Discussion
Dextrain, post-stroke
SECONDARY
This randomized, dose-matched, controlled trial did not show a significantly larger effect on BBT-change immediately after the 12 Dextrain therapy sessions compared to conventional post-stroke therapy, with both groups improving similarly, displacing about 5 more blocks/min. About 40% of patients showed a clinically significant BBT difference, indicative of comparable improvement in gross dexterity. Interestingly, however, there was a nearly significant larger improvement in BBT at the 3-month follow-up assessment in the Dextrain group (this difference was significant when using age normalized BBT scores). Although many secondary outcomes also showed similar changes post-training, we found signals for greater improvements in several trained and non-trained dexterity components in the Dextrain group. TMS showed enhanced cortical inhibition correlating with positive BBT-change. An exploratory analysis suggested a greater benefit of Dextrain therapy in patients with moderate (rather than mild) baseline motor impairment.