UPPER AND LOWER LIMB MOTOR RECOVERY DURING EIGHT WEEKS OF ADJUNCTIVE PSYCHOMOTOR THERAPY AFTER ISCHEMIC STROKE

Abstract

This study aimed to compare changes in upper- and lower-extremity Fugl–Meyer Assessment (FMA) motor scores following standard rehabilitation with or without adjunctive psychomotor therapy (PMT) in patients after ischemic stroke. This prospective, open-label controlled study used random allocation and included 100 patients in the final analysis, with 50 patients per group. PMT was administered over eight weeks, four sessions per week, with a planned session duration of 60 minutes, individually extended to 90 minutes when required. FMA motor scores were assessed at baseline and week 8. Changes were evaluated using a 2 × 2 mixed-design analysis of variance, with between-group differences in mean change, 95% confidence intervals (CIs), and effect sizes reported. Upper-extremity scores increased from 33.56 to 49.28 in the PMT group and from 32.18 to 37.44 in the comparison group, while lower-extremity scores increased from 23.26 to 30.78 and from 22.82 to 25.84, respectively. The between-group differences in mean change favored PMT by 10.46 points (95% CI 8.77–12.15) for the upper extremity and 4.50 points (95% CI 3.20–5.80) for the lower extremity. Both time × group interactions were statistically significant (p < 0.001), and both between-group change contrasts remained significant after Holm adjustment (p < 0.001). Adjunctive PMT was therefore associated with greater improvement in both FMA motor domains over eight weeks among patients included in the final analysis. However, attrition, the open-label design, and additional treatment exposure limit causal interpretation and generalizability.