BMJ Case Reports 2017; doi:10.1136/bcr-2017-219250

Improvement in arm and hand function after a stroke with task-oriented training

  1. Eli Carmeli1
  1. 1Department of Physical Therapy, University of Haifa, Haifa, Israel
  2. 2Department of Neuroscience, The National Institute for Brain and Rehabilitation Sciences, Nazareth, Israel
  3. 3Department of Clinical Neurophysiology, Universidad de Ciencias Medicas de La Habana, La Habana, Cuba
  1. Correspondence to Professor Gerry Leisman, g.leisman{at}
  • Accepted 4 March 2017
  • Published 17 March 2017


A man aged 77 years sustained a left-hemisphere stroke with right hemiparesis. After spending 10 days in the hospital, he was referred to an area rehabilitation centre. There he carried out daily physical, occupational and speech therapy, with an emphasis on task-oriented treatment. The patient's upper-extremity motor performance was evaluated at admission to the rehabilitation centre and before leaving the hospital by 3 different measurement tools: the upper-extremity motor part of the Fugl-Meyer assessment scale, electromyography in hand-reach and grasp and object manipulation and handwriting tasks. Significant improvement in hand function was observed in proximal as well as in distal skills. Significant improvement in handwriting skills and decreased impairment level of the upper extremity had considerable effects on the quality of life of the patient. The case report emphasises the importance of intensive task-oriented training during the first 3 months after stroke to support the natural recovery of the lesioned area.


  • Contributors SI evaluated the patient and decided on the treatment plan, as well as recording electrophysiological data. GL and EC analysed the data and all three authors equally contributed to writing the final paper.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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