation program for this patient population. Together with clinical trials with stroke patients with more pronounced arm paresis,8, 9, 10 the results suggest that central arm paresis is amenable to specific
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2018, Journal of BiomechanicsChanges in motor cortex excitability for the trained and non-trained hand after long-term unilateral motor training
2017, Neuroscience LettersCitation Excerpt :Aim of our study was to investigate the modulation of the ICF in either hemisphere after unilateral, repetitive, long-term motor learning. We therefore asked healthy strongly right-handed participants to train their left non-dominant hand with a comprehensive hand motor training (arm ability training; [28]) for two weeks one hour a day. We used a comprehensive motor training that had clinically been validated for stroke patients with mild paresis [29,30], since observed changes in ICF with such a training could well be relevant for our understanding of complex, prolonged and clinically relevant motor training conditions.
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2017, Brain StimulationCitation Excerpt :Based on these interactions, motor training of hand and finger performance might well profit from somatosensory priming. We therefore explored the efficacy of a combination of rES of the fingertips before 2 weeks of motor training (arm ability training (AAT) [16]) of the left arm in healthy right handed participants. With the current study, we intended to investigate changes of neural representation after rES-primed motor training within the sensorimotor system.
The Effects of Combination of Robot-Assisted Therapy With Task-Specific or Impairment-Oriented Training on Motor Function and Quality of Life in Chronic Stroke
2016, PM and RCitation Excerpt :Participants with a pretest FMA-UE score greater than 35 and who had precision grip ability received the Arm Ability training. The Arm Ability training provided 8 kinds of activities, including aiming, tapping, cancellation, turning coins, maze tracking, bolt and nut, placing small objects, and placing large objects [26]. Patients were asked to implement at home the programs taught by the therapist, comprising 2 tasks for 30 minutes daily.
Increased ventral premotor cortex recruitment after arm training in an fMRI study with subacute stroke patients
2016, Behavioural Brain ResearchCitation Excerpt :After completion of the 8 × 2 task-set, the series was performed a second time, resulting in a total number of four repetitions per task. The following tasks were trained repetitively: Aiming, tapping, crossing circles, turning coins, labyrinth, nuts and bolts, placing small objects, placing large objects (see also Fig. 1 and [28,29]). At the first day of training, the individual number of repetitions within one minute for each task and block was determined for every patient based on the patient’s individual motor capacities and kept constant for the following training days.
Technologies for restoring limb function
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Supported by Bundesministerium für Bildung und Forschung (grant no. 01K095168).
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to Thomas Platz, MD, Klinik Berlin, Kladower Damm 223, 14089 Berlin, Germany.
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