Upper Limb Isokinetic Strengthening Versus Passive Mobilization in Patients With Chronic Stroke: A Randomized Controlled Trial.
Arch Phys Med Rehabil
; 99(2): 321-328, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-28947166
ABSTRACT
OBJECTIVE:
To assess the benefit of isokinetic strengthening of the upper limb (UL) in patients with chronic stroke as compared to passive mobilization.DESIGN:
Randomized blinded assessor controlled trial.SETTING:
Physical Medicine and Rehabilitation departments of 2 university hospitals.PARTICIPANTS:
Patients (N=20) with incomplete hemiplegia (16 men; mean age, 64y; median time since stroke, 32mo).INTERVENTIONS:
A 6-week comprehensive rehabilitation program, 3d/wk, 3 sessions/d. In addition, a 45-minute session per day was performed using an isokinetic dynamometer, with either isokinetic strengthening of elbow and wrist flexors/extensors (isokinetic strengthening group) or passive joint mobilization (control group). MAIN OUTCOMEMEASURES:
The primary endpoint was the increase in Upper Limb Fugl-Meyer Assessment (UL-FMA) score at day 45 (t1). Secondary endpoints were increases in UL-FMA scores, Box and Block Test scores, muscle strength, spasticity, and Barthel Index at t1, t2 (3mo), and t3 (6mo).RESULTS:
Recruitment was stopped early because of excessive fatigue in the isokinetic strengthening group. The increase in UL-FMA score at t1 was 3.5±4.4 in the isokinetic strengthening group versus 6.0±4.5 in the control group (P=.2). Gains in distal UL-FMA scores were larger (3.1±2.8) in the control group versus 0.6±2.5 in the isokinetic strengthening group (P=.05). No significant group difference was observed in secondary endpoints. Mixed models confirmed those results. Regarding the whole sample, gains from baseline were significant for the UL-FMA at t1 (+4.8; P<.001), t2, and t3 and for the Box and Block Test at t1 (+3; P=.013) and t2.CONCLUSIONS:
In a comprehensive rehabilitation program, isokinetic strengthening did not show superiority to passive mobilization for UL rehabilitation. Findings also suggest a sustained benefit in impairments and function of late UL rehabilitation programs for patients with stroke.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Modalidades de Fisioterapia
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Acidente Vascular Cerebral
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Extremidade Superior
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Reabilitação do Acidente Vascular Cerebral
Tipo de estudo:
Clinical_trials
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Prognostic_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
França