Effect of self-managed training of the paretic upper limb in stroke patients in the convalescent phase: application of the Transfer Package, an element of CI therapy

Onose T, Ohnaka K, Suzuki K, Anzai M, Sato N, Kimura M, Shimokurosawa A. Effect of self-managed training of the paretic upper limb in stroke patients in the convalescent phase: application of the Transfer Package, an element of CI therapy. Jpn J Compr Rehabil Sci 2016; 7: 45-50.Objective: Transfer package (TP) is one of the elements of constraint-induced movement therapy (CI therapy). This study evaluated the effectiveness of implementing TP as self-training in addition to occupational therapy for the upper paretic limb in the convalescent phase after stroke.Methods: Twelve patients at 8 to 16 weeks after onset of primary stroke were recruited in the study. A comparative study was conducted by dividing the subjects into two groups: a group that implemented self-training consisting of TP in addition to routine occupational therapy (TP group) and a group that implemented self-training including stretching and self-assisted exercise in addition to routine occupational therapy (non-TP group). In both groups, self-training was conducted for approximately 30 min a day, everyday for three weeks. At the beginning and three weeks after intervention, the patients were evaluated using the manual function test (MFT) and the motor activity log (MAL). Wilcoxon signed rank test was used to evaluate the changes in various evaluation parameters before and after intervention.Results: The MFT score improved significantly in both groups. For the MAL evaluation, the Amount of Use and Quality of Movement improved significantly in the TP group compared to the non-TP group.Conclusion: The present study indicates that self-training incorporating TP in the convalescent phase of stroke is effective in improving the amount of use and quality of movement of the paretic upper limb at the level of daily life.