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Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early after Stroke: The EXPLICIT-Stroke Randomized Clinical Trial

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Publication date

2016-10-01

Authors

Kwakkel, Gert
Winters, Caroline
Van Wegen, Erwin E H
Nijland, Rinske H M
Van Kuijk, Annette A A
Visser-Meily, J. M.A.ISNI 0000000387554577
De Groot, Jurriaan
De Vlugt, Erwin
Arendzen, J. Hans
Geurts, Alexander C H

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DOI

https://doi.org/10.1177/1545968315624784

Document Type

Article

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Abstract

Background and Objective. Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods. A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10° of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only. Both interventions started within 14 days poststroke, lasted up until 5 weeks, focused at preservation or return of FE. Results. Upper limb capacity was measured with the Action Research Arm Test (ARAT), assessed weekly within the first 5 weeks poststroke and at postassessments at 8, 12, and 26 weeks. Clinically relevant differences in ARAT in favor of mCIMT were found after 5, 8, and 12 weeks poststroke (respectively, 6, 7, and 7 points; P

Keywords

constraint-induced movement therapy (CIMT), electromyography-triggered neuromuscular stimulation (EMG-NMS), randomized controlled trial (RCT), stroke, upper limb, Rehabilitation, Neurology, Clinical Neurology, Journal Article, Multicenter Study, Randomized Controlled Trial

Citation

Kwakkel, G, Winters, C, Van Wegen, E E H, Nijland, R H M, Van Kuijk, A A A, Visser-Meily, A, De Groot, J, De Vlugt, E, Arendzen, J H, Geurts, A C H & Meskers, C G M 2016, 'Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early after Stroke : The EXPLICIT-Stroke Randomized Clinical Trial', Neurorehabilitation and Neural Repair, vol. 30, no. 9, pp. 804-816. https://doi.org/10.1177/1545968315624784

URI

http://hdl.handle.net/1874/342957