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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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INTRODUÇÃO: Dificuldades de locomoção e equilíbrio são comuns entre os indivíduos com doença de Parkinson (DP). Vários programas diferentes de exercícios foram sugeridos para tratar de problemas de equilíbrio e de marcha para melhorar a qualidade de vida e a adesão do paciente aos exercícios de DP. A dança pode ser uma ferramenta eficaz para resolver esses problemas porque inclui elementos-chave de equilíbrio dinâmico, pode melhorar a mobilidade funcional e, ao mesmo tempo, é agradável e envolvente. OBJETIVOS: O objetivo deste estudo foi avaliar o efeito do movimento de dança Kathak além da fisioterapia convencional no equilíbrio e na marcha em pacientes com doença de Parkinson. MÉTODOS E MATERIAIS: Um total de 44 pacientes diagnosticados com Parkinson foram incluídos no estudo com uma idade média de 63,20 + 8,5 anos. Os pacientes foram divididos aleatoriamente em dois grupos, o grupo controle recebeu fisioterapia convencional, e o grupo experimental recebeu o mesmo juntamente com movimentos de dança Kathak que foram Tatkar e Gatnikas. A intervenção foi dada três dias por semana durante quatro semanas. A pré e pós-avaliação para equilíbrio e marcha foi avaliada por escalas incluindo o teste TUG, Tinetti, FOG-Q e UPDRS-III. A comparação dentro do grupo foi feita usando o teste Wilcoxon Signed rank e entre o grupo usando o teste Mann Whitney U para ver o efeito da intervenção de tratamento. RESULTADOS: A idade média dos participantes de ambos os grupos foi de 64,18±8,53 e 62,23±6,21, respectivamente. A comparação mostrou uma diferença significativa em TUG, Tinetti, e FOG-Q dentro do grupo com p<0,01. A comparação entre grupos não mostrou diferença significativa entre as duas intervenções de tratamento com p=0,361 para TUG, p=0,479 para Tinetti, e p= 0,73 para FOG-Q. CONCLUSÃO: Ambos os grupos mostraram melhorias semelhantes no equilíbrio e na marcha de pacientes com DP. Assim, concluímos que o movimento da Dança Kathak pode ser usado para complementar os exercícios de fisioterapia convencional.
INTRODUCTION: Difficulties with gait and balance are common among individuals with Parkinson's disease (PD). Several different exercise programs have been suggested to address balance and gait problems to improve the quality of life and patient compliance with PD exercises. Dance may be an effective tool for addressing these problems because it includes key elements of dynamic balance, can improve functional mobility, and is, at the same time, enjoyable and engaging. OBJECTIVES: The purpose of this study was to assess the effect of Kathak dance movement in addition to conventional physiotherapy on balance and gait in Parkinson's disease patients. METHODS AND MATERIALS: A total of 44 patients diagnosed with Parkinson's disease were included in the study with a mean age of 63.20 + 8.5 years. Patients were randomly divided into two groups, the control group received conventional physiotherapy, and the experimental group received the same along with Kathak dance movements which were Tatkar and Gatnikas. The intervention was given three days a week for four weeks. Preand post-assessment for balance and gait was assessed by scales including TUG test, Tinetti, FOG-Q, and UPDRS-III. The within-group comparison was made using Wilcoxon Signed rank test and between the group using the Mann Whitney U test to see the effect of treatment intervention. RESULTS: The mean age of participants for both groups were 64.18±8.53 and 62.23±6.21, respectively. The comparison showed a significant difference in TUG, Tinetti, and FOG-Q within the group with p<0.01. The between-group comparison showed no significant difference between the two treatments interventions with p=0.361 for TUG, p=0.479 for Tinetti, and p= 0.73 for FOG-Q. CONCLUSION: Both groups showed similar improvements in balance and gait in PD patients. Thus, we conclude that the Kathak Dance movement can be used to complement conventional physical therapy exercises.
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Doença de Parkinson , Modalidades de Fisioterapia , MarchaRESUMO
Objective:To explore application value of dance movement therapy in the chemotherapy of young and middle-aged patients with breast cancer, so as to provide reference for rehabilitation nursing.Methods:By convenient sampling method, 90 young and middle-aged female breast cancer patients during chemotherapy from June 2020 to June 2021 in Renmin Hospital of Wuhan University were enrolled in the present study. They were assiged to experimental group and control group with 45 cases in each group according to the enrolled ward. The control group received routine nursing and the experimental group received 4 cycles of dance movement therapy. Before and after intervention, the effects were assessed by Cancer Fatigue Scale (CFS) and Patient-Generated Subjective Global Assessment (PG-SGA) as well as biochemical nutrition indexes.Results:After intervention, the physical fatigue score, emotional fatigue score, cognitive fatigue score and total CFS score were (8.29 ± 3.58), (7.74 ± 1.68), (5.57 ± 1.11), (21.59 ± 4.41) points in the experimental group, which were significantly lower than (9.86 ± 3.49), (8.95 ± 2.62), (6.27 ± 1.70), (25.09 ± 4.33) points in the control group ( t values were 2.07-3.71, all P<0.05). After intervention, the PG-SGA score was (2.81 ± 0.71) points in the experimental group, which was significantly lower than (3.29 ± 1.15) points in the control group ( t=2.37, P<0.05). Conclusions:Dance movement therapy can alleviate the cancer related fatigue and promote nutritional status of young and middle-aged female breast cancer patients with chemotherapy.
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Objective:To explore the dance movement therapy on nutritional status and muscle strength in older patients with sarcopenia.Methods:A total of 35 older sarcopenia patients from May 2019 to April 2020 in Nanfang Hospital, Southern Medical University were enrolled as the intervention group with dance movement therapy; another 35 older sarcopenia patients from May 2018 to April 2019 were selected as control group with routine exercise intervention. Nutritional indicators and muscle strength were compared between two groups on admission, at 1, 3, 6 months after intervention.Results:At 3, 6 months after intervention, hemoglobin and body mass index were (124.10 ± 16.59) g/L, (128.33 ± 14.50) g/L and (21.40 ± 1.87) kg/m 2, (21.40 ± 1.87) kg/m 2 in the intervention group, higher than in the control group (116.03 ± 12.23) g/L, (120.09 ± 11.34) g/L and (20.03 ± 1.93) kg/m 2, (19.97 ± 1.99) kg/m 2. The differences were statistically significant ( t values were 2.17-2.84, all P<0.05). At 6 months after intervention, serum albumin was (33.73 ± 5.23) g/L in the intervention group, significantly higher than that in the control group (30.88 ± 5.17) g/L, the difference was statistically significant ( t=2.16, P<0.05). At 3, 6 months after intervention, muscle strength were (21.63 ± 1.54) kg, (23.17 ± 1.72) kg and short physical performance battery scores were 7.83 ± 1.56, 7.47 ± 1.59 in the intervention group, significantly higher than in the control group (19.66 ± 2.50) kg, (20.91 ± 2.83) kg and 6.59 ± 1.64, 5.97 ± 1.49, the differences were statistically significant ( t values were 3.05-3.83, all P<0.05). At 6 months after intervention, appendicular skeletal muscle mass index (ASMI) was (6.03 ± 1.47) kg/m 2 in the intervention group, significantly higher than (5.13 ± 1.36) kg/m 2 in the control group, the difference was statistically significant ( t=2.52, P<0.05). Conclusions:Dance movement therapy can improve the nutritional status and muscle strength of older patients with sarcopenia.
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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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Resumo O artigo apresenta e discute as atuais abordagens que se utilizam do corpo em movimento com propósito terapêutico, assinalando o contexto histórico de seu desenvolvimento e destacando seus principais conceitos e práticas. Identificamos as propostas psicoterápicas mais citadas na literatura acadêmica e no contexto de atuação profissional, em especial a dança-movimento terapia, abarcando oito principais abordagens, e as danças terapêuticas, não estritamente pertencentes ao campo psicoterápico, como a biodança e os grupos que aliam dança contemporânea aos princípios da educação somática. Sistematizamos em quadro comparativo as abordagens apresentadas, discutindo suas aproximações e seus afastamentos, de modo a contribuir para a identificação mais precisa de cada abordagem e maior diálogo entre as vertentes.
Abstract This article discusses current therapeutic approaches that use the body in motion, noting the historical context and highlighting the main concepts and practices. The most frequently cited psychotherapeutic suggestions in the academic literature and in professional practice are identified, particularly dance/movement therapy (with eight main approaches) and therapeutic dance practices not strictly located within the field of psychotherapy (such as biodance and groups that link contemporary dance with the principles of somatic education). These approaches are compared and contrasted to more precisely identify each approach and augment dialog between them.
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Humanos , História do Século XIX , História do Século XX , História do Século XXI , Dançaterapia , Brasil , MovimentoRESUMO
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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Objective To observe the effect of supplementing constraint-induced movement therapy (CIMT) with virtual reality games in rehabilitating the motor function of hemiplegic children with cerebral palsy (CP).Methods Fifty hemiplegic children with CP were randomly divided into a control group and a treatment group,each of 25.All were given conventional rehabilitation.The children in the control group received CIMT for 4 hours,plus 1 hour of occupational therapy for the more-affected limb supported by therapists and 3 hours of daily training in life activities with their guardians' help.Those in the treatment group received occupational therapy for 1 hour,played virtual reality games for 1 hour and practiced daily life activities for 2 hours per day.All of the treatments were carried out five days a week for 3 weeks.Before and after the intervention the quality of upper extremity skills test (QUEST),the Chinese version of the gross motor function measuring scale (GMFM) and the pediatric evaluation of disability inventory (PEDI) were used to evaluate upper limb function,gross motor function and the social abilities.Results After the treatment,significant improvement was observed in the average QUEST,GMFM and PEDI scores of both groups,but the average scores in the treatment group were significantly higher than among the controls.Conclusions CIMT combined with playing virtual reality games improves the motor function and social abilities of hemiplegic children with CP.
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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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Feminino , Humanos , Artroplastia do Joelho , Joelho , Força Muscular , Mialgia , Amplitude de Movimento Articular , Escala Visual AnalógicaRESUMO
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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Introduction: The stroke is one of the incident diseases in the world, causing numerous changes to the functionality especially those related to upper limb functions. Objective: To evaluate the influence of modified Constraint-Induced Movement Therapy (mCIMT) on functional recovery, range of motion (ROM) and muscle tone of chronic hemiparetic upper limb (UL). Methods: Seven subjects (52.75 ± 6.63 years old) were evaluated before, straightaway and one month after 12 sessions of mCIMT, by goniometry, modified Fugl-Meyer Assessment (mFMA) and modified Ashworth Scale (MAS). Results: Functionality improved 74.7% after treatment and 79.5% one month after the end of treatment. There was improvement in passive motion (p = 0.01), in pain (p = 0.004) and UL motor function (p ≤ 0.001), increased range of flexion, extension, abduction and adduction of the shoulder and flexion and radial deviation of the wrist (p = 0.05) and muscle tone reduction (p < 0.05). Conclusion: mCIMT was effective for recovery of ROM in shoulder and wrist; recovery of the paretic UL functionality and spasticity reduction, and the results remained after the end of treatment.(AU)
Introdução: O AVE é uma das doenças mais incidentes no mundo, provocando inúmeras alterações para a funcionalidade, principalmente relacionadas às funções do membro superior. Objetivos: Avaliar a influência da Terapia de Restrição e Indução do Movimento (TRIM) na recuperação da funcionalidade, amplitude de movimento (ADM) e tônus do membro superior (MS) de pacientes hemiparéticos crônicos. Material e métodos: Sete voluntários (52,75 ± 6,63 anos) foram avaliados antes, imediatamente após e um mês após 12 sessões de TRIM, pela goniometria, Modified Fugl-Meyer Assessment e Modified Ashworth Scale. Resultados: A funcionalidade melhorou 74,7% após intervenção e 79,5% um mês após o término do tratamento. Houve melhora da movimentação passiva (p = 0,01), da dor (p = 0,004) e da função motora do MS (p ≤ 0,001); aumento da ADM de flexão, extensão, abdução e adução do ombro e flexão e desvio radial do punho (p ï¼ 0,05) e redução do tônus muscular (p < 0,05). Conclusão: A TRIM foi eficaz para recuperação da ADM do ombro e punho; retorno da funcionalidade do MS parético e redução da espasticidade, tendo os resultados se mantido após o término do tratamento. (AU)
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Movimento , Acidente Vascular Cerebral , Especialidade de Fisioterapia , ReabilitaçãoRESUMO
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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Humanos , Lesões Encefálicas , Hemiplegia , Humanos , Reabilitação , Extremidade SuperiorRESUMO
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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Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Paralisia Cerebral/reabilitação , Terapia por Exercício/métodos , Paresia/reabilitação , Extremidade Superior/lesões , Atividade Motora , Estudos Retrospectivos , Restrição Física/métodos , Resultado do TratamentoRESUMO
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.
Assuntos
Humanos , Biorretroalimentação Psicológica , Força da Mão , Terapia Ocupacional , Tamanho da Amostra , Acidente Vascular Cerebral , Extremidade Superior , LobosRESUMO
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.
RESUMO
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.
RESUMO
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.
RESUMO
@#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.