Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial

Chung shan Hung, Keh chung Lin*, Wan ying Chang, Wen chih Huang, Ya Ju Chang, Chia ling Chen, Kaiping Grace Yao, Ya yun Lee

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

24 Scopus citations

Abstract

Objective: To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. Design: A single-blind, randomized controlled trial. Setting: Four hospitals. Participants: Outpatients with chronic stroke and mild to moderate motor impairment (N=44). Intervention: UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. Main Outcome Measures: Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. Results: The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01). Conclusions: BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.

Original languageEnglish
Pages (from-to)2225-2232
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume100
Issue number12
DOIs
StatePublished - 12 2019

Bibliographical note

Publisher Copyright:
© 2019 American Congress of Rehabilitation Medicine

Keywords

  • Randomized controlled trial
  • Rehabilitation
  • Robotics
  • Stroke
  • Therapy

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