Dynamic Lycra® orthoses as an adjunct to arm rehabilitation after stroke: a single-blind, two-arm parallel group, randomized controlled feasibility trial

OBJECTIVE: The aim of this study was to explore the feasibility of conducting a randomized controlled trial of dynamic Lycra(®) orthoses as an adjunct to arm rehabilitation after stroke and to explore the magnitude and direction of change on arm outcomes. DESIGN: This is a single-blind, two-arm para...

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Detalles Bibliográficos
Autores principales: Morris, Jacqui H, John, Alexandra, Wedderburn, Lucy, Rauchhaus, Petra, Donnan, Peter T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Evaluative Studies
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613174/
https://www.ncbi.nlm.nih.gov/pubmed/30977382
http://dx.doi.org/10.1177/0269215519840403
Descripción
Sumario:OBJECTIVE: The aim of this study was to explore the feasibility of conducting a randomized controlled trial of dynamic Lycra(®) orthoses as an adjunct to arm rehabilitation after stroke and to explore the magnitude and direction of change on arm outcomes. DESIGN: This is a single-blind, two-arm parallel group, feasibility randomized controlled trial. SETTING: In-patient rehabilitation. SUBJECTS: The study participants were stroke survivors with arm hemiparesis two to four weeks after stroke receiving in-patient rehabilitation. INTERVENTIONS: Participants were randomized 2:1 to wear Lycra(®) gauntlets for eight hours daily for eight weeks, plus usual rehabilitation (n = 27), or to usual rehabilitation only (n = 16). MAIN MEASURES: Recruitment, retention, fidelity, adverse events and completeness of data collection were examined at 8 and 16 weeks; arm function (activity limitation; Action Research Arm Test, Motor Activity Log) and impairment (Nine-hole Peg Test, Motricity Index, Modified Tardieu Scale). Structured interviews explored acceptability. RESULTS: Of the target of 51, 43 (84%) participants were recruited. Retention at 8 weeks was 32 (79%) and 24 (56%) at 16 weeks. In total, 11 (52%) intervention group participants and 6 (50%) control group participants (odds ratio = 1.3, 95% confidence interval = 0.2 to 7.8) had improved Action Research Arm Test level by 8 weeks; at 16 weeks, this was 8 (61%) intervention and 6 (75.0%) control participants (odds ratio = 1.1, 95% confidence interval = 0.1 to 13.1). Change on other measures favoured control participants. Acceptability was influenced by 26 adverse reactions. CONCLUSION: Recruitment and retention were low, and adverse reactions were problematic. There were no indications of clinically relevant effects, but the small sample means definitive conclusions cannot be made. A definitive trial is not warranted without orthoses adaptation.

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