A structured, task-oriented rehabilitation program showed no greater benefit to motor function or recovery than usual rehabilitation for patients with moderate upper extremity impairment due to stroke, according to results recently published in JAMA. According to a press release, the study compared rehabilitation programs during a period of 12 months.
In the study, led by Carolee J. Winstein, PhD, PT, FAPTA, professor of biokinesiology and physical therapy at the University of Southern California, Los Angeles, researchers assigned 361 patients, with an average age of 61 years, to one of three groups that received either structured, task-oriented upper extremity therapy (n=119); dose-equivalent occupational therapy (n=120); or monitoring-only occupational therapy (n=122). Patients in the dose-equivalent therapy group received 30 hour-long sessions for 10 weeks, while the monitoring-only occupational therapy group was monitored without a specification of dose. All patients were tested at 12 months using a variety of motor function and recovery measures.
Among the 304 patients who completed the 12-month primary outcome assessment, Winstein and colleagues found no group differences in upper extremity motor performance and the structured, task-oriented motor therapy showed no additional benefit for an evidence-based, intensive, restorative therapy program. No advantage was found when researchers provided more than twice the average dose (54 hours compared with 27 hours) of therapy compared with the average 11 hours for the observation-only group. The result indicated substantially more therapy time was not associated with additional motor restoration.
Researchers said the study data on the dose of rehabilitation therapy could inform policy makers and with cost estimation and expectations for aftercare in the outpatient setting.
Winstein CJ, et al. JAMA. 2016;doi:10.1001/jama.2016.0276.