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Abstract Introduction Spastic hemiparetic cerebral palsy (CP) is the most prevalent type of CP. Children with spastic hemiparesis experience difficulties when using their affected upper extremities, and one effective treatment is the Constraint-Induced Movement Therapy (CIMT). The study of rest-activity patterns provides information on children's daily activities with spastic hemiparetic CP during the day and sleep. Objective To investigate the effect of CIMT on the rest-activity patterns in children with spastic hemiparetic CP vs in a healthy group. Methods Nonrandomized controlled trial was conducted at the Neuropediatric Center of the Hospital de Clínicas Complex, in Curitiba, Brazil. Children with spastic hemi-paretic CP between 5 and 16 years old participated in the study group and receive the CIMT. The healthy group was composed of children between 5 and 15 years old. Both groups used accelerometer to record rest-activity patterns, that may be studied through nonparametric variables of accelerometer: M10 (an individual's most active 10h); L5 (an individual's least active 5h); and RA (relative amplitude of the circadian rest-activity patterns). Results Forty-five children were recruited, and 38 were included in the analyses (19 allocated to each group). In the study group, there was a significant increase in M10 and L5 (p < 0.001) after CIMT. The values of M10 and L5 were significantly higher (p < 0.001) in the healthy group compared to the study group after CIMT. Conclusion Our results showed that children with spastic hemiparetic CP became more active and participant in their daily life during the day as well as more efficient sleeping.
Resumo Introdução A paralisia cerebral (PC) hemiparética espástica é o tipo de PC mais prevalente. Crianças com hemiparesia es-pástica apresentam dificuldades ao usar as extremidades superiores afetadas e um tratamento eficaz é a Terapia por Contensão Induzida (TCI). O estudo dos padrões de atividade-repouso fornece informações sobre as atividades diárias de crianças com PC hemiparética espástica durante o dia e o sono. Objetivo Investigar o efeito da TCI nos padrões de repouso-atividade em crianças com PC hemiparética espástica versus um grupo saudável. Métodos Realizou-se um ensaio controlado não randomizado no Centro de Neuropediatria do Complexo do Hospital de Clínicas, Curitiba, Brasil. Crianças com PC hemi-parética espástica entre 5 e 16 anos participaram do grupo de estudo e receberam a TCI. O grupo saudável foi composto por crianças entre 5 e 15 anos. Ambos os grupos utilizaram um acelerômetro para registrar padrões de atividade-repouso, os quais podem ser estudados através de variáveis não paramé-tricas do acelerômetro: M10 (10h mais ativas de um indivíduo); L5 (5h menos ativas de um indivíduo); e AR (amplitude rela-tiva dos padrões de atividade-repouso). Resultados Foram recrutadas 45 crianças e 38 foram incluídas nas análises (19 alocadas em cada grupo). No grupo de estudo, houve aumento significativo de M10 e L5 (p < 0,001) após TCI. Os valores de M10 e L5 foram significativamente maiores (p < 0,001) no grupo saudável em comparação ao grupo de estudo após TCI. Conclusão Os resultados do presente estudo mostraram que crianças com PC hemiparética espástica tornaram-se mais ativas e participantes de sua vida diária durante o dia, bem como dormiram mais eficientemente.
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ObjectiveTo understand the current research status, research hotspots and development trends of constraint-induced movement therapy (CIMT) in the field of rehabilitation. MethodsThe relevant articles of CIMT in rehabilitation from January, 2000 to October, 2022 in CNKI and Web of Science were retrieved. The authors, institutions, countries, keywords and burst words were extracted with CiteSpace 6.1.R3 to draw knowledge mapping. ResultsA total of 1 165 articles were included, 359 articles in Chinese and 806 in English. The trend of annual publications was generally consistent, and after a period of rapid growth, the current annual publications showed a fluctuating trend. There was more cooperation among the institutions in English articles, with geographical limitation. The institutions in Chinese articles had the problem of insufficient cooperation. The researches mainly focused on the application of CIMT in different diseases, the improvement of motor function by CIMT, the application of CIMT in combination with other therapies, and the study of the related mechanisms of CIMT. In recent years, Chinese burst keywords included modified constraint-induced movement therapy, stroke hemiparesis, clinical efficacy and repetitive transcranial magnetic stimulation; English burst keywords included transcranial direct current stimulation, non-invasive brain stimulation, and unilateral cerebral palsy. ConclusionResearch on CIMT in the field of rehabilitation is in a period of steady development, and CIMT combined with non-invasive brain stimulation is likely to be a hotspot in future research.
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Objective To study the correlation between regional cerebral glucose metabolism and behavioral scores in middle cerebral artery occlusion(MCAO)model rats before and after the intervention of constraint induced movement therapy(CIMT),and the correlation between the natural recovery processand motor function recovery in MCAO model rats and the brain activation after CIMT intervention,and to further explore the mechanism of CIMT. Methods Twenty-two adult male Sprague-Dawley(SD)rats were randomly divided into an ischemic group treated with CIMT (CIMT,n=6),an ischemic group (Control,n=6),a sham-operated group(Sham,n=6),and a blank control group(Normal,n=4). The MCAO models of rats in the CIMT group and Control group were established by thread embolism method. The middle cerebral artery was not blocked during the operation for the Sham group,and the Normal group was not given any special treatment. After operation,rats in the CIMT group and Sham group were treated with CIMT. On the 7th day(d7)and the 22nd day(d22)after surgery,foot-fault test(FFT)and the beam balance and walking (BBW) test were used to evaluate the forelimb motor;micro positron emission tomography-computed tomography (micro PET/CT) imaging with fluorodeoxyglucose (18F-FDG) was used to scan the glucose metabolism in different brain regions of rats;Pearson correlation analysis was used to analyze the correlation between behavioral scores and glucose metabolism level in the CIMT group and Control group. Results On d7,the BBW score in the CIMT group and Control group was negatively correlated with glucose metabolism in the left insular cortex and the auditory cortex,and positively correlated with glucose metabolism in the right posterior hippocampus,superior colliculus,and inferior colliculus,with statistically significant differences;the FFT score was negatively correlated with glucose metabolism in the left somatosensory cortex, insular cortex and orbitofrontal cortex, and positively correlated with glucose metabolism in the right midbrain,with statistically significant differences. On d22, the BBW score in the CIMT group and Control group was positively correlated with glucose metabolism in the amygdala,caudate putamen,insular cortex and entorhinal cortex,and negatively correlated with glucose metabolism in the nucleus accumbens (Acb) core shell and caudate putamen in the right brain region,with statistically significant differences;the FFT score was negatively correlated with the entorhinal cortex in the right hemisphere and the difference was statistically significant. Conclusion The recovery of motor function promoted by CIMT was associated with the activation of both cerebral hemispheres in rats. The improvement of balance function promoted by CIMT in rats with cerebral ischemia was mainly related to the activation of Acb core shell in the right hemisphere. The recovery of fine grasping function promoted by CIMT may be related to the activation of the right entorhinal cortex.
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Background: A significant percent of cardiovascular event occurs without well-known modifiable risk. A new tool for early identification for atherosclerosis is required for early intervention. Aims and objectives of the study was to study the risk factors for CAD and its correlation with CIMT.Methods: One hundred and forty subjects were studied for the risk factors of CAD in Department of Medicine of G.R. Medical College, Gwalior from 2012 to 2013. Out of 140 subjects, 100 were patients having CAD and 40 age matched subjects were included as control group. Data was also recorded from their offspring. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries. The maximum CIMT of any one side of carotid artery was taken for study.Results: CAD was more prevalent among males (78%). Majority of the offspring of cases had age between 28-42 years and majority were male (73%). Most common risk factors for CAD was dyslipidemia (48%), hypertension (24%), diabetes (12%) and smoking (21%), whereas in offspring’s of CAD patients, dyslipidemia was seen in 28%, hypertension in 3%, diabetes and tobacco smoking in 12% and 24% respectively. The CIMT of CAD patients was significantly increased with increasing the number of risk factors and the same pattern was also seen in controls. The CIMT of asymptomatic offspring’s having positive family history was significantly more than the asymptomatic offspring without positive family history of CAD.Conclusions: CIMT measurements can be used as a surrogate marker of atherosclerosis as it has showed a direct link with number of risk factors of CAD.
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INTRODUCTION: Stroke is most common in hypertensive patients in old age. This definition of stroke is the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24–hour limit divides stroke from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours. Various physiotherapy techniques used for the rehabilitation after stroke. Constraint induced movement therapy is from one of the technique used for stoke rehabilitation. Constraint Induced Movement Therapy is a new treatment technique that claims to improve the arm motor ability and the functional use of a paretic arm – hand. Constraint Induced Movement Therapy focus the use of the affected side by restraining the unaffected side. It is observed that patients with hemiparesis did not use their affected extremity (hemi –neglecting). The application of the method is the patients wear a mitt on the unaffected arm 90% of their waking hours and perform repetitive exercises with the more affected arm six to seven hours per day during two to three weeks OBEJECTIVE: The objective of this project is to determine the effects of constraint induced movement therapy in stoke rehabilitation. CONCLUSION: It can be concluded from the present study that Constraint Induced Movement Therapy might be beneficial than traditional rehabilitation therapy in stroke. These findings from the articles which are included in the study have clinical significance for the rehabilitation of patient within stroke. These articles shows significant effects of constraint induced movement therapy in Stroke Rehabilitation.
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PURPOSE: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. METHODS: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. RESULTS: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p < 0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p < 0.05). CONCLUSION: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.
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Female , Humans , Arthroplasty, Replacement, Knee , Knee , Muscle Strength , Myalgia , Range of Motion, Articular , Visual Analog ScaleABSTRACT
Objective To compare the effect of clustered acupuncture of the scalp combined with constraint induced movement therapy (CIMT) with that of conventional acupuncture of the body points plus conventional rehabilitation intervention after cerebral infarction using blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods Thirty acute cerebral infarction patients with hemiplegia were equally divided into two groups at random.The test group received the clustered acupuncture of the scalp combined with CIMT,while the control group received the body point acupuncture plus conventional rehabilitation intervention.Before and after two weeks of treatment,blood oxygenation level-dependent functional magnetic resonance imaging at 3.0 T was performed during a passive digital opposition movement.The volume and intensity of the activated areas were compared.Fugl-Meyer assessment (FMA) was carried out as well.Results The most pronounced activation appeared in the contralateral somatosensory motor cortex for both groups.There was no significant difference in average FMA scores between the two groups before the treatment,but after the treatment the averages were significantly different.An increase in activated volume and intensity in the contralateral SMC was observed in both groups after the treatment,but the test group showed a much larger change in both activated volume and intensity.Conclusion The clustered acupuncture of the scalp combined with CIMT can achieve a more significant improvement in functional recovery after acute cerebral infarction than conventional acupuncture of the body points plus conventional rehabilitation intervention.Such combined therapy is worthy of application in clinical practice.
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Introdução: A Terapia por Contensão Induzida (TCI) é uma técnica de reabilitação que tem como objetivo melhora da função do membro superior acometido. Objetivos: Determinar se o protocolo da TCI é adequado para a reabilitação do membro superior em adultos com Lesões Encefálicas Adquiridas (LEA). analisar a manutenção dos resultados e identificar possíveis preditores de eficácia da técnica. Método: Estudo retrospectivo, 40 pacientes. As escalas utilizadas foram Motor Activity Log (MAL), Quantidade (QT) e Qualidade (QL) de movimento do membro superior acometido e Wolf Motor Function Test (WMFT). Resultados e discussão: As médias de QT e QL do membro superior acometido no pré e pós-tratamento tiveram um aumento significativo (p < 0,001), enquanto as do WMFT apresentaram uma redução significativa do tempo (p <0,001), o que representa uma melhora na habilidade motora e maior uso fora do ambiente terapêutico. Os ganhos foram mantidos após 12 meses do termino do protocolo, e não foi evidenciado nenhum preditor de evolução. Conclusão: A TCI demonstrou eficácia na melhora da habilidade motora e reversão do não uso aprendido do membro superior acometido, estes resultados foram mantidos após um ano da intervenção. Não foi evidenciado no estudo nenhum fator preditor de eficácia da técnica. (AU)
Introduction:The Constraint Induced Therapy (CIT) is a rehabilitation techique that aims to improve the function of the impaired upper limb. Objectives: To determine if the CIT protocol is suitable for rehabilitation of the upper limb in adults with brain injury, if if the results are maintained and identify possible predictors of technique effectiveness. Method: Retrospective study, 40 patients. The Scales used were Motor Motor Activity Log (MAL), How often (HO) and How Well (HW) of movement of affected upper limb and Wolf Motor Function Test (WMFT). Results and discussion: The averages of HO and HW of the affected upper limb in pre and post-treatment had a significant increase (p <0.001), and the WMFT showed a significant decrease of time (p < 0.001), which represents an improvement of motor skill, and more use out of therapeutic environment. The gains were kept after 12 months after the end of the protocol, and did not show any predictor of unfavorable outcome. Conclusion: The CIT demonstrated effectiveness in improving motor skills and reversal learned non-use of affected upper limb; these results were kept after one year of intervention. This study did not show any predictor of the technique effectiveness. (AU)
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Humans , Brain Injuries , Hemiplegia , Humans , Rehabilitation , Upper ExtremityABSTRACT
ABSTRACT Objective To determine if the original protocol of Constraint-Induced Movement Therapy (CIMT), is adequate to reverse the nonuse of the affected upper limb (AUL) in patients with Cerebral Palsy (CP) in adulthood. Method The study included 10 patients diagnosed with CP hemiparesis had attended the adult protocol CIMT, from January/August 2009/2014. Results Average age 24.6 (SD 9.44); MAL average pretreatment How Often (HO) = 0.72 and How Well (HW) = 0.68 and post-treatment HO = 3.77 and HW = 3.60 (p ≤ 0.001) and pretreatment WMFT average = 21.03 and post-treatment average = 18.91 (p = 0.350). Conclusion The constraint-induced movement therapy is effective to reverse the nonuse learn of the AUL in adult patients with CP.
RESUMO Objetivo Determinar se o protocolo original da Terapia por Contensão Induzida (TCI), é adequado para reverter o não uso do membro superior afetado (MSA) em pacientes com Paralisia Cerebral (PC) na fase adulta. Método Foram incluídos no estudo 10 pacientes com diagnóstico de PC hemiparéticos que haviam realizado o protocolo adulto da TCI, no período de janeiro/2009 a agosto/2014. Resultados Média de idade 24,6 (DP 9,44); MAL média pré-tratamento Quantidade (QT) = 0,72 e Qualidade (QL) = 0,68 e no pós-tratamento QT = 3,77 e QL = 3,60 (p ≤ 0,001) e WMFT média pré-tratamento = 21,03 e média pós-tratamento = 18,91 (p = 0,350). Conclusão A terapia por contensão induzida é eficaz para reverter o não uso do MSA em pacientes adultos com PC.
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Adult , Female , Humans , Male , Young Adult , Cerebral Palsy/rehabilitation , Exercise Therapy/methods , Paresis/rehabilitation , Upper Extremity/injuries , Motor Activity , Retrospective Studies , Restraint, Physical/methods , Treatment OutcomeABSTRACT
Modified constraint-induced movement therapy (mCIMT), which is modified from constraint-induced movement therapy (CIMT), is used in hemiplegics for rehabilitation. It may be used in the selected patients in certain function and age. mCIMT is more flexible than CIMT, which is mainly consisted of intervention movement, intensity, and the time of training and limitation. mCIMT is also used with other rehabilitation methods. There are various assessment for the evaluation of upper extremity motor function. By using Contract and Mo-tor Activity Log, researchers can better guarantee the curative effect.
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OBJECTIVE: To Investigate the synergic effects of short-term constraint-induced movement therapy (CIMT) and visual biofeedback training (VBT) in subacute stroke patients. METHODS: Thirty-two subacute stroke patients were enrolled and randomly assigned to one of three groups: short-term CIMT with VBT, VBT only, and control groups. We applied CIMT for an hour daily during VBT instead of the ordinary restraint time, referred to as 'short-term' CIMT. Short-term CIMT with VBT group received simultaneous VBT with CIMT, whereas the VBT the only group received VBT without CIMT for an hour a day for 2 weeks. The control group received conventional occupational therapy (OT) alone. Patients underwent the Purdue Pegboard Test, the JAMAR grip strength test, the Wolf Motor Function Test, the Fugl-Meyer Assessment (upper extremity), Motricity index and the Korean version of Modified Barthel Index test to evaluate motor functions of the hemiplegic upper limb at baseline, post-treatment, and 2 weeks after treatment. RESULTS: No significant differences were observed between short-term CIMT with VBT and VBT only groups. Both groups showed significantly higher scores compared to the control group in the WMFT and FMA tests. However, the short-term CIMT with VBT group showed significant improvement (p<0.05) compared with the control group in both grasp and pad pinch at post-treatment and 2 weeks after treatment while the VBT only group did not. CONCLUSION: Short-term CIMT with VBT group did not show significant improvement of hemiplegic upper limb function of subacute stroke patients, compared to VBT only group. Larger sample sizes and different restraint times would be needed to clarify the effect.
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Humans , Biofeedback, Psychology , Hand Strength , Occupational Therapy , Sample Size , Stroke , Upper Extremity , WolvesABSTRACT
ObjectiveTo observe the clinical efficacy of electroacupuncture plus constraint-induced movement therapy (CIMT) in recovering neurologic function of patients with spastic hemiplegia.MethodSixty patients with post-stroke spastic hemiplegia were randomized into an electroacupuncture group, a CIMT group, and an electroacupuncture+CIMT (integrated) group to receive corresponding intervention in addition tothe ordinary rehabilitation treatment, 20 cases in each group. Before treatment and after 4-week treatment, the modified Ashworth Scale, Clinical Neurologic Deficit Scale, Short-form Fugl-Meyer Assessment Scale (FMA), and Berg Balance Scale (BBS) were adopted for evaluation and comparison.ResultAfter 4-week treatment, the Ashworth score and neurologic deficit score were significantly reduced in the three groups (P<0.01), and the scores in CIMT group were significantly lower than that in the electroacupuncture group (P<0.05), and the scores in the integrated group were markedly lower than that in the other two groups (P<0.05); the FMA and BBS scores were significantly increased after intervention in the three groups (P<0.01), and the scores in CIMT group were higher than that in the elctroacupuncture group (P<0.05), and the scores in the integrated group were higher than that in the other two groups(P<0.05).ConclusionElectroacupuncture plus CIMT can reduce the muscular tension of the affected limb in patients with spastic hemiplegia, and improve the neurologic function, motor function, and the quality of life of the patients.
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@#Constraint induced movement therapy (CIMT) is considered to be effective in restoring the impaired limb motor function in patients after stroke. CIMT enhanced neurogenesis in sub-ventricular zone and promoted the proliferation and long-term survival of the newborn neurons in the ischemic penumbra region. CIMT also enhanced the midline-crossing phenomenon, which means the midline crossing of the contralesional corticospinal tract originated nerve fibers to the denervated side in the cervical spinal cord. CIMT down-regulated the expression of Neurite outgrowth inhibitor-A (Nogo-A) as well as regulated other molecules to promote the growth of nerve fibers. In addition, CIMT ajusted the expression of brain- derived neurotrophic factor and Rho kinsase. Nevertheless, whether the structural plasticity caused by CIMT really participated in limb function remains unknown. And many studies on molecular mechanisms lack the evidence of necessary promotion and inhibition of the related molecule.
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Constraint induced movement therapy (CIMT) is considered to be effective in restoring the impaired limb motor function in patients after stroke. CIMT enhanced neurogenesis in sub-ventricular zone and promoted the proliferation and long-term survival of the new-born neurons in the ischemic penumbra region. CIMT also enhanced the midline-crossing phenomenon, which means the midline crossing of the contralesional corticospinal tract originated nerve fibers to the denervated side in the cervical spinal cord. CIMT down-regulated the expression of Neurite outgrowth inhibitor-A (Nogo-A) as well as regulated other molecules to promote the growth of nerve fibers. In addi-tion, CIMT ajusted the expression of brain-derived neurotrophic factor and Rho kinsase. Nevertheless, whether the structural plasticity caused by CIMT really participated in limb function remains unknown. And many studies on molecular mechanisms lack the evidence of necessary promotion and inhibition of the related molecule.
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Introducción: Los niños con hemiparesia presentan disminución de habilidades motrices y funcionales de la extremidad afectada, con escasa integración de ésta en actividades cotidianas; la terapia restrictiva ha sido escasamente estudiada en la realidad nacional. Objetivo: Evaluar eficacia de terapia restrictiva con yeso y terapia restrictiva más infiltración de onabotulinumtoxinA (Botox®), en funcionalidad de extremidad superior parética, en niños de 3-8 años de edad, con hemiparesia y compromiso funcional leve o moderado del Instituto Teletón Valparaíso-Chile. Método: Estudio experimental, controlado, aleatorio, simple ciego en 42 pacientes con consentimiento informado. Se distribuyen en tres grupos: sólo terapia convencional (control); con terapia convencional más restricción de extremidad indemne con yeso y terapia convencional con restricción de extremidad indemne con yeso más infiltración de onabotulinumtoxinA. Concluyen el estudio 29 niños, sometidos a tratamiento durante 6 semanas, con 3 sesiones semanales de 45 min cada una. Un terapeuta ocupacional ciego al grupo de pertenencia del paciente, evalúa calidad de movimiento (prueba Quest), actividades de la vida diaria (WeeFIM) y posicionamiento del pulgar (prueba House) al inicio, final del tratamiento y seguimiento en 3 meses. Resultados: Dentro de los grupos experimentales, las medianas de las pruebas WeeFIM y Quest, disminuyen al término del tratamiento y al seguimiento en relación al momento basal. La prueba House no cambia durante el proceso. No se registran diferencias significativas respecto del grupo control. Conclusión: No se comprueba mejoría de funcionalidad motriz de la extremidad superior parética y nivel de independencia en las AVD, con terapia restrictiva y adicionada con onabotulinumtoxina .
Introduction: Children with hemiparetic cerebral palsy show decreased motor and functional skills of their paretic extremity, along with scarce integration of it in daily activities. Constraint-induced movement therapy has been scantily studied in our country. Objective: To assess the effectiveness of plaster constraint-induced movement therapy alone and plaster constraint-induced movement therapy plus a onabotulinumtoxinA (Botox®) infiltration, on paretic upper limb function, in children from 3 to 8 years old, with hemiparetic cerebral palsy, and mild or moderate functional impairment, all patients at Valparaísos Teleton Institute in Chile. Method: An experimental, controlled, randomized and simple blind clinical trial was conducted with 42 patients who were distributed into three groups: only conventional therapy (control); conventional therapy with plaster constraint of undamaged upper extremity; and conventional therapy with plaster constraint of undamaged upper extremity plus a onabotulinum toxin A (Botox) infiltration.The protocol was completed by 29 children who participated during 6 weeks of treatment, with three 45 minutes sessions each week. A blind occupational therapist assessed quality of movement (QUEST), daily live activities (WEE FIM) and position of thumb at onset and end of treatment; and at 3 months follow-up. Results: WEE FIM and QUEST median scores for the experimental groups declined by the end of treatment and at follow-up, when compared to baseline measures. HOUSE test results showed no improvement either. No differences between control and experimental groups were observed. Conclusion: Motor functionality improvement of hemiparetic upper extremity and level of independence in daily activities, was not demonstrated for plaster constraint induced movement therapy alone or with infiltration of onabotulinumtoxinA (Botox).
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Humans , Male , Female , Child, Preschool , Child , Cerebral Palsy/rehabilitation , Paresis/rehabilitation , Upper Extremity , Cerebral Palsy/physiopathology , Paresis/physiopathology , Restraint, PhysicalABSTRACT
Objective To investigate the effects of constraint-induced movement therapy (CIMT) on the function of hemiplegic upper extremity in the early subacute stroke patients.Methods A prospective,single-blinded,randomized controlled study was conducted.Forty-seven stroke patients with hemiplegic upper limb dysfunction were randomly divided into 2 groups:a CIMT group and a control group.The CIMT group received constraintinduced movement therapy and the control group was treated with conventional rehabilitation therapy.Both groups were treated 3 h daily,5 d a week for 2 weeks.The Wolf motor function test (WMFT) and Fugl-Meyer Assessment (FMA) were used to evaluate upper extremity motor function,and motor activity log (MAL) was used to assess upper extremity ability in activities.WMFT,FMA and MAL were measured before and after 1 day and 6 months of treatment.Results After 1 day of treatment,FMA,WMFT,MAL-AU and MAL-HW were 53.81 ± 2.59,66.68 ± 3.54,1.89 ± 0.88 and 3.26 ± 0.65,respectively,in the CIMT group,and 48.61 ± 4.48,62.10 ± 7.97,1.25 ± 0.64 and 2.65 ± 0.93,respectively,in the control group.After 6 months of treatment,FMA,WMFT,MAL-AU and MAL-HW were 57.53 ±2.01,69.57 ± 3.00,3.00 ±0.82 and 3.84 ±0.69,respectively,in the CIMT group,and 53.30 ± 2.88,66.20 ±3.59,2.20 ± 1.06 and 3.25 ±0.64,respectively,in the control group.The scores of FMA,WMFT,MAL in the CIMT group were all higher than those in the control group at 1 day and 6 months post-treatment,and the differences were statistically significant (P ＜ 0.05).Conclusion Constraint-induced movement therapy can significantly improve the patients' hand function in the early stage of subacute stroke,which maintain up to 6 months of follow-up.
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Hemiplegia is a common type of physical disability in children with brain damage. For many kinds of reasons, the outcome of rehabilitation of the affected upper limb is not good enough, especially in the affected hand. Recently, many studies engaged in the modi-fied Constraint-induced Movement Therapy (mCIMT) to explore the child-friendly way of restraint to improve hand function in hemiplegic children, and were summarized in this paper.
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OBJECTIVE: To evaluate the effectiveness of constraint-induced movement therapy (CIMT) and combined mirror therapy for inpatient rehabilitation of the patients with subacute stroke. METHODS: Twenty-six patients with subacute stroke were enrolled and randomly divided into three groups: CIMT combined with mirror therapy group, CIMT only group, and control group. Two weeks of CIMT for 6 hours a day with or without mirror therapy for 30 minutes a day were performed under supervision. All groups received conventional occupational therapy for 40 minutes a day for the same period. The CIMT only group and control group also received additional self-exercise to substitute for mirror therapy. The box and block test, 9-hole Pegboard test, grip strength, Brunnstrom stage, Wolf motor function test, Fugl-Meyer assessment, and the Korean version of Modified Barthel Index were performed prior to and two weeks after the treatment. RESULTS: After two weeks of treatment, the CIMT groups with and without mirror therapy showed higher improvement (p<0.05) than the control group, in most of functional assessments for hemiplegic upper extremity. The CIMT combined with mirror therapy group showed higher improvement than CIMT only group in box and block test, 9-hole Pegboard test, and grip strength, which represent fine motor functions of the upper extremity. CONCLUSION: The short-term CIMT combined with mirror therapy group showed more improvement compared to CIMT only group and control group, in the fine motor functions of hemiplegic upper extremity for the patients with subacute stroke.
Subject(s)
Humans , Hand Strength , Inpatients , Occupational Therapy , Organization and Administration , Rehabilitation , Stroke , Upper Extremity , WolvesABSTRACT
@#Hemiplegia is a common type of physical disability in children with brain damage. For many kinds of reasons, the outcome of rehabilitation of the affected upper limb is not good enough, especially in the affected hand. Recently, many studies engaged in the modified Constraint-induced Movement Therapy (mCIMT) to explore the child-friendly way of restraint to improve hand function in hemiplegic children, and were summarized in this paper.
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Objective To explore the effects of constraint-induced movement therapy (CIMT) on the expression of tyrosine hydroxylase (TH) and glial cell derived neurotrophic factor (GDNF) in Parkinson's disease (PD) model rats. MethodsPD models were established by microinjection of 6-hydroxydopamine (6-OHDA) solution into substantia nigra of rats' right cerebral hemisphere.Forty-two model rats were divided randomly into an exercise group and a control group 1 week after microinjection.The exercise group rats were forced to use their impaired limbs by placing their nonimpaired fore-limbs in casts.The control group rats were housed in the same environment without any special treatment.Two weeks after 6-OHDA infusion and exercise training,the behavioral changes of rats were examined after intraperitoneal injection apomorphine ( APO).The content of dopamine (DA) and dihydroxyphenylacetic acid (DOPAC) was measured by high performance liquid chromatography with electrochemistry ( HPLAEC) ; the expressions of TH and GDNF in striatum were detected by immunohistochemical methods and TH,GDNF mRNA were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results After 2 weeks of training,the rotating laps of the rats in exercise group within 30 min after APO induction,reduced to a significantly greater extent when compared to the control group (P ＜ 0.05).The content of DA and it's metabolites DOPAC in striatum homogenate was significantly higher in exercise group than that in the control group ( P ＜ 0.05 ),and the expression levels,of TH and GDNF protein/ mRNA were also significantly higher in the exercise group than those in control group ( P ＜ 0.05 ).Conclusions CIMT can improve the behavioral performance of PD rats,probably through promoting the expressions of TH and GDNF protein/mRNA in striatum,and increasing DA and it's metabolites DOPAC level.