[Abstract] Enriched, Task-Specific Therapy in the Chronic Phase After Stroke: An Exploratory Study

Abstract

Background and purpose: There is a need to translate promising basic research about environmental enrichment to clinical stroke settings. The aim of this study was to assess the effectiveness of enriched, task-specific therapy in individuals with chronic stroke.

Methods: This is an exploratory study with a within-subject, repeated-measures design. The intervention was preceded by a baseline period to determine the stability of the outcome measures. Forty-one participants were enrolled at a mean of 36 months poststroke. The 3-week intervention combined physical therapy with social and cognitive stimulation inherent to environmental enrichment. The primary outcome was motor recovery measured by Modified Motor Assessment Scale (M-MAS). Secondary outcomes included balance, walking, distance walked in 6 minutes, grip strength, dexterity, and multiple dimensions of health. Assessments were made at baseline, immediately before and after the intervention, and at 3 and 6 months.

Results: The baseline measures were stable. The 39 participants (95%) who completed the intervention had increases of 2.3 points in the M-MAS UAS and 5 points on the Berg Balance Scale (both P < 0.001; SRM >0.90), an improvement of comfortable and fast gait speed of 0.13 and 0.23 m/s, respectively. (P < 0.001; SRM = 0.88), an increased distance walked over 6 minutes (24.2 m; P < 0.001; SRM = 0.64), and significant improvements in multiple dimensions of health. The improvements were sustained at 6 months.

Discussion and conclusions: Enriched, task-specific therapy may provide durable benefits across a wide spectrum of motor deficits and impairments after stroke. Although the results must be interpreted cautiously, the findings have implications for enriching strategies in stroke rehabilitation.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A304

Similar articles

• A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial

  DK Rose et al. J Neurol Phys Ther 42 (1), 12-21. Jan 2018. PMID 29232308. – Randomized Controlled Trial

  Individuals 1-week poststroke tolerated 30 min/d of additional therapy. At 1-month postintervention, BWT resulted in greater improvements in both forward and backward wal …
• Erratum

  Mult Scler 22 (12), NP9-NP11. Oct 2016. PMID 26041800.

  See Nilsagard et al.²⁵Qualitative research approach. Interviewed (15-45 mins) within two weeks after the end of the intervention period. Interview covered refl …
• Motor Learning During Poststroke Gait Rehabilitation: A Case Study

  TM Kesar et al. J Neurol Phys Ther 38 (3), 183-9. Jul 2014. PMID 24933501. – Case Reports

  (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A72, for more insights from the authors.).
• Yoga for Stroke Rehabilitation

  M Lawrence et al. Cochrane Database Syst Rev 12 (12), CD011483. 2017. PMID 29220541. – Review

  Yoga has the potential for being included as part of patient-centred stroke rehabilitation. However, this review has identified insufficient information to confirm or ref …
• Motor-Cognitive Dual-Task Training in Persons With Neurologic Disorders: A Systematic Review

  NE Fritz et al. J Neurol Phys Ther 39 (3), 142-53. Jul 2015. PMID 26079569. – Review

  While the range of training protocols and outcome assessments in available studies limited comparison of the results across studies motor-cognitive dual-task deficits in …

See all similar articles

via Enriched, Task-Specific Therapy in the Chronic Phase After Stroke: An Exploratory Study – PubMed