Is forced use of the paretic upper limb beneficial?

[wildwilly]

Clin Rehabil. 2009 Mar 25.

Is forced use of the paretic upper limb beneficial? A randomized pilot study during subacute post-stroke recovery.

Hammer A, Lindmark B.

Department of Rehabilitation Medicine, Orebro University Hospital, and the School of Health and Medical Sciences, Orebro University, Orebro, Sweden.

Objective: To evaluate the effect of two weeks of forced use of the paretic upper limb, as a supplement to the rehabilitation programme in the subacute phase after stroke, on self-rated use of that limb.Design: A randomized, non-blind, parallel group, clinical, before-and-after trial. A forced use group and a conventional group were followed up one and three months after intervention.Setting: In- and outpatient units of rehabilitation at a University Hospital.Subjects: Thirty patients were allocated to two groups, 15 in each, 1-6 months (mean 2.4) after stroke onset. Twenty-six patients completed the study.Interventions: The patients of both groups participated in two weeks of daily training on weekdays. In addition, the forced use group wore a restraining sling on the non-paretic arm for up to 6 hours per weekday.Main measure: The Motor Activity Log; patients scored 0-5 for 30 daily tasks concerning both amount of use and quality of movement.Results: The forced use group tended to achieve larger improvements immediately post-intervention, but this was not clearly demonstrated. The small differences also levelled out up to the three-month follow-up, with both groups earning an approximately 1.0 score point on both scales of the Motor Activity Log.Conclusions: This pilot study did not reveal any additional benefit of forced use on self-rated performance in daily use of the paretic upper limb. Both groups performed fairly extensive, active training with a similar duration, amount and content.

http://www.ncbi.nlm.nih.gov/pubmed/19321522?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=1&log$=relatedarticles& logdbfrom=pubmed