Study samples
Patients were recruited from the Department
of Rehabilitation Medicine of King Chulalongkorn
Memorial Hospital. Chronic stroke patients who met
the following criteria were included: (1) age 18 to 80
years; (2) having a history of a single stroke; (3) the
duration of stroke before the start of the study was
between 1 to 10 years; (4) having a minimum of 20
degrees of active wrist extension and 10 degrees of
finger extension; (5) Action Research Arm (ARA)test
score < 51 (maximum score, 57)(23); (6) being able to
walk indoors without a stick, indicating no major
balance problems; (7) no severe aphasia; (8) no sensory
disorder; and (9) no severe cognitive impairments.
In an observer-blinded randomized clinical
trial, patients were randomized individually into 2
groups by using the table of randomization. One group
of patients received forced use treatment for 2 weeks;
the other group received equally intensive bimanual
training based on NDT for 2 weeks. All patients were
treated in groups of 3-4.