Constraint-induced movement therapy in the rehabilitation of stroke patients

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda – Constraint-induced movement therapy in the rehabilitation of stroke patients. Fizjoterapia Polska 2004; 4(1); 19-24

Abstract

Background. This article presents some preliminary results from the rehabilitation of patients with impaired hand function after stroke. The basis for therapy was the method introduced by Taub, known as Constraint-Induced Movement Therapy (CIMT), which involves the temporary constraint of the healthy upper limb, with simultaneous intensive motor rehabilitation of the dysfunctional limb. Material and methods. Our research involved 10 patients treated in the Rehabilitation Clinic at the Jagiellonian University College of Medicine for post-stroke hemiparesis. There were 5 men and 5 women in this group, ranging in age from 57 to 77 years (ave. 66.5). The time since onset ranged from 1 to 50 months (ave. 11.4 months). CIMT was used in all patients. Results. After 2 weeks of rehabilitation all the patients required less time to perform manual tests, and showed marked functional improvement in the affected hand. Conclusions. The CIMT method is effective in the rehabilitation of patients with post-stroke hemiparesis.

Key words:
Stroke, rehabilitation of the hand, CIMT
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Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda – Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke. Fizjoterapia Polska 2007; 7(1); 21-28

Abstract

Background. The authors attempted to evaluate the effect of selected demographic and clinical factors on the efficacy of Constraint-Induced Movement Therapy (CIMT) in improving the mobility of a paretic hand following cerebral stroke. The analysis focussed on factors such as age, gender, side of paresis and time elapsed since stroke. It is commonly known that post-stroke rehabilitation is relatively difficult and poses a challenge not only to the therapeutic team, but also to the patient’s family. Despite activities geared towards improved mobility, satisfactory effects cannot always be achieved. Until recently, physiotherapy was mainly geared towards the compensation of deficits rather than functional restoration. Nowadays, specialised neurological rehabilitation centres introduce novel methods based on the concept of brain adaptability, aimed primarily at functional restoration. The CIMT method is being used more and more frequently. It can be succinctly defined as a strategy for the activation of paretic parts of the body through constraining or totally preventing the use of their healthy counterparts. Material and methods. The study group comprised 21 persons (11 women and 10 men) following cerebral stroke. Mean patient age was 65 years. The efficacy end-point for the rehabilitation approach was time required to carry out 10 basic everyday activities using the affected hand. This assessment was carried out four times: at baseline, after two weeks of intensive exercise in a hospital rehabilitation ward as well as at 4 and 12 weeks of independent practice at home. Results. The therapeutic programme lead to a highly significant (p<0.001) improvement of the performance of the motor function impaired hand. Subgroup analysis did not demonstrate any significant influence of individual factors on the efficacy of the method used to improve hand motor function after cerebral stroke. Conclusions. Regardless of the age and gender of cerebral stroke patients, the CIMT method demonstrated significant efficacy in improving hand motor function. Time elapsed since stroke has no impact on the improvement of the paretic hand using the C1MT method. Regardless of the affected side, the method activates the motor functions of the paretic hand.

Key words:
stroke, improvement of hand mobility, CIMT
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