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Trunk restraint therapy: the continuous use of the harness could promote feedback dependence in poststroke patients: a randomized trial
de Oliveira Cacho R, Cacho EWA, Ortolan RL, Cliquet A Jr, Borges G
Medicine 2015 Mar;94(12):e641
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The objective of this study was to evaluate the long-term effects of the task-specific training with trunk restraint compared with the free one in poststroke reaching movements. The design was randomized trial. The setting was University of Campinas (Unicamp). Twenty hemiparetic chronic stroke patients were selected and randomized into 2 training groups: trunk restraint group (TRG) (reaching training with trunk restraint) and trunk free group (TFG) (unrestraint reaching). Twenty sessions with 45 minutes of training were accomplished. The patients were evaluated in pretreatment (PRE), posttreatment (POST) and 3 months after the completed training (RET) (follow-up). Main outcome measures were modified Ashworth scale, Barthel Index, Fugl-Meyer scale, and kinematic analysis (movement trajectory, velocity, angles). A significant improvement, which maintained in the RET test, was found in the motor (p < 0.001) and functional (p = 0.001) clinical assessments for both groups. For trunk displacement, only TFG obtained a reduction statistical significance from PRE to the POST test (p = 0.002), supporting this result in the RET test. Despite both groups presenting a significant increase in the shoulder horizontal adduction (p = 0.003), only TRG showed a significant improvement in the shoulder (p = 0.001 -- PRE to POST and RET) and elbow (p = 0.038 -- PRE to RET) flexion extension, and in the velocity rate (p = 0.03 -- PRE to RET). The trunk restraint therapy showed to be a long-term effective treatment in the enhancement of shoulder and elbow active joint range and velocity rate but not in the maintenance of trunk retention. TRIAL REGISTRATION: NCT02364141.

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