OBJECTIVE: We investigated the effect of long-term practice on motor improvements in chronic stroke patients. DESIGN: Randomized parallel group controlled study. SETTING: Motor Behavior Laboratory, University of Florida. SUBJECTS: Eighteen individuals who experienced a stroke more than nine months prior to enrolling. INTERVENTIONS: The treatment interventions were bilateral arm movements coupled with active neuromuscular stimulation on the impaired arm for both practice duration groups. The short-term group received one treatment protocol, whereas, over 16 months, the long-term practice group completed 10 treatment protocols. All protocol sessions were 6 hours long (90 minutes 1 day/week/4 weeks) and were separated by 22 days. MAIN OUTCOME MEASURES: Repeated data collection on three primary outcome measures (ie, Box and Block test, fractionated reaction times, and sustained force production) evaluated motor capabilities across rehabilitation times. RESULTS: Mixed design ANOVAs (group x retention test: 2x4; group x retention test x arm condition: 2x4x2) revealed improved motor capabilities for the long-term practice duration group on each primary measure. At the 16-month delayed retention test, when compared to the short-term group, the long-term group demonstrated: (a) more blocks moved (43 versus 32), (b) faster premotor reaction times (158 versus 208 ms), and (c) higher force production (75 versus 45 N). CONCLUSION: Sixty hours of rehabilitation over 16 months provided by various bilateral arm movements and coupled active stimulation improved motor capabilities in chronic stroke.

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