Arm ability training for stroke and traumatic brain injury patients with mild arm paresis: a single-blind, randomized, controlled trial.

OBJECTIVE To test the efficacy of the arm ability training (AAT) on a sample of patients with central arm paresis after traumatic brain injury (TBI) or stroke. DESIGN Single-blind, randomized, controlled trial. SETTING Inpatient rehabilitation center. PATIENTS Consecutive sample of 74 patients of whom 60 (45 with stroke, 15 with TBI) completed the study; 37 patients received a 1-year follow-up. INTERVENTION Daily AAT with (n = 20) or without (n = 20) knowledge of results, or no AAT (n = 20) during a 3-week intervention period. MAIN OUTCOME MEASURES Summary time scores of the Test Evaluant les Membres superieurs des Personnes Agees (TEMPA)-a test of upper extremity function with daily function-like activities (focal disability)-and kinematic analysis of aimed movements. RESULTS Patients with AAT realized superior improvement as compared with controls. Mean improvement in the time needed to perform (1) all TEMPA tasks was 41.4 versus 12.8 seconds (p =.0012); (2) unilateral TEMPA tasks, 16.5 versus 4.2 seconds (p =.0036); and (3) the ballistic component of aimed movements, 96 versus 20ms (p =.0115). Knowledge of result did not substantially modify these effects. A functional benefit existed at 1-year follow-up. CONCLUSION The AAT reduces focal disability among stroke and TBI patients with mild central arm paresis.