Neuromuscular reeducation versus traditional programs for stroke rehabilitation

This study compares long-term effectiveness of traditional functional retraining (TFR) with neuromuscular retraining techniques (NRT) after cerebrovascular accident (CVA). Groups of post-CVA patients from two different rehabilitation programs were matched according to early prognostic indicators. In one program NRT was emphasized while in the other the emphasis was restricted to TFR of spontaneously acquired upper extremity dexterity. Follow-up was possible in 19 of the TFR group and 20 of the NRT group who survived eight months after CVA. At least eight months post-CVA patients/families completed a telephone questionnaire regarding current functional abilities. With the single exception of self-feeding, no statistically significant differences in skill levels were found. NRT patients showed a slightly greater independence in feeding than the patients in functional retraining. It was also noted that rehabilitation hospitalization was significantly longer in the NRT group (28.57 days vs 68.3 days). The reason for this is not clear. If choice of therapeutic techniques was a contributing factor to increased lengths of stay, however, this would have major cost/effectiveness implications for program planning.