Evidence map›Paper›PMID 29554849›Full record

Trial reportNeurorehabilitation and neural repair2018

Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial.

Rebecca Lewthwaite, Carolee J Winstein, Christianne J Lane, Sarah Blanton, Burl R Wagenheim, Monica A Nelsen, Alexander W Dromerick, Steven L Wolf

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurorehabilitation and neural repair, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00871715 (Interdisciplinary Comprehensive Arm Rehab Evaluation), which is not on this map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00871715 nacompletednot on this map

Interdisciplinary Comprehensive Arm Rehab Evaluation (ICARE) Stroke Initiative

TypeinterventionalSponsorUniversity of Southern CaliforniaRan2009 to 2014Enrolled361ConditionsStroke, Brain Infarction, Brain Ischemia, Cerebral InfarctionArmsAccelerated Skill Acquisition Program (ASAP), Dose-Equivalent Usual & Customary Care - DEUCC, Usual and Customary Care - UCC
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Integrated care management for patients following acute stroke: a systematic review.QJM : monthly journal of the Association of Physicians · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Dosage Matters.Stroke · 2019
    Trial
  6. How deep is your recovery? Rethinking true motor recovery versus compensation in neurorehabilitation.International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Autonomy support encourages use of more-affected arm post-stroke.Journal of neuroengineering and rehabilitation · 2023
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rebecca Lewthwaite1 University of Southern California, Los Angeles, CA, USA.
Carolee J Winstein1 University of Southern California, Los Angeles, CA, USA.
Christianne J Lane1 University of Southern California, Los Angeles, CA, USA.
Sarah Blanton3 Emory University, Atlanta, GA, USA.
Burl R Wagenheim2 Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA.
Monica A Nelsen1 University of Southern California, Los Angeles, CA, USA.
Alexander W Dromerick4 Georgetown University, Washington, DC, USA.
Steven L Wolf3 Emory University, Atlanta, GA, USA.

Funding

Interdisciplinary Comprehensive Arm Rehab Evaluation (I-CARE) Stroke InitiativeU01NS056256 · NINDS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI DROMERICK, ALEXANDER W, WINSTEIN, CAROLEE J · 2008 to 2013
$12.7M
NINDS NIH HHS U01 NS056256
6 · The paper itself

Abstract

backgroundTask-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.

objectiveTo compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes.

methodsOn 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.

resultsAcross 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.

conclusionsCustomized 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).

Indexed as

Activities of Daily LivingAgedExercise TherapyFemaleHumansMaleMiddle AgedOccupational TherapyQuality of LifeRecovery of FunctionSelf EfficacySocial ParticipationStroke RehabilitationTreatment OutcomeInternational Classification of Disability and Functioning (ICF)patient-centeredquality of liferehabilitationtask-oriented

Identifiers

PMID29554849
PMCPMC5863583

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.