Repetitive practice of a single joint movement for enhancing elbow function in hemiparetic patients.

The primary goal of this study was to assess whether repetitive practice of flexion-extension movements of the affected elbow in hemiparetic patients enhances performance and to compare the effects of this practice mode to the effects of the physical therapy variable exercise program which is routinely applied during sessions. Subjects were 27 poststroke hemiparetic patients, residents of a rehabilitation institute, divided into an experimental (n = 15) and a control group (n = 12). The former were treated with 800 repeated elbow movements in a maximal predetermined amplitude of 80 degrees, provided in 8 equal sessions every other day. The latter received 10 min. of conventional physical therapy for the paretic upper extremity at similar time intervals. Pre- and posttreatment assessments included the bilateral measurements of kinematic variables and activation latencies of the biceps and triceps brachi muscles as well as motor and functional tests. For all criterion variables, the findings pointed to comparable improvement in both groups. It was concluded that repetitive elbow movements had no unique training effect on the kinematics of movement and on activation latencies of the primary muscles controlling elbow function in hemiparetic patients. Further, transfer of the effects of training to execution of movements towards and from the mouth was also comparable in both groups, pointing again to there being no particular advantage in using repetitive movements as a training mode for enhancement of elbow function in hemiparetic patients.