Correlation between recovery of motor function and regional glucose metabolism induced by CIMT in rats with cerebral ischemia / 复旦学报（医学版）

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.

Effect Of Constraint Induced Movement Therpy In Storke Rehbilitation

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.

Effects of the Constraint-Induced Movement Therapy on Cortical Reorganization in Patients with Hemiplegic Cerebral Palsy

OBJECTIVE: To investigate the effects of modified constraint- induced movement therapy (CIMT) on motor function and cortical activation in children with hemiplegic cerebral palsy (CP). METHOD: Five children with hemiplegic cerebral palsy were studied with Jebsen hand function test and quality of upper extremity skills test (QUEST), dynamic electromyography (EMG), and single photon emission computed tomography (SPECT) at rest before and after the CIMT period. Children were treated with a 4-week protocol of modified CIMT, consisting of twice-weekly 2-hour sessions of structured activities and a home program for non-treatment days. Children wore orthoses on their less affected upper extremities for 6 hours per day, during which time they were engaged in play, functional activities and 2-hour protocol of motor tasks. RESULTS: Improvements in upper-extremity function were found in Jebsen hand function test and QUEST. Increased muscle activities in elbow extensors were observed in dynamic EMG during affected hand grip. In right hemiplegic patients, regional cerebral perfusion increased in right Brodmann area (BA) 3 and lentiform nucleus. In left hemiplegic patients, regional cerebral perfusion increased in right BA 6, 9, 21, left BA 19 and left cerebellum, but decreased in left BA 11. CONCLUSION: Modified CIMT appears to change local cerebral perfusion in areas known to participate in movement planning and execution. These changes might be a sign of cortical activation after CIMT in the children with hemiplegic cerebral palsy. Results of this study suggest that modified CIMT may be an effective way of treating children with hemiplegic CP.

Constraint-induced Movement Therapy for Upper Extremity in Early Cerebral Infarction / 中国康复理论与实践

@#Objective To study the feasibility, safety, tolerance and the effectiveness of constraint-induced movement therapy (CIMT) in early cerebral infarction, and the long-term outcome.Methods 2 weeks after cerebral infarction, 22 patients with upper extremity weakness were divided into treatment group (11 cases, accepted CIMT) and control group (11 cases, accepted routine rehabilitation). They were assessed with Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Barthel Index (BI) before and 2 weeks, 3 months after treatment. Results The scores of FMA, WMFT, MAL and BI improved in both group (P<0.05), but more in the treatment group (P<0.05). 3 months after treatment, the score of MAL quality was no different between two group.Conclusion CIMT is safe and effective for early cerebral infarction, and more effective than routine immediately, but it is similar 3 months later.

Effects of Constraint-induced Movement Training on Neurological Medullary Sheath in Rats after Middle Cerebral Artery Occlusion / 中国康复理论与实践

@#Objective To study the effects of constraint-induced movement train (CIMT) on the neurological medullary sheath in the rats after middle cerebral artery occlusion (MCAO). Methods 55 SD rats were randomly divided into CIMT group and nature recovery (NR) group after MCAO. The CIMT group were trained with balance beam and rolling cage everyday, with restrictting the movement of the intact upper limbs. The NR group lived in the same condition. The rats in CIMT group were assessed with ethology 5 d, 10 d, 15 d, 30 d and 60 d after operation respectively. At last, 5 rats of each group were checked with MRI, then they were immolated for myelin staining. Results The balance and muscle strength of CIMT group improved better compared with the NR ones (P<0.05), as well as the diameter and the demyelination of neurofibril in the infarcted area. Conclusion CIMT can collect more functional neurofibra and decrease myelinolysis.

Effect of Constraint-Induced Movement Therapy on Improving the Flexibilty of Upper Extremities and the Ability of Daily Living of Patients With Hemiplegia / 中国康复理论与实践

@#ObjectiveTo investigate the effect of constraint-induced movement therapy(CIMT) on improving the flexibilty of upper extremities and the ability of daily living(ADL) of patients with hemiplegia.Methods36 patients with hemiparesis were randomized to two groups: CIMT and traditional rehabilitation(TR).In CIMT group,18 patients received intensive shaping training of 5 h/d,lasting 3 weeks, with the constraint of unaffected arms.In TR group,patients received traditional rehabilitation in the same times,without the constraint of unaffected arms. They were evaluated with Action Research Arm(ARA) Test and Barthel Index(BI) before intervention,immediate after intervention,4 and 12 weeks after intervention respectively.Patients in CIMT group were also evaluated with ARA tests 2 and 3 weeks after training.ResultsSignificant difference was found between CIMT and TR group on the improvement of ARA test(P<0.05).There was no significant difference between 2 and 3 weeks after training in CIMT group.Significant difference in BI was also found in CIMT group(P<0.01),but has not been found between CIMT and TR group.ConclusionCIMT significantly improved the flexibilty of upper extremities and ADL of patients with hemiplegia,which is superior to the traditional rehabilitation.

Efficacy of Constraint-induced Movement Therapy on Motor Function of Upper Extremity of Chronic Stroke Patients / 中国康复理论与实践

@#ObjectiveTo explore the efficacy of constraint-induced movement therapy (CIMT) on motor function of upper extremity of chronic stroke patients.MethodsFifteen chronic stroke patients with hemiparesis (course of diseases more than 13.5 months) were treated by CIMT, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training (by shaping) of the more affected extremity for 6 hours on the 10 workdays during that period. The therapeutic effect was evaluated with upper extremity function test (UEFT) and simple test for evaluating hand function (STEF).ResultsPatients showed a significant and very large degree of improvement after treatment on UEFT and STEF (ES, 0.8 and 0.5, respectively).ConclusionCIMT may be an efficacious method for improvement of the affected arm function of chronic stroke patients.

Effects of Constraint-induced Movement Therapy on Upper-extremity Function of Children with Hemiplegic Cerebral Palsy / 中国康复理论与实践

@#ObjectiveTo observe the effects of a modified version of constraint-induced movement therapy (CIMT) on upper-extremity function of children with hemiplegic cerebral palsy.Methods22 patients were divided randomly into treatment group (n=10) and control group (n=12). Cases of control group received routine rehabilitation therapy, otherwise, those of treatment group were treated with CIMT. It involved restraining the unimpaired extremity with a restraining-instrument, and having the child engage in activities with the involved extremity 4 hours a day for 2 months repeatedly. Before and after treatment, affected upper-extremity function of all children were assessed with the Fine Motor Function Measure (FMFM) scale.ResultsThe fine motor function of all children in two groups improved significantly(P<0.05), but effect of treatment group was better than that of control group (P<0.05).ConclusionThe treatment of CIMT can improve upper-extremity function of children with hemiplegic cerebral palsy.

Effect of constraint-induced movement therapy on hemiplegia in children / 中国康复理论与实践

@#ObjectiveTo explore the effect of constraint-induced movement therapy on hemiplegia in children.Methods30 hemiplegia children caused by cerebral palsy or trauma were divided into 2 groups.Treatment group accepts the Constraint-Induced Movement Therapy (CIMT) combined with Bobath approach. The control group accepts the Baboth approach only. Before after 12-week treatment, Ueda Test and the Brunnstrom's test were used to classify every stage of the recovery. ResultsBoth groups improved their motor function assessed either with Ueda Test or Brunnstrom's test, which was better in treatment group than in control group.ConclusionThe CIMT with Bobath approach together can remarkably raise the rate of utilization of the hemiplegia suffering limbs as well as improve the learned non-use of the suffering parts.