Effects of intensity of arm training on hemiplegic upper extremity motor recovery in stroke patients: a randomized controlled trial

Objective: To investigate the effects of different intensities of arm rehabilitation training on the functional recovery of hemiplegic upper extremity. Design: A randomized controlled trial. Interventions: Thirty-two stroke patients meeting the enrolment criteria were randomly divided into three groups: group A (n = 11), group B (n = 10) and group C (n = 11). Each group received arm training for 1 hour, 2 hours and 3 hours a day respectively, 5 days per week, for a period of six weeks. Main measures: Motor function was assessed by Fugl-Meyer Assessment, Action Research Arm Test and Barthel Index, carried out before treatment, two weeks, four weeks and six weeks after treatment. Results: When comparing the three groups, the Fugl-Meyer Assessment improvement was more significant in group C (20.50 +/- 7.84) than that in group A (11.90 +/- 6.52) and group B (13.80 +/- 6.41) after four weeks of treatment (P < 0.05). The Action Research Arm Test score improvement was more significant in group C (7.30 +/- 2.95) than in group A (3.30 +/- 2.91) (P < 0.05). After six weeks of treatment, the Fugl-Meyer Assessment and Action Research Arm Test score improvements were more significant in group C (24.50 +/- 7.96, 10.90 +/- 3.60) and group B (19.70 +/- 7.09, 8.70 +/- 4.62) than in group A (13.00 +/- 6.38, 5.30 +/- 3.40) (P < 0.05). There were no significant differences of Barthel Index among the three groups (P > 0.05). In each group, Fugl-Meyer Assessment, Action Research Arm Test and Barthel Index scores increased significantly after six weeks of treatment (P < 0.05). Conclusions: An increase in the intensity of arm training might improve the motor function of the arm after stroke.