Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial. 2017

Lina Bunketorp-Käll, and Åsa Lundgren-Nilsson, and Hans Samuelsson, and Tulen Pekny, and Karin Blomvé, and Marcela Pekna, and Milos Pekny, and Christian Blomstrand, and Michael Nilsson
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.).

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

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009147 Music Therapy The use of music as an adjunctive therapy in the treatment of neurological, mental, or behavioral disorders. Therapy, Music
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071939 Stroke Rehabilitation Restoration of functions to the maximum degree possible in a person or persons suffering from a stroke. Rehabilitation, Stroke
D000359 Aftercare The care and treatment of a convalescent patient, especially that of a patient after surgery. After Care,After-Treatment,Follow-Up Care,Postabortal Programs,Postabortion,After Treatment,After-Treatments,Care, Follow-Up,Cares, Follow-Up,Follow Up Care,Follow-Up Cares,Postabortal Program,Program, Postabortal,Programs, Postabortal
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D016037 Single-Blind Method A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned. Single-Masked Study,Single-Blind Study,Single-Masked Method,Method, Single-Blind,Method, Single-Masked,Methods, Single-Blind,Methods, Single-Masked,Single Blind Method,Single Blind Study,Single Masked Method,Single Masked Study,Single-Blind Methods,Single-Blind Studies,Single-Masked Methods,Single-Masked Studies,Studies, Single-Blind,Studies, Single-Masked,Study, Single-Blind,Study, Single-Masked
D017063 Outcome Assessment, Health Care Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). Assessment, Outcome,Outcome Assessment,Outcome Assessment (Health Care),Outcomes Research,Assessment, Outcomes,Outcome Measures,Outcome Studies,Outcomes Assessment,Assessment, Outcome (Health Care),Assessments, Outcome,Assessments, Outcome (Health Care),Assessments, Outcomes,Measure, Outcome,Measures, Outcome,Outcome Assessments,Outcome Assessments (Health Care),Outcome Measure,Outcome Study,Outcomes Assessments,Research, Outcomes,Studies, Outcome,Study, Outcome

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