Arm ability training for stroke and traumatic brain injury patients with mild arm paresis: a single-blind, randomized, controlled trial

Abstract

Objective: To test the efficacy of the arm ability training (AAT) on a sample of patients with central arm paresis after traumatic brain injury (TBI) or stroke.

Design: Single-blind, randomized, controlled trial.

Setting: Inpatient rehabilitation center.

Patients: Consecutive sample of 74 patients of whom 60 (45 with stroke, 15 with TBI) completed the study; 37 patients received a 1-year follow-up.

Intervention: Daily AAT with (n = 20) or without (n = 20) knowledge of results, or no AAT (n = 20) during a 3-week intervention period.

Main outcome measures: Summary time scores of the Test Evaluant les Membres superieurs des Personnes Agees (TEMPA)-a test of upper extremity function with daily function-like activities (focal disability)-and kinematic analysis of aimed movements.

Results: Patients with AAT realized superior improvement as compared with controls. Mean improvement in the time needed to perform (1) all TEMPA tasks was 41.4 versus 12.8 seconds (p =.0012); (2) unilateral TEMPA tasks, 16.5 versus 4.2 seconds (p =.0036); and (3) the ballistic component of aimed movements, 96 versus 20ms (p =.0115). Knowledge of result did not substantially modify these effects. A functional benefit existed at 1-year follow-up.

Conclusion: The AAT reduces focal disability among stroke and TBI patients with mild central arm paresis.