Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: a randomized controlled trial.

Only 28 people were studied, all from one hospital in Myanmar, and all completed the 4-week program, so the result may not apply to larger or different services. Participants had to be aged 40 to 70, 1 to 6 months after stroke, have Fugl-Meyer upper extremity scores 19 to 58, some active wrist and finger extension, be right-handed before stroke, understand instructions, and have no aphasia or uncorrected visual problems, so people with more severe, very recent, chronic, left-handed, aphasic, or medically unstable stroke were not represented. Follow-up stopped at 4 weeks, so it does not show whether gains lasted or whether more training would have helped. The paper reports assessor blinding only, so participants and therapists were not described as blinded. The task-oriented program was a package of chosen functional tasks, progression, feedback, and manual assistance, so the study cannot separate which part produced the benefit. The authors state that functional improvement could not be explained from cortical activation patterns.

The authors declared no conflicts of interest. The study was funded by the Back, Neck and Other Joint Pain Research Group, Khon Kaen University, Thailand.

Do not conclude that task-oriented training is the best upper extremity treatment for all stroke patients. This trial compared one 20-hour task-oriented program with one dose-matched conventional program in 28 selected people with subacute stroke who had some active wrist and finger extension, and it did not follow patients after 4 weeks.