Extended, progressive physical therapy aids stroke survivor...( randomly assigned to one of two groups....),Health

Those in the intervention group performed progressively intensive exercises focusing on their strength, balance, cardiovascular endurance and use of their arms and hands in 36 supervised sessions during the 12-week study. Forty-six percent of survivors in the usual care group did not receive any therapy. The remainder received an average of 8.7 physical therapy visits and an average of 10.4 occupational therapy visits. The usual care therapy mostly consisted of balance and mobility exercises, upper extremity function and range of motion function. Endurance training was rarely incorporated and the therapy was not progressive, Duncan notes.

Both groups showed improvement when tested again after three months. However, those in the intervention group improved significantly more in several key areas balance, endurance and mobility. They scored 4.36 points higher on balance tests compared to their baseline tests. Participants in the usual care group scored 1.70 points higher than their baseline scores.

The intervention group bicycled during stress tests an average 1.39 minutes longer than they could at enrollment, while the usual care group bicycled an average 0.16 minutes longer than their enrollment times. Patients in the intervention group walked an average 61.61 meters (about 200 feet) farther in six minutes compared to their baseline; and usual care participants walked an average of 33.59 meters (110 feet) farther.

The difference in gains in strength and extremity function was not significant between the two groups. Upper extremity gains were better for the intervention group compared to usual care among patients who were only mildly paralyzed.
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
14-Aug-2003