Muscle weakness after stroke affects peoples' everyday lives. One example is being unable to unscrew the top from a coffee jar.
This early phase trial investigated whether adding muscle strengthening to functional training (functional strength training) could enhance recovery of the ability to use the arm and hand. Functional Strength Training was compared with a course of Physical Therapy which is routinely used in clinical practice (Conventional Physical Therapy).
Participants in the trial were in the early stages after stroke. All 30 participants had weakness in their affected arm and hand. On average they entered the trial 20 days after a stroke. Participants were randomly allocated to one of three groups so that they received one of the following interventions:
The standard amount of Conventional Physical Therapy
Extra Conventional Physical Therapy in addition to the standard amount
Functional Strength Training plus the standard amount of Conventional Physical Therapy
The intervention phase of the trial lasted for 6 weeks. At the end of the intervention phase, the group who received the Functional Strength Training did better than those, who in turn did better than the group receiving the standard amount of Conventional Physical Therapy. This is illustrated in the graphs below.
However, there was considerable variability between individuals in the way they responded. This means that the differences were not significantly significant.
CPT = standard amount of Conventional Physical Therapy
CPT+CPT = extra Conventional Physical Therapy in addition to the standard amount FST+CPT = Functional Strength Training plus the standard amount of Conventional Physical Therapy.
The promising trends found in this early phase trial need to be confirmed in a larger trial involving. The funding to conduct this larger trial in three UK clinical centres has now been secured. The FAST INdiCATE Trial has begun. For more information please see current research.
Donaldson C, Tallis R, Miller S, Sunderland, Lemon R, Pomeroy V. Effects of Conventional Physical Therapy and Functional Strength training on upper limb motor recovery after stroke: a randomized Phase II study. Neurorehabilitation and Neural Repair 2009;23(4):389-397.
Professor Valerie Pomeroy
Faculty of Medicine and Health Sciences
University of East Anglia