Repetitive bilateral arm training and motor cortex activation in chronic stroke

A randomized controlled trial

Andreas R. Luft, Sandy McCombe-Waller, Jill Whitall, Larry W. Forrester, Richard Macko, John D. Sorkin, Jörg B. Schulz, Andrew P. Goldberg, Daniel F Hanley

Research output: Contribution to journalArticle

Abstract

Context: Reorganization in central motor networks occurs during early recovery from hemiparetic stroke. In chronic stroke survivors, specific rehabilitation therapy can improve upper extremity function. Objective: To test the hypothesis that in patients who have chronic motor impairment following stroke, specific rehabilitation therapy that improves arm function is associated with reorganization of cortical networks. Design, Setting, and Patients: A randomized controlled clinical trial conducted in a US ambulatory rehabilitation program with 21 patients (median [IQR], 50.3 [34.8-77.3] months after unilateral stroke). Data were collected between 2001 and 2004. Interventions: Patients were randomly assigned to bilateral arm training with rhythmic auditory cueing (BATRAC) (n=9) or standardized dose-matched therapeutic exercises (DMTE) (n=12). Both were conducted for 1 hour, 3 times a week, for 6 weeks. Main Outcome Measures: Within 2 weeks before and after the intervention, brain activation during elbow movement assessed by functional magnetic resonance imaging (fMRI) and functional outcome assessed using arm function scores. Results: Patients in the BATRAC group but not in the DMTE group increased hemispheric activation during paretic arm movement (P = .03). Changes in activation were observed in the contralesional cerebrum and ipsilesional cerebellum (P=.009). BATRAC was associated with significant increases in activation in precentral (P

Original languageEnglish (US)
Pages (from-to)1853-1861
Number of pages9
JournalJournal of the American Medical Association
Volume292
Issue number15
DOIs
StatePublished - Oct 20 2004

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Motor Cortex
Arm
Randomized Controlled Trials
Stroke
Rehabilitation
Exercise
Cerebrum
Therapeutics
Elbow
Upper Extremity
Cerebellum
Survivors
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Brain

ASJC Scopus subject areas

  • Medicine(all)

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Repetitive bilateral arm training and motor cortex activation in chronic stroke : A randomized controlled trial. / Luft, Andreas R.; McCombe-Waller, Sandy; Whitall, Jill; Forrester, Larry W.; Macko, Richard; Sorkin, John D.; Schulz, Jörg B.; Goldberg, Andrew P.; Hanley, Daniel F.

In: Journal of the American Medical Association, Vol. 292, No. 15, 20.10.2004, p. 1853-1861.

Research output: Contribution to journalArticle

Luft, AR, McCombe-Waller, S, Whitall, J, Forrester, LW, Macko, R, Sorkin, JD, Schulz, JB, Goldberg, AP & Hanley, DF 2004, 'Repetitive bilateral arm training and motor cortex activation in chronic stroke: A randomized controlled trial', Journal of the American Medical Association, vol. 292, no. 15, pp. 1853-1861. https://doi.org/10.1001/jama.292.15.1853
Luft, Andreas R. ; McCombe-Waller, Sandy ; Whitall, Jill ; Forrester, Larry W. ; Macko, Richard ; Sorkin, John D. ; Schulz, Jörg B. ; Goldberg, Andrew P. ; Hanley, Daniel F. / Repetitive bilateral arm training and motor cortex activation in chronic stroke : A randomized controlled trial. In: Journal of the American Medical Association. 2004 ; Vol. 292, No. 15. pp. 1853-1861.
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