Article

OBJECTIVE: To determine whether the combination of Constraint-Induced Movement
Therapy (CIMT) and conventional rehabilitation techniques can produce meaningful
motor improvement in chronic stroke patients with initially fisted hands. DESIGN: Case series. SETTING: University hospital outpatient laboratory. PARTICIPANTS:
Consecutive sample (N=6) >1 year poststroke with plegic hands. INTERVENTIONS:
Treatment consisted of an initial period of 3 weeks (phase A) when adaptive
equipment in the home, orthotics, and splints were employed to improve ability to
engage in activities of daily living. This was continued in phase B, when CIMT
and selected neurodevelopmental treatment techniques were added. MAIN OUTCOME
MEASURES: Motor Activity Log (MAL), accelerometry, Fugl-Meyer Motor Assessment
(F-M). RESULTS: Patients exhibited a large improvement in spontaneous real-world
use of the more-affected arm (mean lower-functioning MAL change=1.3+/-0.4 points;
P<.001; d'=3.0) and a similar pattern of increase in an objective measure of
real-world more-affected arm movement (mean change in ratio of more- to
less-affected arm accelerometer recordings=0.12+/-0.1 points; P=.016; d'=1.2). A
large improvement in motor status was also recorded (mean F-M change=5.3+/-3.3
points; P=.005; d'=1.6). CONCLUSIONS: The findings of this pilot study suggest
that stroke patients with plegic hands can benefit from CIMT combined with some
conventional rehabilitation techniques, even long after brain injury. More
research is warranted.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS