A massively successful experience is needed for spontaneous use in post-stroke: a randomized controlled trial-Reference-Cited by-同舟云学术

A massively successful experience is needed for spontaneous use in post-stroke: a randomized controlled trial

Published:2023-01-25 Issue: Volume: Page:
ISSN:
Container-title:
language:
Short-container-title:

Author:

Kim Sujin¹,Shin Yumi²,Jeong Yeonwoo²,Na Seungyoung³,Han Cheol E⁴

Affiliation:

1. Department of Physical therapy, Jeonju University

2. Department of Rehabilitative & Assistive Technology, National Rehabilitation Center

3. Department of Rehabilitation and Medicine, Ongoul rehabilitation hospital

4. Department of Electronics and Information Engineering, Korea University

Abstract

Abstract Background:Motivation to use the more-affected arm is an essential indicator of recovery in stroke survivors. This study aimed to investigate whether personal mastery experience via intensive repetitive reaching movements with autonomy support may increase self-efficacy and thus increase performance and use of the more-affected arm in mild-to-moderate subacute to chronic stroke patients. Methods:Twenty-six participants with stroke were divided into two groups: a motivation group (with autonomy support) and a control group (without autonomy support). Five weeks of training and test sessions were administered using the individualized motivation enhancement system that we developed. The task difficulty parameter modulated the time limit for attaining targets to provide autonomy support. We analyzed various clinical and behavioral measures using mixed-effect models. Results:Successful experiences did not change in the control group (p = .129),but dramatically increased in the motivation group (p < .0001). Performance significantly improved in the retention test for both groups (p < .0001), without any group differences (p = .329). However, the motivation group exhibited a dramatic increase in the use of the more-affected arm (p < .0001), whereas the control group did not (p Conclusions: The successful experience of personal mastery accomplished by autonomy support increased the use of the affected arm. Autonomy support in the motivation group may make a participant aware of the training goal: to use the more-affected arm as much as possible or make the affected arm use more habitual. Trial registration: The study was registered with The Clinical Research Information Service (CRIS), KCT0008117. Registered retrospectively on January 13, 2023, at https://cris.nih.go.kr/cris/search/detailSearch.do/23875

Publisher

Research Square Platform LLC

Reference29 articles.

1. Sterr A, Freivogel S, Schmalohr D. Neurobehavioral aspects of recovery: Assessment of the learned nonuse phenomenon in hemiparetic adolescents. Arch Phys Med Rehabil [Internet]. 2002;83:1726–31. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12474177

2. Hidaka Y, Han CE, Wolf SL, Winstein CJ, Schweighofer N. Use it and improve it or lose it: Interactions between arm function and use in humans post-stroke.PLoS Comput Biol. 2012;8.

3. Taub E, Crago JE, Burgio LD, Groomes TE, Cook EW, DeLuca SC et al. an Operant Approach To Rehabilitation Medicine: Overcoming Learned Nonuse By Shaping. J Exp Anal Behav [Internet]. 1994;61:281–93. Available from: http://doi.wiley.com/10.1901/jeab.1994.61-281

4. Taub E, Uswatte G, Mark VW, Morris DM. The learned nonuse phenomenon: Implications for rehabilitation. Eura Medicophys [Internet]. 2006;42:241–55. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med5&NEWS=N&AN=17039223

5. Winstein CJ, Wolf SL, Dromerick AW, Lane CJ, Nelsen MA, Lewthwaite R et al. Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE): A randomized controlled trial protocol. BMC Neurol [Internet]. 2013;13:5. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3547701&tool=pmcentrez&rendertype=abstract