Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke

Previous studies have shown that multiple sessions of reach training lead to long-term improvements in movement time and smoothness in individuals post-stroke. Yet such long-term training regimens are often difficult to implement in actual clinical settings. In this study, we evaluated the long-term and generalization effects of short-duration and intensive reach training in 16 individuals with chronic stroke and mild to moderate impairments. Participants performed 2 sessions of unassisted intensive reach training, with 600 movements per session, and with display of performance-based feedback after each movement. The participants' trunks were restrained with a belt to avoid compensatory movements. Training resulted in significant and durable (1 month) improvements in movement time (20.4% on average) and movement smoothness (22.7% on average). The largest improvements occurred in individuals with the largest initial motor impairments. In addition, training induced generalization to nontrained targets, which persisted in 1-day and in 1-month retention tests. Finally, there was a significant improvement in the Box and Block test from baseline to 1-month retention test (23% on average). Thus, short-duration and intensive reach training can lead to generalized and durable benefits in individuals with chronic stroke and mild to moderate impairments.