Motor Relearning Program for Enhancing Upper Limb Function in Post-stroke Rehabilitation: A Randomised Controlled Trial
Venugopal Pawar *
Department of Physiotherapy, JRNRVU, Dabok, Udaipur, India and DCMS College of Physiotherapy, Hyderabad, India.
Rakesh Kumar Singh
Department of Physiotherapy, JRNRVU, Dabok, Udaipur, India.
Shailendra Mehta
Department of Physiotherapy, Janardan Rai Nagar Rajasthan Vidyapeeth (Deemed to be University), Udaipur, India.
Manisha D
DCMS College of Physiotherapy, Hyderabad, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Upper limb dysfunction following stroke remains a significant barrier to regaining independence. While conventional physiotherapy offers moderate improvement, the Motor Relearning Program (MRP) emphasises functional task training and cortical reorganisation, showing promise in facilitating neuroplasticity and functional gains.
Objective: To compare the effectiveness of MRP combined with conventional physiotherapy versus conventional physiotherapy alone in improving upper limb function and independence among post-stroke patients.
Methods: A randomised controlled trial was conducted on 30 post-stroke participants aged 40 to 65 years with Brunnstrom Stage 2 or 3 upper limb involvement. Participants were randomly allocated to two groups: Group A (MRP + conventional therapy) and Group B (conventional therapy only), with 15 participants in each group. Outcome measures included the Modified Ashworth Scale (MAS) for spasticity and the Barthel Index for activities of daily living. Assessments were performed at baseline, 4th week and 8th week.
Results: Group A showed a greater reduction in MAS scores from baseline to 8th week (mean reduction: 1.12 ± 0.35) compared to Group B (mean reduction: 0.65 ± 0.28) (p-vaue-0.545). Similarly, Group A exhibited a more significant increase in Barthel Index scores (mean increase: 25.4 ± 6.1) than Group B (mean increase: 16.3 ± 4.8) (p-vaue-0011), indicating improved functional independence. Inter-group differences were statistically significant (p < 0.05).
Conclusion: The Motor Relearning Program, when integrated with conventional physiotherapy, leads to superior improvements in upper limb function and daily activity performance among stroke survivors compared to conventional therapy alone. These findings support the implementation of MRP as a central rehabilitation strategy for upper extremity recovery post-stroke.
Keywords: Stroke rehabilitation, motor relearning program, upper limb function, modified Ashworth scale, barthel index, randomised controlled trial