- •The modified Constraint Induced Movement Therapy Protocol may be administered in subacute phase of stroke without exacerbation of fatigue.
- •No significant adverse events occurred during the treatment period
- •No loss of motor function caused by the restraint of the unaffected hand could be detected.
Abstract
Objectives
There is a little available information about the fatigue status among people receiving
modified constraint induced movement therapy. The study examined such changes. The
effect of using restraint on motor performance was also evaluated in sub acute phase
after stroke.
Materials and methods
The study was designed as two group pretest and post-test study. The experimental
design included a pretest and post test measures of dependent variables fatigue and
motor function. All patients were recruited from the Safdurjung Hospital. 20 patients
in subacute phase of stroke (3-9 months), (N = 10) mean age±SD 51.90±15.27, MAS score mean ± SD 1.90±.316 and post stroke duration
mean ±SD 6.45±2.26 were included in the experimental group and (N = 10) mean age ± SD 54.10±17.42, MAS score mean ±SD 1.52±0.52 and post stroke duration
mean±SD score 4.55± 2.52 were included in the control group. The subjects in the experimental
group were restrained for six hours every week day with task training for 2 h per
day five times a week for three weeks and the subjects in the controlled group received
task training for 2 h per day five times a week for three weeks with no restrain.
Motor Performance and fatigue were measured on day to day basis by Wolf Motor Function
Test Scores (WMFT) and 11th item of Barrow Neurological Institute (BNI) scale in both
experimental and controlled group.
Results
The restraint group exhibited significant better motor performance than the controlled
group. Mean difference between Pre- WMFT scores and Post WMFT scores were (0.533±.362)
as compared to controlled group (0.192±.23). No significant statistical difference
was observed in the difference of mean Pre- BNI and Post – BNI scores in either of
the two groups (p = .57). Difference between the experimental and controlled group in motor performance
and fatigue scores were nonsignificant.
Conclusions
Restraint improves motor performance in subacute therapy group and the intensive practice
associated with m-CIMT may be administered without the exacerbation of fatigue.
Key Words
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References
- Effects of forced use on arm function in sub acute phase after stroke.Phys Ther. 2009; 89: 526-539
- Exploiting interlimb coupling to improve paretic arm reaching performance in people with chronic stroke.Arch Phys Med Rehabil. 2005; 86: 2131-2137
- Mirror therapy improves hand function in subacute stroke.Arch Phys Med Rehabil. 2008; 89: 393-398
- Functional outcome in post stroke patients with or without fatigue.Am J Phys Med Rehabil. 2009; 88: 554-558
- Experience of severe fatigue long after stroke and its relation with depressive symptoms and disease characteristics.J Eur Neurol. 2001; 45: 28-33
- Post stroke fatigue where is the evidence to guide practice?.N Z Med J. 2007; 120: 120-1264
- Fatigue review and symptomatic approach to potential causes.Rev Med Suisse. 2006; 89: 2725-2731
- A population based study of the prevalence of fatigue after transient ischemic attack and minor stroke.Stroke. 2009; 40: 757-761
- Fatigue in neurological disorders.The Lancet. 2004; 363: 978-988
- Evaluation of fatigue scales in stroke patients.Stroke. 2007; 38: 2090-2095
- Fatigue after brain injury: initial reliability of BNI fatigue scale.Brain Injury. 2004; 18: 685-690
- Effects of constraint induced movement therapy on patients with chronic motor deficits after stroke.Stroke. 1999; 30: 586-592
- Revisiting constraint induced movement therapy: are we too smitten with the mitten? Is all nonuse “ Learned”? and other quandaries.Phys Therapy:. 2007; 87: 1212-1223
- Constraint induced movement therapy: some thoughts about theories and evidence.J Rehabil Med. 2003; 41: 41-45
- The excite trial: relationship of intensity of constraint induced movement therapy to improvement in the wolf motor function test.Restorative Neurol Neurosci. 2007; 25: 549-562
- An application of upper extremity constraint induced movement therapy in a patient with subacute stroke.J Phys Therapy. 1999; 79: 847-853
- Motor recovery and cortical reorganization after constraint induced movement therapy in stroke patients.Neurorehabil Neural Repair. 2002; 16: 326-328
- Shortened constraint induced movement therapy in subacute stroke. No effect of using a restraint.J Rehabil Med. 2009; 41: 231-236
- Stroke.Physical Rehablitation. 4th ed. Jaypee Publishers, 2001: 519-564
- The assessment of fatigue a practical guide for clinicians and researches.J Psychomatic Res. 2004; 56: 57-170
- The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer.Oncol Nurs Forum. 1998; 25: 677-684
- Fluoxetine is not effective in the treatment of post stroke fatigue.Cerebrovasc Dis. 2006; 23: 103-108
- Pain, fatigue and intensity of practice in people with stroke who are receiving constraint induced movement therapy.Phys Ther. 2006; 86: 1241-1250
- Constraint induced movement therapy after stroke: efficacy for patients with minimal upper extremity motor ability.Arch Phys Med Rehabil. 2005; 86: 1867-1873
- Assessing Wolf motor function test as outcome measure for research in patients after stroke.Stroke. 2001; 32: 1635-1639
- Effects of modified constraint-induced movement therapy on movement kinematics and daily function in patients with stroke: a kinematic study of motor control mechanisms.Neurorehabil Neural Repair. 2007; 21: 460-466
Article info
Publication history
Published online: October 17, 2020
Accepted:
September 29,
2020
Received in revised form:
September 25,
2020
Received:
July 12,
2020
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105378
Copyright
© 2020 Elsevier Inc. All rights reserved.
