Benefits of a repetitive facilitative exercise program for the upper paretic extremity after subacute stroke: A randomized controlled trial

Megumi Shimodozono, Tomokazu Noma, Yoshiko Nomoto, Noriaki Hisamatsu, Katsuya Kamada, Ryuji Miyata, Shuji Matsumoto, Atsuko Ogata, Seiji Etoh, Jeffrey R. Basford, Kazumi Kawahira

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background. Repetitive facilitative exercise (RFE), a combination of high repetition rate and neurofacilitation, is a recently developed approach to the rehabilitation of stroke-related limb impairment. Preliminary investigations have been encouraging, but a randomized controlled evaluation has yet to be performed. Objectives. To compare the efficacy of RFE with that of conventional rehabilitation in adults with subacute stroke. Methods. A total of 52 adults with stroke-related upper-limb impairment (Brunnstrom stage ≥III) of 3 to 13 weeks' duration participated in this randomized, controlled, observer-blinded trial. Participants were randomized into 2 groups and received treatment on a 4-week, 40 min/d, 5 d/wk schedule. Those assigned to RFE received 100 standardized movements of at least 5 joints of their affected upper extremity, whereas those in the control group participated in a conventional upper-extremity rehabilitation program. Primary and secondary outcomes (improvement in group Action Research Arm Test [ARAT] and Fugl-Meyer Arm [FMA] scores, respectively) were assessed at the end of training. Results. In all, 49 participants (26 receiving RFE) completed the trial. ARAT and FMA scores at baseline were 19 ± 21 and 39 ± 21 (mean ± standard deviation). Evaluation at the trial's completion revealed significantly larger improvements in the RFE group than in the control group in both ARAT (F = 7.52; P =.009) and FMA (F = 5.98; P =.019) scores. Conclusions. These findings suggest that RFE may be more effective than conventional rehabilitation in lessening impairment and improving upper-limb motor function during the subacute phase of stroke.

Original languageEnglish (US)
Pages (from-to)296-305
Number of pages10
JournalNeurorehabilitation and Neural Repair
Issue number4
StatePublished - May 2013


  • Action Research Arm Test
  • Fugl-Meyer Arm
  • exercise
  • rehabilitation
  • stroke
  • upper extremity

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology


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