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The Role of Technology in Task-Oriented Training in Persons with Subacute Stroke: A Randomized Controlled Trial

Department of Rehabilitation and Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Laval University, carol.richards{at}rea.ulaval.ca

Francine Malouin

Department of Rehabilitation and Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Laval University

Gina Bravo

Research Center on Aging, Sherbrooke University, Geriatric Institute

Francine Dumas

Department of Rehabilitation and Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Laval University

Sharon Wood-Dauphinee

School of Physical and Occupational Therapy and Department of Epidemiology, Biostatistics and Occupational Health, McGill University

This trial compares the effects of task-oriented physical therapy (PT) provided with and without the use of rehabilitation technology on locomotor recovery in 63 persons with subacute stroke. Participants in the experimental (EXP) group used a treadmill, a Kinetron isokinetic exerciser, and a limb-load monitor, whereas those in the control (CTL) group did not while engaging in PT 1 h per day, 5 days per week for 2 months. Locomotor recovery was assessed by clinical (gait speed, Fugl Meyer motor leg and arm subscores, the Balance Scale, the Timed Up and Go, and the Barthel ambulation subscore) and laboratory outcomes (gait kinematics and kinetics) pre- and posttherapy and 3 months later. Within groups, gait speed (P < 0.01) and all secondary measures improved posttherapy (P < 0.01-0.05), and improvements in clinical measures were maintained at follow-up, but there was no difference between groups (P > 0.05). When the groups were pooled, the increase in gait speed was associated (r = 0.52, P = 0.003) with an increase in ankle power generation of the affected leg. The results demonstrate that the efficacy of the task-oriented approach is not dependent on rehabilitation technology.

Key Words: Subacute stroke • Task-oriented • Locomotor training • Physical therapy • Gait speed • Randomized controlled trial

Neurorehabilitation and Neural Repair, Vol. 18, No. 4, 199-211 (2004)
DOI: 10.1177/1545968304269397


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