Citation: Neurorehabilitation & Neural Repair. 32(2):150-165, 2018 Feb.Journal: Neurorehabilitation and neural repair.Published: 2018ISSN: 1545-9683.Full author list: Lewthwaite R; Winstein CJ; Lane CJ; Blanton S; Wagenheim BR; Nelsen MA; Dromerick AW; Wolf SL.UI/PMID: 29554849.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar National Rehabilitation NetworkActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1177/1545968318760726 (Click here)Abbreviated citation: Neurorehabil Neural Repair. 32(2):150-165, 2018 Feb.Local Holdings: Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006.Abstract: BACKGROUND: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many.Abstract: OBJECTIVE: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes.Abstract: METHODS: On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC). Outcomes were taken at baseline, posttreatment, 6 months, and 1 year after randomization. Longitudinal mixed effect models compared group differences in poststroke improvement during treatment and follow-up phases.Abstract: RESULTS: Across all groups, most improvement occurred during the treatment phase, followed by change more slowly during follow-up. Compared with DEUCC and UCC, ASAP group gains were greater during treatment for Stroke Impact Scale Hand, Strength, Mobility, Physical Function, and Participation scores, self-efficacy, perceived health, reintegration, patient-centeredness, and quality of life outcomes. ASAP participants reported higher Motor Activity Log-28 Quality of Movement than UCC posttreatment and perceived greater study-related improvements in quality of life. By end of study, all groups reached similar levels with only limited group differences.Abstract: CONCLUSIONS: Customized task-oriented training can be implemented to accelerate gains across a full spectrum of patient-reported outcomes. While group differences for most outcomes disappeared at 1 year, ASAP participants achieved these outcomes on average 8 months earlier (ClinicalTrials.gov: Interdisciplinary Comprehensive Arm Rehabilitation Evaluation [ICARE] Stroke Initiative, at www.ClinicalTrials.gov/ClinicalTrials.gov . Identifier: NCT00871715).