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Effects of a home-based upper-limb training program in patients with multiple sclerosis: a randomized controlled trial
Ortiz-Rubio A, Cabrera-Martos I, Rodriguez-Torres J, Fajardo-Contreras W, Diaz-Pelegrina A, Valenza MC
Archives of Physical Medicine and Rehabilitation 2016 Dec;97(12):2027-2033
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*

OBJECTIVE: To evaluate the effects of home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip stregth and finger prehension force were analyzed. DESIGN: Randomized, single-blinded controlled trial. SETTING: Home-based. PARTICIPANTS: Thirty-seven patients with a clinical diagnosis of MS acknowledging impaired manual ability were randomized into two groups. INTERVENTION: Those patients in the experimental group were included in a supervised home-based upper limb training program during 8 weeks twice a week. Those in the control group received information in form of a leaflet with a schedule of upper limb exercise training. MAIN OUTCOME MEASURES: Primary outcome measure was arm function (motor functioning assessed using Finger Tapping Test and a functional measure, the Action Research Arm Test, ARAT). Secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test, handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. RESULTS: After 8 weeks, a significant between-group improvement (p < 0.05) was found on the ARAT bilaterally and the Finger Tapping Test in the most affected upper limb. Secondary outcomes also improved in the most affected limb in the experimental group. CONCLUSIONS: An 8-weeks home-based intervention program focused on upper limbs twice a week improves arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared to a control group.

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