Long-term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial

Journal

Stroke

Year

2017

Abstract

BACKGROUND AND PURPOSE: Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. METHODS: Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up. RESULTS: One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery (mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy (5.2 [95% confidence interval, 0.79-9.61]) and horse-riding therapy participants (9.8 [95% confidence interval, 6.00-13.66]), compared with controls (-0.5 [-3.20 to 2.28]); P=0.001 (1-way ANOVA). The improvements were sustained in both intervention groups 6 months later, and corresponding gains were observed for the secondary outcomes. CONCLUSIONS: Multimodal interventions can improve long-term perception of recovery, as well as balance, gait, grip strength, and working memory in a mixed population of individuals in late phase after stroke. CLINICAL TRIAL REGISTRATION: URL: http//www.ClinicalTrials.gov. Unique identifier: NCT01372059.

Music and Health Institute Terms

Cognitive Abilities; Functional Status; Gait; Memory; Mobility; Music in Combination with Other Techniques; Receptive Music Methods; Stroke

Indexed Terms

Stroke; Aftercare; Elderly; cognition; Equine-Assisted Therapy; follow-up studies; Outcome Assessment, Health Care; randomized controlled trial; rehabilitation; Single-Blind Method; stroke; Stroke Rehabilitation

Study Type

Quasi-Experimental Study; Quantitative Methods

Document Type

Article

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