Comparing unilateral and bilateral upper limb training: the ULTRA-stroke program design.
Identifieur interne : 001197 ( PubMed/Corpus ); précédent : 001196; suivant : 001198Comparing unilateral and bilateral upper limb training: the ULTRA-stroke program design.
Auteurs : A Lex E Q. Van Delden ; C Lieke E. Peper ; Jaap Harlaar ; Andreas Daffertshofer ; Nienke I. Zijp ; Kirsten Nienhuys ; Peter Koppe ; Gert Kwakkel ; Peter J. BeekSource :
- BMC neurology [ 1471-2377 ] ; 2009.
English descriptors
- KwdEn :
- MESH :
- physiology : Movement.
- physiopathology : Paresis, Stroke, Upper Extremity.
- rehabilitation : Paresis, Stroke.
- Adult, Aged, Clinical Protocols, Exercise Therapy, Humans, Middle Aged, Motor Skills, Patient Selection, Recovery of Function.
Abstract
About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions--constraint-induced movement therapy (CIMT) and bilateral arm training with rhythmic auditory cueing (BATRAC)--have shown promising results in the treatment of upper limb paresis in chronic stroke patients. The ULTRA-stroke (acronym for Upper Limb TRaining After stroke) program was conceived to assess the effectiveness of these interventions in subacute stroke patients and to examine how the observed changes in sensori-motor functioning relate to changes in stroke recovery mechanisms associated with peripheral stiffness, interlimb interactions, and cortical inter- and intrahemispheric networks. The present paper describes the design of this single-blinded randomized clinical trial (RCT), which has recently started and will take several years to complete.
DOI: 10.1186/1471-2377-9-57
PubMed: 19895679
Links to Exploration step
pubmed:19895679Le document en format XML
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<term>Middle Aged</term>
<term>Motor Skills</term>
<term>Movement (physiology)</term>
<term>Paresis (physiopathology)</term>
<term>Paresis (rehabilitation)</term>
<term>Patient Selection</term>
<term>Recovery of Function</term>
<term>Stroke (physiopathology)</term>
<term>Stroke (rehabilitation)</term>
<term>Upper Extremity (physiopathology)</term>
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<front><div type="abstract" xml:lang="en">About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions--constraint-induced movement therapy (CIMT) and bilateral arm training with rhythmic auditory cueing (BATRAC)--have shown promising results in the treatment of upper limb paresis in chronic stroke patients. The ULTRA-stroke (acronym for Upper Limb TRaining After stroke) program was conceived to assess the effectiveness of these interventions in subacute stroke patients and to examine how the observed changes in sensori-motor functioning relate to changes in stroke recovery mechanisms associated with peripheral stiffness, interlimb interactions, and cortical inter- and intrahemispheric networks. The present paper describes the design of this single-blinded randomized clinical trial (RCT), which has recently started and will take several years to complete.</div>
</front>
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<pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">19895679</PMID>
<DateCreated><Year>2009</Year>
<Month>11</Month>
<Day>25</Day>
</DateCreated>
<DateCompleted><Year>2009</Year>
<Month>12</Month>
<Day>09</Day>
</DateCompleted>
<DateRevised><Year>2014</Year>
<Month>12</Month>
<Day>04</Day>
</DateRevised>
<Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2377</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>9</Volume>
<PubDate><Year>2009</Year>
</PubDate>
</JournalIssue>
<Title>BMC neurology</Title>
<ISOAbbreviation>BMC Neurol</ISOAbbreviation>
</Journal>
<ArticleTitle>Comparing unilateral and bilateral upper limb training: the ULTRA-stroke program design.</ArticleTitle>
<Pagination><MedlinePgn>57</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2377-9-57</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions--constraint-induced movement therapy (CIMT) and bilateral arm training with rhythmic auditory cueing (BATRAC)--have shown promising results in the treatment of upper limb paresis in chronic stroke patients. The ULTRA-stroke (acronym for Upper Limb TRaining After stroke) program was conceived to assess the effectiveness of these interventions in subacute stroke patients and to examine how the observed changes in sensori-motor functioning relate to changes in stroke recovery mechanisms associated with peripheral stiffness, interlimb interactions, and cortical inter- and intrahemispheric networks. The present paper describes the design of this single-blinded randomized clinical trial (RCT), which has recently started and will take several years to complete.</AbstractText>
<AbstractText Label="METHODS/DESIGN" NlmCategory="METHODS">Sixty patients with a first ever stroke will be recruited. Patients will be stratified in terms of their remaining motor ability at the distal part of the arm (i.e., wrist and finger movements) and randomized over three intervention groups receiving modified CIMT, modified BATRAC, or an equally intensive (i.e., dose-matched) conventional treatment program for 6 weeks. Primary outcome variable is the score on the Action Research Arm test (ARAT), which will be assessed before, directly after, and 6 weeks after the intervention. During those test sessions all patients will also undergo measurements aimed at investigating the associated recovery mechanisms using haptic robots and magneto-encephalography (MEG).</AbstractText>
<AbstractText Label="DISCUSSION" NlmCategory="CONCLUSIONS">ULTRA-stroke is a 3-year translational research program which aims (1) to assess the relative effectiveness of the three interventions, on a group level but also as a function of patient characteristics, and (2) to delineate the functional and neurophysiological changes that are induced by those interventions.The outcome on the ARAT together with information about changes in the associated mechanisms will provide a better understanding of how specific therapies influence neurobiological changes, and which post-stroke conditions lend themselves to specific treatments.</AbstractText>
<AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">The ULTRA-stroke program is registered at the Netherlands Trial Register (NTR, http://www.trialregister.nl, number NTR1665).</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>van Delden</LastName>
<ForeName>A Lex E Q</ForeName>
<Initials>AL</Initials>
<AffiliationInfo><Affiliation>Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands. l.vandelden@fbw.vu.nl</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Peper</LastName>
<ForeName>C Lieke E</ForeName>
<Initials>CL</Initials>
</Author>
<Author ValidYN="Y"><LastName>Harlaar</LastName>
<ForeName>Jaap</ForeName>
<Initials>J</Initials>
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<Author ValidYN="Y"><LastName>Daffertshofer</LastName>
<ForeName>Andreas</ForeName>
<Initials>A</Initials>
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<Author ValidYN="Y"><LastName>Zijp</LastName>
<ForeName>Nienke I</ForeName>
<Initials>NI</Initials>
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<Author ValidYN="Y"><LastName>Nienhuys</LastName>
<ForeName>Kirsten</ForeName>
<Initials>K</Initials>
</Author>
<Author ValidYN="Y"><LastName>Koppe</LastName>
<ForeName>Peter</ForeName>
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<Author ValidYN="Y"><LastName>Kwakkel</LastName>
<ForeName>Gert</ForeName>
<Initials>G</Initials>
</Author>
<Author ValidYN="Y"><LastName>Beek</LastName>
<ForeName>Peter J</ForeName>
<Initials>PJ</Initials>
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<Language>eng</Language>
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<Month>11</Month>
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