Response to intensive upper extremity therapy by individuals with ataxia from stroke

Objective: This study investigated whether or not individuals with ataxia from stroke improve their upper extremity motor function with intense motor practice. Method: Three individuals with ataxia from chronic stroke completed modified constraint-induced movement therapy (CIMT) protocols. Stroke Participants 1 and 2 completed 60 hours and Stroke Participant 3 completed 30 hours of graded task practice while being asked to wear a mitt on the nonparetic arm for 90% of waking hours. Outcome measures were the upper extremity subscale of the Fugl-Meyer Motor Assessment, Wolf Motor Function Test, Motor Activity Log, and kinematics of reaching. Results: All stroke participants improved on either the Fugl-Meyer or the Wolf tests and increased their daily use of the paretic upper extremity. Participants 1 and 2 also improved on all kinematic measures: maximum velocity and time to maximum velocity increased, while index of curvature, number of peaks in the velocity profile, and trunk movement decreased. Participant 3 improved on some kinematic measures (smoother velocity profile, increased time to maximum velocity, decreased number of peaks in the velocity profile) but not all (decreased maximum velocity, increased index of curvature). Conclusion: Individuals with ataxia from stroke can improve their motor function with intense motor practice.