Reward During Arm Training Improves Impairment and Activity After Stroke: A Randomized Controlled Trial.
Mario Widmer, Jeremia P O Held, Frieder Wittmann and 6 others
PMID 34937456WHAT IT FOUND
The primary measure of arm movement range showed no difference between groups.
However, rewarded training led to significantly better scores on standard clinical tests of arm impairment and activity at three months.
Key findings
01There was no significant difference between the rewarded and control groups in the primary outcome of arm workspace.
02The rewarded group showed significantly greater improvement in the Fugl-Meyer Assessment for upper extremity at 3 months compared to the control group.
03The rewarded group showed significantly greater improvement in the Box and Block Test at 3 months compared to the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was terminated early after recruiting only 37 patients instead of the planned 74, due to the pandemic and adverse events, which reduces the reliability of the findings. The primary outcome measure showed no difference between groups, so the positive results are based on secondary outcomes and should be viewed as preliminary. The reward intervention included multiple components (visual, auditory, and monetary), so it is not possible to determine which specific element caused the improvement.
Declared interests
The study was funded by university research programs, foundations, and a Swiss technology commission. One author reported personal fees from Amgen, Moleac, and Bayer outside the submitted work.
The easy way to misread this
Do not conclude that rewarded training is proven effective for arm recovery after stroke. The study was underpowered and terminated early, and the primary outcome was null, so the positive findings in secondary measures require confirmation in larger trials.