Feasibility of a high-dose behavioural exercise intervention on upper limb motor function in chronic stroke survivors

BackgroundStroke is a leading cause of adult disability and high-dose interventions may help reduce it. However, current practice does not allow for this. PurposeThis study tests the feasibility of a high-dose upper limb therapy in chronic stroke survivors using a neuroanimation therapy (NAT). MethodsFour chronic stroke survivors underwent 20 NAT sessions, 3 or 5 times a week for 90 minutes time-on-task. Feasibility was assessed with compliance to number of sessions and total time-on-task. Secondary outcomes included Fugle-Meyer Upper Extremity motor score (FM-UE), Action Research Arm Test (ARAT), grip strength, movement kinematics and cognition assessed using robotic technology. ResultsAll participants attended the 20 prescribed sessions on the 3-day per week schedule. Two completed 90 minutes time-on-task in all sessions. Two showed clinical improvements in their FM-UE and ARAT. Movement kinematic analysis demonstrated improvements in motor control and cognition, however these changes did not seem to last when re-tested 1 month after the last training session. Conclusion20 sessions of NAT is feasible in the chronic phase of stroke recovery with a 3-day per week schedule. Clinical improvements in arm function were observed in this high-dose upper limb NAT therapy, in one mild and one moderately affected stroke survivor.