[Abstract] Improvement of upper limb motor control and function after competitive and non-competitive volleyball exercises in chronic stroke survivors: A randomized clinical trial

Abstract

Objectives

To investigate the effects of competitive and non-competitive volleyball exercises on the functional performance and motor control of the upper limbs in chronic stroke survivors.

Design

Randomized clinical trial.

Setting

Outpatient rehabilitation center.

Participants

Forty-eight chronic stroke survivors.

Interventions

Participants were randomly assigned to competitive (n=16) or non-competitive (n=16) volleyball exercise groups (60 min/day volleyball exercise + 30 min/day traditional rehabilitation, 3 day/week for 7 weeks) and control group (n=16).

Main outcome measures

Reach and grasp motor control measures were evaluated through kinematic analysis. Functional outcomes were assessed via Motor Activity Log, Wolf Motor Function Test, Box and Block Test, as well as, Wrist Position Sense Test.

Results

Significant improvement of functional performance was observed in both competitive (P <0.0001) and non-competitive volleyball exercise groups (P <0.01), but not in the control group (P >0.05), with the exception of Wolf Motor Function Test score. Volleyball training, in general, resulted in more efficient spatiotemporal control of reach and grasp functions, as well as less dependence on feedback control as compared to the control group. Moreover, the competitive volleyball exercise group exhibited greater improvement in both functional performance and motor control levels.

Conclusions

Volleyball team exercises, especially in a competitive format, resulted in enhancing the efficacy of the pre-programming and execution of reach and grasp movements, as well as a shift from feedback to feedforward control of the affected upper limb in chronic stroke survivors. This may well be a potential underlying mechanism for improving functional performance.

List of abbreviations:

ADL (activities of daily living), ANOVA (one-way analysis of variance), AOU (amount of use), BBT (Box and Block Test), FAS (functional ability scale), MAL (Motor Activity Log), MGA (maximum grip aperture), NMT (normalized movement time), NTD (normalized total distance), PMGA (percentage of movement time in which MGA occurs), PPV (percentage of movement time in which PV occurs), PV (peak velocity), QOM (quality of movement), WMFT(Wolf motor function test), WPST (wrist position sense test)

 

via Improvement of upper limb motor control and function after competitive and non-competitive volleyball exercises in chronic stroke survivors: A randomized clinical trial – Archives of Physical Medicine and Rehabilitation