Insights into upper limb kinematics and trunk control one year after task-related training in chronic post-stroke individuals

Study design: Randomized clinical trial. Introduction: Long-term follow-up of training investigations involving post-stroke individuals can lead to advancing clinical decisions. Extended task-related training (TRT) effects on reaching with the impaired upper limb were evaluated, using a pre-test/posttest/follow-up design. Purpose: One-year follow-up examinations analyzed whether improved shoulder and elbow motion were maintained following prolonged practice of the upper limb. Methods: Long-term kinematic analysis on 21 moderately impaired post-stroke participants (upper extremity Fugl-Meyer between 19 and 40/66), as well as results from standardized outcome measures performed on these patients and another 16 post-stroke participants. Results: Significant initial changes were maintained for kinematic shoulder and elbow motion, as well as functional measures. Compensatory reaching involving the trunk has been shown to be maintainable, but ultimately less efficient. Conclusions: Training that involves a conscious decision to control the trunk led to the most improved functional performance, and may lead to ideal restorative strategies. Level of evidence: 2B. (C) 2013 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.