Enriched, Task-Specific Therapy in the Chronic Phase After Stroke: An Exploratory Study.

The study had no comparison group, so it cannot separate the effect of the program from time, prior therapy, or other influences. Participants chose to apply to the program and traveled to Spain, so they may have been more motivated and less representative than people who cannot or will not seek intensive rehabilitation. The outcome assessor was not blinded to the intervention, and the same assessor traveled to the rehabilitation site to test participants before and after the program. The primary scale's minimal detectable change and clinically important difference were not established, so it is unclear how much of the 2.3-point motor change matters clinically. The program included physical therapy, speech therapy, outdoor activities, excursions, social interaction, and cognitive and sensory stimulation, so the contribution of any single component cannot be separated. Two participants discontinued during the program and three discontinued after the post-intervention assessment, and missing follow-up data were carried forward from the last observation. During baseline, more than half of participants received therapist-led rehabilitation and many engaged in self-managed rehabilitation, and baseline therapist-led hours correlated with later motor gains, so usual rehabilitation may have influenced the results.

Funding came from Swedish foundations, the Swedish state ALF agreement, the Swedish Stroke Association, the Swedish Medical Research Council, and other named foundations. The supplied text reports no conflicts of interest.

Do not conclude that high-dose physical therapy alone caused the improvements. The program also included task-specific physical therapy, speech therapy for aphasia, outdoor activities, excursions, social interaction, and cognitive and sensory stimulation, and there was no comparison group. The contribution of any single component cannot be separated.