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Effect of crossed-education using a tilt table task-oriented approach in subjects with post-stroke hemiplegia: a randomized controlled trial [with consumer summary]
Kim C-Y, Kim H-D
Journal of Rehabilitation Medicine 2018 Sep;50(9):792-799
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; 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 determine the effect of crossed-education, using task-related training on a tilt table, on upper extremity function and grip strength in subjects with post-stroke hemiplegia. DESIGN: Double-blind, randomized controlled, pilot study. PATIENTS: A total of 45 patients between 6 and 12 months post-stroke. METHODS: Subjects were randomly allocated to the control group, or experimental group I or II. All subjects received conventional upper limb training for 30 min, 3 times a week for 6 weeks, and training on 3 different tilt table applications for 20 min a day. The outcome was evaluated using the Fugl-Meyer scale, Wolf Motor Function Test, and measurements of grip strength using a hydraulic hand dynamometer, prior to and 6 weeks post-intervention. RESULTS: There was a significantly greater increase, post-test, in the Fugl-Meyer scale (p = 0.003), maximal grip strength of the affected hand (p = 0.04), and grip strength, compared with the less-affected hand (p = 0.03), in subjects who underwent supplementary task-oriented training on a tilt table compared with those in the control group. There was also a significantly greater increase in Wolf Motor Function score (p = 0.001), post-test, in subjects who underwent task-oriented training on a tilt table compared with those in the 2 experimental groups. CONCLUSION: Compared with tilt table or conventional training alone, crossed-education using task-oriented training on a tilt table may result in improvements in arm function and maximal grip strength in persons with chronic hemiplegia post-stroke.

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