Forcing stroke patients to use an impaired arm by immobilizing their good one for two weeks produces significant long-term improvements in the affected arm’s function, improving mobility and quality of life, researchers reported Wednesday.
The therapy is the opposite of conventional treatments, which emphasize using the unimpaired arm.
“This study is likely to have a significant impact on clinical care for stroke survivors,” said Dr. Elias Zerhouni, director of the National Institutes of Health.
The government-sponsored study, published in the Journal of the American Medical Association, also is one of the “very, very few controlled trials” that have been conducted in stroke rehabilitation, said Dr. Richard Zorowitz of the Johns Hopkins Bayview Medical Center in Baltimore, who is the rehabilitation and recovery chairman of the National Stroke Association.
Current rehab techniques are based on guesswork and experience, not scientific evidence, he said.
An estimated 730,000 Americans suffer strokes each year, and as many as 85 percent of them have partial paralysis on one side of the body.
The technique, called constraint-induced movement therapy, has been shown to be effective for many patients in small, uncontrolled trials, but it never had been compared directly against conventional therapy.
The new trial, sponsored by two institutes at NIH, enrolled 222 stroke patients at seven U.S. hospitals. All had suffered an ischemic stroke – caused by a blood clot in the brain – three to nine months before enrollment.
Half received conventional treatment, and half received an intensive two-week course of treatment in which the less-impaired arm and hand were immobilized.
Those receiving the therapy showed a greater reduction in the time required to complete certain tasks with the impaired arm and an increase in the proportion of daily tasks accomplished.
The improvements were maintained for at least a year.
