Combining physical rehabilitation and pharmacotherapy for the treatment of hemiparetic stroke.
Published: 2006
Language: eng
Number of pages: 158
ISBN-13: 9780494219744
Description: Results. Baseline hemiparesis was severe overall (mean FM score: 27.7 +/- 20.0). Motor scores improved during treatment in both groups (mean change, baseline to 3 months: 29.5 +/- 16.6). Repeated measures analysis of variance revealed no significant differences in recovery between the treatment groups for the entire cohort (n=67), or for subgroups with a severe hemiparesis (n=43), moderate hemiparesis (n=24), or cortically-based stroke (n=26). In the moderate subgroup, there was a significant drug x time interaction for upper extremity motor recovery (F=5.14, p&lt;0.001), although there was a significant baseline imbalance in motor scores in this subgroup.Background. Improved neurorehabilitation interventions to promote stroke recovery are urgently needed. Hemiparesis affects about 80% of stroke survivors and is a leading cause of chronic disability and poor quality of life. In animals, dextroamphetamine (AMPH) paired with training enhances motor recovery, but its clinical efficacy is uncertain.Conclusions. In stroke patients with a severe motor deficit, AMPH 10 mg coupled with physiotherapy twice/week for 5 weeks in the early poststroke period provided no additional benefit in motor or functional recovery compared to physiotherapy alone. Patients with moderate severity hemiparesis deserve further investigation. Increased intensity and longer duration drug/therapy dosing regimens should be explored targeting the upper and lower limbs separately.Methods. In a randomized, double-blind, placebo-controlled trial, 71 stroke patients were stratified by hemiparesis severity and randomly assigned to 10 sessions of physiotherapy coupled with either AMPH 10 mg or placebo. Study treatments were administered by one physiotherapist, beginning 5-10 days poststroke and continuing twice/week for 5 weeks. Outcomes were assessed by one physiotherapist at baseline, after each treatment session, at 6 weeks, and at 3 months. The primary outcome was motor recovery (impairment level) on the Fugl-Meyer (FM) scale. Secondary outcomes assessed mobility/ambulation, arm/hand function, and independence in activities of daily living.
Notes: Source: Dissertation Abstracts International, Volume: 68-01, Section: B, page: 0250.

Thesis (Ph.D.)--University of Toronto, 2006.

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