A randomized controlled trial of Cognitive Sensory Motor Training Therapy on the recovery of arm function in acute stroke patients

Abstract

Objective:

The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy (Perfetti’s method) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke.

Design:

Prospective randomized controlled trial.

Setting:

Two rehabilitation centers in Bangkok, Thailand.

Subjects:

Forty first-time acute stroke patients without severe cognitive or language impairment.

Intervention:

All subjects were randomly divided into two groups; one was treated using Perfetti’s method and the other using conventional occupational therapy. Each group underwent therapy for 30 minutes, five times a week for four weeks.

Main measures:

The primary variable was arm function as assessed by the Action Research Arm Test; secondary variables were the extended Barthel Index and the box and block test score.

Results:

The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable.

Conclusions:

There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti’s method and conventional occupational therapy with respect to the restoration of hand and arm function after a stroke.

Keywords

Arm Perfetti rehabilitation sensory stroke

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References

Duncan

Goldstein

Horner

Landsman

Samsa

Matchar

. Similar motor recovery of upper and lower extremities after stroke. Stroke 1994; 25: 1181–1188.

Nakayama

Jorgensen

Raaschou

Olsen

. Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil 1994; 75: 394–398.

Wade

Langton-Hewer

Wood

Skilbeck

Ismail

. The hemiplegic arm after stroke: measurement and recovery. J Neurol Neurosurg Psychiatry 1983; 46: 521–524.

Sunderland

Fletcher

Bradley

Tinson

Hewer

Wade

. Enhanced physical therapy for arm function after stroke: a one year follow up study. J Neurol Neurosurg Psychiatry 1994; 57: 856–858.

Rabadi

. Review of the randomized clinical stroke rehabilitation trials in 2009. Med Sci Monit 2011; 17: RA 25–43.

French

Thomas

Leathley

. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev 2007; (4): CD006073.

Perfetti

. Der aufbau der uegungen. In: Perfetti

(ed.) Der hemiplegische patient cognitive-therapeutische uegungen, first edition. Munich: Pflaum, 1997, pp. 71–106.

Birbamer

Beise

. Das Gehirn denkt nicht in musklekontraktionen. Ars Medici 2001; 6: 282–285.

Wongphaet

Butrach

Sangkrai

Jitpraphai

. Improved function of hemiplegic upper extremity after cognitive sensory motor training in chronic stroke and traumatic brain injury patients: Preliminary reports of a case series. J Thai Med Assoc 2003; 86: 579–584.

10.

Lyle

. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res 1981; 4: 483–492.

11.

Parry

Lincoln

Vass

. Effect of severity of arm impairment on response to additional physiotherapy early after stroke. Clin Rehabil 1999; 13: 187–198.

12.

Wongphaet

Sinlapawonsa

Butrach

Chira-Adisai

Laothamatas

Jitpraphai

. Functional magnetic resonance imaging evidence of brain plasticity after cognitive sensory motor training in a stroke patient. Neurol J Thailand 2005; 5: 123–126.

13.

Platz

Pinkowski

van Wijck

Johnson

. Arm rehabilitation measurement, first edition. Baden Baden: Deutscher Wissenschafts-Verlag, 2005, pp. 17–108.

14.

Jansa

Pogacnik

Gompertz

. An evaluation of the Extended Barthel Index with acute ischemic stroke patients. Neurorehabil Neural Repair 2004; 18: 37–41.

15.

Van der Lee

De Groot

Beckerman

Wagenaar

Lankhorst

Bouter

. The intra-and inter-rater reliability of the action research arm test: A practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil 2001; 82: 14–19.

16.

Platz

Pinkowski

van Wijck

Kim

di Bella

Johnson

. Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: A multicentre study. Clin Rehabil 2005; 19: 404–411.

17.

Desrosiers

Bravo

Hébert

Dutil

Mercier

. Validation of the Box and Block Test as a measure of dexterity of elderly people: Reliability, validity, and norms studies. Arch Phys Med Rehabil 1994; 75: 751–755.

18.

Lang

Edwards

Birkenmeier

Dromerick

. Estimating minimal clinically important differences of upper extremity measures early after stroke. Arch Phys Med Rehabil 2008; 89: 1693–1700.

19.

Kwakkel

Kollen

van der Grond

Prevo

. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke 2003; 34: 2181–2186.

20.

Chen

Winstein

. A systematic review of voluntary arm recovery in hemiparetic stroke critical predictors for meaningful outcomes using the international classification of functioning, disability, and health. J Neurol Phys Ther. 2009; 33: 2–13.

21.

Mead

Lewis

Wardlaw

Dennis

Warlow

. How well does the Oxfordshire Community Stroke Project classification predict the site and size of the infarct on brain imaging? J Neurol Neurosurg Psychiatry 2000; 68: 558–562.

22.

Herrmann

. International experiences with the Hospital Anxiety and Depression Scale – a review of validation data and clinical results. J Psychosom Res 1997; 42: 17–41.

23.

Kasner

Chalela

Luciano

. Reliability and validity of estimating the NIH stroke scale score from medical records. Stroke 1999; 30: 1534–1537.