Task-specific training with trunk restraint on arm recovery in stroke: randomized control trial

Area of Science:

• Neurorehabilitation
• Motor Recovery
• Stroke Rehabilitation

Background:

• Task-specific training enhances functional outcomes post-stroke.
• Compensatory movements can accompany motor gains, potentially hindering full recovery.
• Restricting trunk movements may promote restoration of natural arm movement patterns.

Purpose of the Study:

• To investigate if task-specific training with trunk restraint (TR) yields superior improvements in arm impairment and function compared to training without TR.
• To assess the impact of TR on compensatory trunk movements in patients with chronic hemiparesis.

Main Methods:

• A double-blind randomized controlled trial involving 30 patients with chronic hemiparesis.
• Intervention: Progressive reach-to-grasp training with trunk movement prevention (TR group) vs. training without trunk restraint (Control group).
• Outcome measures included upper limb impairment (Fugl-Meyer Arm Section), function (TEMPA), and movement kinematics (trunk displacement, elbow extension).

Main Results:

• The TR group demonstrated significantly greater improvements in arm impairment and function than the control group.
• Improvements in the TR group were associated with increased active joint range and were more pronounced in patients with initially severe impairments.
• TR training reduced compensatory trunk movements and increased elbow extension in more impaired patients, unlike the control group.

Conclusions:

• Task-specific training with trunk restraint is effective in improving arm movement quality and function after stroke.
• Treatment should be individualized based on arm impairment severity.
• Controlling excessive trunk movements is crucial for optimizing arm motor recovery and functional outcomes.