Arm weight support training improves functional motor outcome and movement smoothness after stroke

Abstract

The aim of this study was to compare the effectiveness in acute stroke patients of a rehabilitation program performed with or without an arm weight support device. Twenty-eight acute, first-ever unilateral stroke patients were enrolled in a single-blind, randomized controlled trial. Clinical evaluation included Fugl-Mayer Assessment, Functional Independence Measure and kinematic analysis [maximum and mean hand velocity, maximum range of motion (Max RoM), normalized jerk (NJ)]. Patients received 12 daily 30-minute sessions (6/week) of additional upper limb therapy performed using an arm weight support device (study group) or additional traditional physiotherapy (control group). The patients were evaluated on admission and at the end of the rehabilitation intervention. The two groups were clinically comparable on admission (p>0.05). Both groups showed significant improvements in clinical scale scores and in Max RoM in flexionextension, while only the study group showed improvements in NJ and in Max RoM in adductionabduction. Rehabilitation training using an arm weight support device appears to be a useful method to supplement conventional therapy in acute stroke patients, increasing smoothness of movement and motor function.

Figure 1

Arm weight support device and marker positioning. Gray spheres: two shoulder markers and a hand marker. The Cartesian reference system (X and Y axes) is embedded in a vertical-to-the ground plane in which hand marker movements were projected. The midpoint of the shoulder markers corresponds to the origin of the reference axes.

Figure 2

CONSORT flow diagram.

Figure 3

Mean + standard error mean (error bars) of the kinematic indices for upper limb motor performance evaluation. Abbreviations: Max Vel= maximum velocity; Mean Vel=mean velocity; Max RoM AA=maximum range of motion in abduction-adduction; Max RoM FE=maximum range of motion in flexion-extension. Gray columns: before rehabilitation treatment (T0); white columns: after rehabilitation treatment (T1). The asterisks represent significant differences.

Figure 4

Mean + standard error mean (error bars) of differences in kinematics indices used for upper-limb motor performance evaluation between the evaluation sessions after and before rehabilitation treatment (T1 and T0, respectively). Abbreviations: Max Vel= maximum velocity; Mean Vel=mean velocity; Max RoM AA=maximum range of motion in abduction-adduction; Max RoM FE=maximum range of motion in flexion-extension. The asterisks represent significant differences.