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Upper Limb Training with a Dynamic Hand Orthosis in Early Subacute Stroke: A Pilot Randomized Trial
Yih Wong, Chao-Jin-Zi Li, Louise Ada
1Research Department, Sunnaas Rehabilitation Hospital, Bjoernemyr, Norway; Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway. birg@oslomet.no.
Objectives:
To investigate the effect of the addition of a dynamic hand orthosis to unilateral task-oriented training in early subacute stroke.
Design:
Pilot randomized trial with concealed allocation, measurer blinding, and intention-to-treat analysis.
Setting:
Rehabilitation hospital.
Participants:
Thirty subacute stroke patients with moderate-to-severe upper limb disability.
Intervention:
All participants received 4 weeks (60 min per day, 5 days a week) of unilateral task-oriented training. The experimental group (n = 15) wore a dynamic hand orthosis during half of the training time (i.e. 30 min per day).
Outcome Measures:
Primary outcome was the upper limb activity measured using the Action Research Arm Test (ARAT) measured at baseline and 4 weeks. Secondary outcomes were the Nine-hole Peg Test, Fugl-Meyer Assessment for upper extremity, grip strength, modified Ashworth Scale, Barthel Index and EuroQol-5D.
Results:
No difference between groups was found for the primary outcome ARAT (mean difference 4/57, 95% confidence interval (95% CI) -5 to 13) nor for any secondary outcome.
Conclusion:
No additional benefit was found of wearing a dynamic hand orthosis during unilateral taskoriented training in the early subacute period.
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