Unilateral versus bilateral upper limb training after stroke: the ULTRA-Stroke clinical trial

A.E.Q. van Delden, C.E. Peper, K. Nienhuys, N.I. Zijp, P.J. Beek, G. Kwakkel

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Background and Purpose - Unilateral and bilateral training protocols for upper limb rehabilitation after stroke represent conceptually contrasting approaches with the same ultimate goal. In a randomized controlled trial, we compared the merits of modified constraint-induced movement therapy, modified bilateral arm training with rhythmic auditory cueing, and a dose-matched conventional treatment. Modified constraint-induced movement therapy and modified bilateral arm training with rhythmic auditory cueing targeted wrist and finger extensors, given their importance for functional recovery. We hypothesized that modified constraint-induced movement therapy and modified bilateral arm training with rhythmic auditory cueing are superior to dose-matched conventional treatment. Methods - Sixty patients, between 1 to 6 months after stroke, were randomized over 3 intervention groups. The primary outcome measure was the Action Research Arm test, which was conducted before, directly after, and 6 weeks after intervention. Results - Although all groups demonstrated significant improvement on the Action Research Arm test after intervention, which persisted at 6 weeks follow-up, no significant differences in change scores on the Action Research Arm test were found between groups postintervention and at follow-up. Conclusions - Modified constraint-induced movement therapy and modified bilateral arm training with rhythmic auditory cueing are not superior to dose-matched conventional treatment or each other in improving upper limb motor function 1 to 6 months after stroke. © 2013 American Heart Association, Inc.
    Original languageEnglish
    Pages (from-to)2613-2616
    Number of pages4
    JournalStroke
    Volume44
    Issue number9
    Early online date18 Jul 2013
    DOIs
    Publication statusPublished - 2013

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