Stroke Recovery: More Rehab Isn’t Better, Study Says
BY JAMIE TALAN
A new study testing the benefits of a task-oriented rehabilitation program to strengthen hand and arm weakness post-stroke suggests that more hours of an intensive program are not necessarily better than usual occupational therapy. Patients who received intensive upper-body training–30 one-hour sessions over a 10-week period–fared no better than those who received a more standard type of rehabilitation, or the usual therapy with significantly fewer hours.
Study Parameters
Researchers at the University of Southern California (USC) randomly assigned 361 stroke patients from seven hospitals around the country to receive either one-hour intensive, structured upper-extremity training three times a week; 30 hours of usual occupational therapy; or occupational therapy that was monitored but with no prescribed amount of hours. The rehabilitation services were delivered in an outpatient setting and the patients’ upper extremity motor function and recovery were measured over the course of a year
Results
As reported in the Journal of the American Medical Association, there were no differences between the groups in upper extremity motor performance. The group undergoing intensive, task-oriented rehabilitation did not have better arm or hand strength than the groups who had usual occupational therapy or monitored-only standard rehabilitation practice. In other words, a more intensive treatment protocol wasn’t better at restoring motor performance. “These findings do not support superiority of this task-oriented rehabilitation program for patients with motor stroke and moderate upper extremity impairment,” the study authors wrote.
Unexpected Findings
The study counters recent research that suggested that more hours of task-oriented upper-extremity training are better for stroke patients than standard occupational and physical therapy. The USC researchers acknowledged that changing practices among physical and occupational therapists could have accounted for the similar motor outcome identified in the study. Also, the variability in the hours of rehabilitation patients received in the control arm of the study could have skewed the results, they said.
Less May Be More
Still, the researchers concluded: “The findings from this study provide important new guidance to clinicians who must choose the best treatment for stroke patients. The results suggest that usual community-based therapy, provided during the typical outpatient rehabilitation time window by licensed therapists, improves upper extremity motor function and that more than doubling the dose of therapy does not lead to meaningful differences in motor outcomes.”
Read the full story from which this post was adapted in Neurology Today at bit.ly/NT-StrokeRehab.
Source: Neurology Now
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