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Stroke. 2017 Jul;48(7):1916-1924. doi: 10.1161/STROKEAHA.116.016433. Epub 2017 Jun 15.

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial.

Author information

1
From the Center for Brain Repair and Rehabilitation, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden (L.B.-K., A.L.-N., H.S., T.P., M. Pekna, M. Pekny, C.B., M.N.); Center for Advanced Reconstruction of Extremities, Institute of Clinical Sciences, Sahlgrenska University Hospital, Mölndal, Sweden (L.B.-K.); Stroke Center West, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden (A.L.-N., C.B.); Department of Psychology, University of Gothenburg, Sweden (H.S.); Occupational Health Care Unit (Hälsan och Arbetslivet), Region Västra Götaland, Gothenburg, Sweden (K.B.); Florey Institute of Neuroscience and and Mental Health, Parkville, Melbourne, Australia (M. Pekna, M. Pekny, M.N.); and Hunter Medical Research Institute and University of Newcastle, Australia (M. Pekna, M. Pekny, M.N.).
2
From the Center for Brain Repair and Rehabilitation, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden (L.B.-K., A.L.-N., H.S., T.P., M. Pekna, M. Pekny, C.B., M.N.); Center for Advanced Reconstruction of Extremities, Institute of Clinical Sciences, Sahlgrenska University Hospital, Mölndal, Sweden (L.B.-K.); Stroke Center West, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden (A.L.-N., C.B.); Department of Psychology, University of Gothenburg, Sweden (H.S.); Occupational Health Care Unit (Hälsan och Arbetslivet), Region Västra Götaland, Gothenburg, Sweden (K.B.); Florey Institute of Neuroscience and and Mental Health, Parkville, Melbourne, Australia (M. Pekna, M. Pekny, M.N.); and Hunter Medical Research Institute and University of Newcastle, Australia (M. Pekna, M. Pekny, M.N.). michael.nilsson@hmri.org.au.

Abstract

BACKGROUND AND PURPOSE:

Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke.

METHODS:

Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up.

RESULTS:

One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery (mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy (5.2 [95% confidence interval, 0.79-9.61]) and horse-riding therapy participants (9.8 [95% confidence interval, 6.00-13.66]), compared with controls (-0.5 [-3.20 to 2.28]); P=0.001 (1-way ANOVA). The improvements were sustained in both intervention groups 6 months later, and corresponding gains were observed for the secondary outcomes.

CONCLUSIONS:

Multimodal interventions can improve long-term perception of recovery, as well as balance, gait, grip strength, and working memory in a mixed population of individuals in late phase after stroke.

CLINICAL TRIAL REGISTRATION:

URL: http//www.ClinicalTrials.gov. Unique identifier: NCT01372059.

KEYWORDS:

cognition; follow-up studies; music; randomized controlled trial; rehabilitation; stroke

PMID:
28619985
DOI:
10.1161/STROKEAHA.116.016433
[Indexed for MEDLINE]

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