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Task-Oriented Rehab Not Superior for Motor Stroke

Task-oriented rehabilitation no better than equivalent or lower dose occupational therapy

elderly man getting physical therapy

WEDNESDAY, Feb. 10, 2016 (HealthDay News) -- For patients with motor stroke and primarily moderate upper extremity impairment, a structured, task-oriented rehabilitation program is not superior to occupational therapy, according to a study published in the Feb. 9 issue of the Journal of the American Medical Association.

Carolee J. Winstein, Ph.D., from the University of Southern California in Los Angeles, and colleagues conducted a phase 3 trial to compare the efficacy of a structured task-oriented motor training program versus usual and customary occupational therapy during stroke rehabilitation. Participants with moderate motor impairment were randomized to receive structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program [ASAP]; 119 patients); dose-equivalent occupational therapy (DEUCC; 120 patients), which included 30 one-hour sessions over 10 weeks; or monitoring-only occupational therapy (UCC; 122 patients). Eighty-four percent of patients completed the 12-month primary outcome assessment of the change in log-transformed Wolf Motor Function Test time score (WMFT).

The researchers found that in intent-to-treat analysis, the mean group change scores (WMFT) were 2.2 to 1.4 for the ASAP group; 2.0 to 1.2 for the DEUCC group; and 2.1 to 1.4 for the UCC group. There were no significant between-group differences: ASAP versus DEUCC: 0.14 (P = 0.16); ASAP versus UCC: −0.01 (P = 0.94); and DEUCC versus UCC: −0.14 (P = 0.15).

"These findings do not support superiority of this program among patients with motor stroke and primarily moderate upper extremity impairment," the authors write.

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