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The effect of a task-oriented intervention on arm function in people with stroke: a randomized controlled trial

School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada

Nancy M Salbach

Department of Epidemiology and Biostatistics and Occupational Health, Faculty of Medicine, McGill University; Department of Physical Therapy, University of Toronto, Montreal, Quebec, Canada

Sharon Wood-Dauphinee

School of Physical and Occupational Therapy and Department of Epidemiology and Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

Carol L Richards

Department of Rehabilitation, Faculty of Medicine, Laval University, Montreal, Quebec, Canada

Robert Côté

Department of Neurology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada

Nancy E Mayo

School of Physical and Occupational Therapy and Department of Epidemiology and Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

Objective: To evaluate the efficacy of a task-oriented intervention in enhancing arm function in people with stroke.

Design: Two-centre, observer-blinded, stratified, block-randomized controlled trial.

Setting: General community.

Patients: Ninety-one individuals within one year of a first or recurrent stroke consented to participate between May 2000 and February 2003.

Interventions: The experimental intervention involved practice of functional, unilateral and bilateral tasks that were designed to improve gross and fine manual dexterity whereas the control intervention was composed of walking tasks. Members in both groups participated in three sessions a week for six weeks.

Main outcome measure(s): The primary test of arm function was the Box and Block Test. Secondary tests included the Nine-Hole Peg Test, maximal grip strength, the Test d'Evaluation des Membres supé rieurs des Personnes Agées (TEMPA) and the Stroke Rehabilitation Assessment of Movement.

Results: Results are for the more affected arm. Baseline performance on the Box and Block Test was an average of 26 blocks (standard deviation (SD=16) in the experimental group (n=47) and 26 blocks (Sd=18) in the control group (n=44). These values represent approximately 40% of age-predicted values. Values for the postintervention evaluation were an average of 28 (SD=17) and 28 (SD=19) blocks for the experimental and control group respectively. No meaningful change on other measures of arm function was observed.

Conclusions: A task-oriented intervention did not improve voluntary movement or manual dexterity of the affected arm in people with chronic stroke.

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