Constraint-Induced Movement Therapy Combined With Conventional Neurorehabilitation Techniques in Chronic Stroke Patients With Plegic Hands: A Case Series
Abstract 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...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2013, Vol.94 (1), p.86-94 |
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| creator | Taub, Edward, PhD Uswatte, Gitendra, PhD Bowman, Mary H., OTR/L Mark, Victor W., MD Delgado, Adriana, MA Bryson, Camille, PT Morris, David, PhD, PT Bishop-McKay, Staci, BS |
| description | Abstract 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 |
| doi_str_mv | 10.1016/j.apmr.2012.07.029 |
| format | Article |
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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.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2012.07.029</identifier><identifier>PMID: 22922823</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cerebral infarction ; Chronic Disease ; Female ; Hand - physiopathology ; Hemiplegia - physiopathology ; Hemiplegia - rehabilitation ; Humans ; Male ; Middle Aged ; Motor skills ; Physical Medicine and Rehabilitation ; Physical Therapy Modalities ; Recovery of Function - physiology ; Rehabilitation ; Restraint, Physical ; Stroke ; Stroke - physiopathology ; Stroke Rehabilitation ; Upper extremity</subject><ispartof>Archives of physical medicine and rehabilitation, 2013, Vol.94 (1), p.86-94</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2013 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-3a4170542f4f7211d5a68d48552c585c31e2d87291d0d624629bc57eaad000b73</citedby><cites>FETCH-LOGICAL-c455t-3a4170542f4f7211d5a68d48552c585c31e2d87291d0d624629bc57eaad000b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999312008799$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22922823$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taub, Edward, PhD</creatorcontrib><creatorcontrib>Uswatte, Gitendra, PhD</creatorcontrib><creatorcontrib>Bowman, Mary H., OTR/L</creatorcontrib><creatorcontrib>Mark, Victor W., MD</creatorcontrib><creatorcontrib>Delgado, Adriana, MA</creatorcontrib><creatorcontrib>Bryson, Camille, PT</creatorcontrib><creatorcontrib>Morris, David, PhD, PT</creatorcontrib><creatorcontrib>Bishop-McKay, Staci, BS</creatorcontrib><title>Constraint-Induced Movement Therapy Combined With Conventional Neurorehabilitation Techniques in Chronic Stroke Patients With Plegic Hands: A Case Series</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract 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.</description><subject>Cerebral infarction</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Hand - physiopathology</subject><subject>Hemiplegia - physiopathology</subject><subject>Hemiplegia - rehabilitation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor skills</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Physical Therapy Modalities</subject><subject>Recovery of Function - physiology</subject><subject>Rehabilitation</subject><subject>Restraint, Physical</subject><subject>Stroke</subject><subject>Stroke - physiopathology</subject><subject>Stroke Rehabilitation</subject><subject>Upper extremity</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UsFu1DAUtBCIbgs_wAH5yCXBduI4QQipiqCtVKDSLoKb5dhvibeJvbWTlfZT-FscbeHAgZP9_GZGfjMPoVeU5JTQ6u0uV_sx5IxQlhORE9Y8QSvKC5bVjP54ilaEkCJrmqY4Q-cx7lJZ8YI-R2eMNYzVrFihX613cQrKuim7cWbWYPBnf4AR3IQ3PQS1P-LWj511qfPdTn2q3CF1rXdqwF9gDj5Arzo72Ektr3gDunf2YYaIrcNtH7yzGq-n4O8B3yVMYseT1t0AP1PvWjkT3-FL3KoIeA3BQnyBnm3VEOHl43mBvn36uGmvs9uvVzft5W2mS86nrFAlFYSXbFtuBaPUcFXVpqw5Z5rXXBcUmKkFa6ghpmJlxZpOcwFKmeRHJ4oL9Oakuw9--fMkRxs1DINy4OcoKRNFyYkQdYKyE1QHH2OArdwHO6pwlJTIJRK5k0skcolEEiFTJIn0-lF_7kYwfyl_MkiA9ycApCkPFoKMOlmUkrAB9CSNt__X__APXQ82Ga6GezhC3Pk5pKDSHDImjlwvS7HsBGWE1CJdfgMUSLN8</recordid><startdate>2013</startdate><enddate>2013</enddate><creator>Taub, Edward, PhD</creator><creator>Uswatte, Gitendra, PhD</creator><creator>Bowman, Mary H., OTR/L</creator><creator>Mark, Victor W., MD</creator><creator>Delgado, Adriana, MA</creator><creator>Bryson, Camille, PT</creator><creator>Morris, David, PhD, PT</creator><creator>Bishop-McKay, Staci, BS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2013</creationdate><title>Constraint-Induced Movement Therapy Combined With Conventional Neurorehabilitation Techniques in Chronic Stroke Patients With Plegic Hands: A Case Series</title><author>Taub, Edward, PhD ; Uswatte, Gitendra, PhD ; Bowman, Mary H., OTR/L ; Mark, Victor W., MD ; Delgado, Adriana, MA ; Bryson, Camille, PT ; Morris, David, PhD, PT ; Bishop-McKay, Staci, BS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-3a4170542f4f7211d5a68d48552c585c31e2d87291d0d624629bc57eaad000b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Cerebral infarction</topic><topic>Chronic Disease</topic><topic>Female</topic><topic>Hand - physiopathology</topic><topic>Hemiplegia - physiopathology</topic><topic>Hemiplegia - rehabilitation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor skills</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Physical Therapy Modalities</topic><topic>Recovery of Function - physiology</topic><topic>Rehabilitation</topic><topic>Restraint, Physical</topic><topic>Stroke</topic><topic>Stroke - physiopathology</topic><topic>Stroke Rehabilitation</topic><topic>Upper extremity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taub, Edward, PhD</creatorcontrib><creatorcontrib>Uswatte, Gitendra, PhD</creatorcontrib><creatorcontrib>Bowman, Mary H., OTR/L</creatorcontrib><creatorcontrib>Mark, Victor W., MD</creatorcontrib><creatorcontrib>Delgado, Adriana, MA</creatorcontrib><creatorcontrib>Bryson, Camille, PT</creatorcontrib><creatorcontrib>Morris, David, PhD, PT</creatorcontrib><creatorcontrib>Bishop-McKay, Staci, BS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taub, Edward, PhD</au><au>Uswatte, Gitendra, PhD</au><au>Bowman, Mary H., OTR/L</au><au>Mark, Victor W., MD</au><au>Delgado, Adriana, MA</au><au>Bryson, Camille, PT</au><au>Morris, David, PhD, PT</au><au>Bishop-McKay, Staci, BS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Constraint-Induced Movement Therapy Combined With Conventional Neurorehabilitation Techniques in Chronic Stroke Patients With Plegic Hands: A Case Series</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2013</date><risdate>2013</risdate><volume>94</volume><issue>1</issue><spage>86</spage><epage>94</epage><pages>86-94</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22922823</pmid><doi>10.1016/j.apmr.2012.07.029</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Cerebral infarction Chronic Disease Female Hand - physiopathology Hemiplegia - physiopathology Hemiplegia - rehabilitation Humans Male Middle Aged Motor skills Physical Medicine and Rehabilitation Physical Therapy Modalities Recovery of Function - physiology Rehabilitation Restraint, Physical Stroke Stroke - physiopathology Stroke Rehabilitation Upper extremity |
| title | Constraint-Induced Movement Therapy Combined With Conventional Neurorehabilitation Techniques in Chronic Stroke Patients With Plegic Hands: A Case Series |
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