Comparison of Two Therapy Approaches in the Rehabilitation of the Pure Motor Hemiparetic Strok

Although there are a variety of therapeutic philosophies applied in stroke rehabilitation, it has not been determined whether one approach is superior to another. We prospectively evaluated twenty-seven patients with pure motor hemiparetic strokes admitted to an acute neurorehabilitation unit and randomized them to treatment with either a traditional functional retraining approach (TFR) or neurodevelopmental techniques (NDT). NDT and TFR treated patients did not differ with regard to age, gender, side of stroke, or days from stroke to study entry. Other than an increased gait velocity in NDT treated patients at hospital discharge (p = 0.04), there was no significant difference in gait measures, upper extremity motor skills, or Functional Independence Measure (FIM) scores at hospital discharge, six month, or twelve month follow-up. Rehab length of stay did not differ significantly between the two treatment groups. This data suggests that TFR and NDT approaches are equally efficacious in treating pure motor hemiparetic strokes in terms of functional outcomes, gait measures, and upper extremity motor skills.