OBJECTIVE To analyze the effectiveness of a home-based restorative and compensatory upper limb apraxia (ULA) rehabilitation program. DESIGN A randomized controlled trial. SETTING Neurology Unit of San Cecilio Hospital, and two private and specialized healthcare centers. PARTICIPANTS 38 community dwelling participants (25-95 years old, sex ratio 1:1) with unilateral mild-to-moderate poststroke lesions (time of evolution since stroke (months) 12.03±8.98) and secondary ULA. INTERVENTIONS Participants were randomly assigned to an 8-week combined ULA functional rehabilitation group (n=19) 3 days/week for 30 min and a traditional healthcare education protocol group (n=19) once a month over 8 weeks. Both interventions were carried out at home. MAIN OUTCOME MEASURES Sociodemographic and clinical data, Barthel Index (primary outcome), Lawton and Brody Scale, Observation and scoring-ADL, the De Renzi tests for ideational and ideomotor apraxia and imitating gestures test, the recognition of gestures, TULIA, and stroke-specific quality of life scale (SSQOL-38) were assessed at 3 time points: baseline, post-treatment (8 weeks) and follow-up (8 weeks). RESULTS There were statistically significant differences among the groups regarding ideomotor apraxia, imitating gestures, global recognition of gestures, intransitive gestures, and comprehension of gesture production (p<.05) in favor of the experimental group, but no statistically significant differences were found among groups regarding functionality or quality of life (p>.05). Regarding the within-group effect, statistically significant differences were found in all neuropsychological outcomes at post-treatment and follow-up (p<.05). CONCLUSION A functional rehabilitation program was superior to a traditional healthcare education program and resulted in improvements in the neuropsychological functioning in ULA poststroke. Conventional education showed an insufficient effect on apraxia recovery. Further studies with larger samples are needed to determine the effect of rehabilitation strategies on functionality and quality of life of poststroke ULA patients.

中文翻译：

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中风后患者上肢失用功能康复计划的有效性：一项随机对照试验。

目的分析以家庭为基础的恢复性和代偿性上肢失用症 (ULA) 康复计划的有效性。设计一项随机对照试验。设置 San Cecilio 医院的神经科，以及两个私人和专业医疗中心。参与者 38 名社区居民参与者（25-95 岁，性别比 1:1），单侧轻度至中度卒中后病变（卒中后的演变时间（月）12.03±8.98）和继发性 ULA。干预 参与者被随机分配到一个为期 8 周的联合 ULA 功能康复组（n=19），每周 3 天，持续 30 分钟，以及一个传统的医疗保健教育方案组（n=19），每月一次，持续 8 周。两项干预均在家中进行。主要结果测量 社会人口统计学和临床​​数据、Barthel 指数（主要结果）、劳顿和布罗迪量表、观察和评分-ADL、De Renzi 概念和意念运动性失用测试和模仿手势测试、手势识别、TULIA 和中风特异性生活质量量表 (SSQOL-38) 进行了 3 次评估要点：基线、治疗后（8周）和随访（8周）。结果 各组在观念运动性失用症、模仿手势、手势的全局识别、不及物手势和手势产生的理解方面存在统计学差异（p<.05），实验组有利于实验组，但无统计学差异。关于功能或生活质量的分组 (p>.05)。关于组内效应，在治疗后和随访期间，所有神经心理学结果均存在统计学差异（p<.05）。结论 功能性康复计划优于传统的医疗保健教育计划，并导致 ULA 卒中后神经心理功能的改善。传统教育对失用恢复的效果不足。需要更大样本的进一步研究来确定康复策略对卒中后 ULA 患者功能和生活质量的影响。